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Grodem A.S.,Institute for Social Research
Journal of European Social Policy | Year: 2017

The social political debate on immigration as a challenge to the welfare states has been remarkably silent on gender and family issues. This article argues that immigrants’ use of welfare benefits targeted at families may be particularly problematic, because such benefits embody certain normative tensions that other social policies do not. It is suggested that tensions may be particularly high in Scandinavia, given the Scandinavian countries’ long-term commitment to facilitating employment for women. What happens when immigrants in the Scandinavian countries use policies targeted at families to maintain gender-complimentary family practices and home-based motherhood? Will such practices be met by reforms that streamline benefits around the principle of universal employment? The article highlights policy arrangements that have been described as detrimental to immigrant women’s employment in Norway, Sweden and Denmark, and reviews whether they have been reformed in recent years and, where relevant, what arguments have been used to motivate reforms. The analysis shows that many of the relevant benefits recently have been reformed to become less accommodating of home-based care work. However, politics clearly matter, and it is not given that immigrants’ use of benefits will always be a trump card. Also, dynamics vary according to how controversial the welfare arrangement in question was before it was highlighted as an immigrant issue. A third finding is that even when benefit arrangements that have been highlighted as particularly detrimental to immigrant women’s employment are targeted, politicians often downplay the integration issue when arguing for reform. © 2016, © The Author(s) 2016.


News Article | May 2, 2017
Site: www.eurekalert.org

The National Academy of Sciences announced today the election of 84 new members and 21 foreign associates in recognition of their distinguished and continuing achievements in original research. The National Academy of Sciences announced today the election of 84 new members and 21 foreign associates in recognition of their distinguished and continuing achievements in original research. Those elected today bring the total number of active members to 2,290 and the total number of foreign associates to 475. Foreign associates are nonvoting members of the Academy, with citizenship outside the United States. Newly elected members and their affiliations at the time of election are: Bates, Frank S.; Regents Professor, department of chemical engineering and materials science, University of Minnesota, Minneapolis Beilinson, Alexander; David and Mary Winton Green University Professor, department of mathematics, The University of Chicago, Chicago Bell, Stephen P.; investigator, Howard Hughes Medical Institute; and professor of biology, department of biology, Massachusetts Institute of Technology, Cambridge Bhatia, Sangeeta N.; John J. (1929) and Dorothy Wilson Professor, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge Buzsáki, György; professor, Neuroscience Institute, departments of physiology and neuroscience, New York University Langone Medical Center, New York City Carroll, Dana; distinguished professor, department of biochemistry, University of Utah School of Medicine, Salt Lake City Cohen, Judith G.; Kate Van Nuys Page Professor of Astronomy, department of astronomy, California Institute of Technology, Pasadena Crabtree, Robert H.; Conkey P. Whitehead Professor of Chemistry, department of chemistry, Yale University, New Haven, Conn. Cronan, John E.; professor and head of microbiology, professor of biochemistry, and Microbiology Alumni Professor, department of microbiology, University of Illinois, Urbana-Champaign Cummins, Christopher C.; Henry Dreyfus Professor of Chemistry, Massachusetts Institute of Technology, Cambridge Darensbourg, Marcetta Y.; distinguished professor of chemistry, department of chemistry, Texas A&M University, College Station DeVore, Ronald A.; The Walter E. Koss Professor and distinguished professor, department of mathematics, Texas A&M University, College Station Diamond, Douglas W.; Merton H. Miller Distinguished Service Professor of Finance, The University of Chicago, Chicago Doe, Chris Q.; investigator, Howard Hughes Medical Institute; and professor of biology, Institute of Molecular Biology, University of Oregon, Eugene Duflo, Esther; Co-founder and co-Director of the Abdul Latif Jameel Poverty Action Lab, and Professor of Poverty Alleviation and Development Economics, Massachusetts Institute of Technology, Cambridge Edwards, Robert Haas; professor of neurology and physiology, University of California, San Francisco Firestone, Mary K.; professor and associate dean of instruction and student affairs, department of environmental science policy and management, University of California, Berkeley Fischhoff, Baruch; Howard Heinz University Professor, department of social and decision sciences and department of engineering and public policy, Carnegie Mellon University, Pittsburgh Ginty, David D.; investigator, Howard Hughes Medical Institute; and Edward R. and Anne G. Lefler Professor of Neurobiology, department of neurobiology, Harvard Medical School, Boston Glass, Christopher K.; professor of cellular and molecular medicine and professor of medicine, University of California, San Diego Goldman, Yale E.; professor, department of physiology, Pennsylvania Muscle Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia González, Gabriela; spokesperson, LIGO Scientific Collaboration; and professor, department of physics and astronomy, Louisiana State University, Baton Rouge Hagan, John L.; John D. MacArthur Professor of Sociology and Law, department of sociology, Northwestern University, Evanston, Ill. Hatten, Mary E.; Frederick P. Rose Professor, laboratory of developmental neurobiology, The Rockefeller University, New York City Hebard, Arthur F.; distinguished professor of physics, department of physics, University of Florida, Gainesville Jensen, Klavs F.; Warren K. Lewis Professor of Chemical Engineering and professor of materials science and engineering, Massachusetts Institute of Technology, Cambridge Kahn, Barbara B.; vice chair for research strategy and George R. Minot Professor of Medicine at Harvard Medical School, Beth Israel Deaconess Medical Center, Boston Kinder, Donald R.; Philip E. Converse Collegiate Professor of Political Science and Psychology and research scientist, department of political science, Center for Political Studies, Institute for Social Research, University of Michigan, Ann Arbor Lazar, Mitchell A.; Willard and Rhoda Ware Professor in Diabetes and Metabolic Diseases, and director, Institute for Diabetes, Obesity, and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia Locksley, Richard M.; investigator, Howard Hughes Medical Institute; and professor, department of medicine (infectious diseases), and Marion and Herbert Sandler Distinguished Professorship in Asthma Research, University of California, San Francisco Lozano, Guillermina; professor and chair, department of genetics, The University of Texas M.D. Anderson Cancer Center, Houston Mavalvala, Nergis; Curtis and Kathleen Marble Professor of Astrophysics and associate head, department of physics, Massachusetts Institute of Technology, Cambridge Moore, Jeffrey Scott; Murchison-Mallory Professor of Chemistry, department of chemistry, University of Illinois, Urbana-Champaign Moore, Melissa J.; chief scientific officer, mRNA Research Platform, Moderna Therapeutics, Cambridge, Mass.; and Eleanor Eustis Farrington Chair of Cancer Research Professor, RNA Therapeutics Institute, University of Massachusetts Medical School, Worcester Nunnari, Jodi M.; professor, department of molecular and cellular biology, University of California, Davis O'Farrell, Patrick H.; professor of biochemistry and biophysics, department of biochemistry and biophysics, University of California, San Francisco Ort, Donald R.; research leader and Robert Emerson Professor, USDA/ARS Global Change and Photosynthesis Research Unit, departments of plant biology and crop sciences, University of Illinois, Urbana-Champaign Parker, Gary; professor, department of civil and environmental engineering and department of geology, University of Illinois, Urbana-Champaign Patapoutian, Ardem; investigator, Howard Hughes Medical Institute; and professor, department of molecular and cellular neuroscience, The Scripps Research Institute, La Jolla, Calif. Pellegrini, Claudio; distinguished professor emeritus, department of physics and astronomy, University of California, Los Angeles Pikaard, Craig, S.; investigator, Howard Hughes Medical Institute and Gordon and Betty Moore Foundation; and distinguished professor of biology and molecular and cellular biochemistry, department of biology, Indiana University, Bloomington Read, Nicholas; Henry Ford II Professor of Physics and professor of applied physics and mathematics, Yale University, New Haven, Conn. Roediger, Henry L.; James S. McDonnell Distinguished and University Professor of Psychology, department of psychology and brain sciences, Washington University, St. Louis Rosenzweig, Amy C.; Weinberg Family Distinguished Professor of Life Sciences, and professor, departments of molecular biosciences and of chemistry, Northwestern University, Evanston, Ill. Seto, Karen C.; professor, Yale School of Forestry and Environmental Studies, New Haven, Conn. Seyfarth, Robert M.; professor of psychology and member of the graduate groups in anthropology and biology, University of Pennsylvania, Philadelphia Sibley, L. David; Alan A. and Edith L. Wolff Distinguished Professor in Molecular Microbiology, department of molecular microbiology, Washington University School of Medicine, St. Louis Spielman, Daniel A.; Henry Ford II Professor of Computer Science and Mathematics, departments of computer science and mathematics, Yale University, New Haven, Conn. Sudan, Madhu; Gordon McKay Professor of Computer Science, John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Mass. Tishkoff, Sarah; David and Lyn Silfen University Professor, departments of genetics and biology, University of Pennsylvania, Philadelphia Van Essen, David C.; Alumni Professor of Neurobiology, department of anatomy and neurobiology, Washington University School of Medicine, St. Louis Vidale, John E.; professor, department of earth and space sciences, University of Washington, Seattle Wennberg, Paul O.; R. Stanton Avery Professor of Atmospheric Chemistry and Environmental Science and Engineering, California Institute of Technology, Pasadena Wilson, Rachel I.; Martin Family Professor of Basic Research in the Field of Neurobiology, department of neurobiology, Harvard Medical School, Boston Zachos, James C.; professor, department of earth and planetary sciences, University of California, Santa Cruz, Santa Cruz Newly elected foreign associates, their affiliations at the time of election, and their country of citizenship are: Addadi, Lia; professor and Dorothy and Patrick E. Gorman Chair of Biological Ultrastructure, department of structural science, Weizmann Institute of Science, Rehovot, Israel (Israel/Italy) Folke, Carl; director and professor, The Beijer Institute of Ecological Economics, Royal Swedish Academy of Sciences, Stockholm, Sweden (Sweden) Freeman, Kenneth C.; Duffield Professor of Astronomy, Mount Stromlo and Siding Spring Observatories, Research School of Astronomy and Astrophysics, Australian National University, Weston Creek (Australia) Lee, Sang Yup; distinguished professor, dean, and director, department of chemical and biomolecular engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea (South Korea) Levitzki, Alexander; professor of biochemistry, unit of cellular signaling, department of biological chemistry, The Hebrew University of Jerusalem, Jerusalem (Israel) Peiris, Joseph Sriyal Malik; Tam Wah-Ching Professorship in Medical Science, School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong, People's Republic of China (Sri Lanka) Robinson, Carol Vivien; Dr. Lee's Professor of Chemistry, Physical and Theoretical Chemistry Laboratory, University of Oxford, Oxford, England (United Kingdom) Thesleff, Irma; academician of science, professor, and research director, developmental biology program, Institute of Biotechnology, University of Helsinki, Helsinki (Finland) Underdal, Arild; professor of political science, department of political science, University of Oslo, Oslo, Norway (Norway) The National Academy of Sciences is a private, nonprofit institution that was established under a congressional charter signed by President Abraham Lincoln in 1863. It recognizes achievement in science by election to membership, and -- with the National Academy of Engineering and the National Academy of Medicine -- provides science, engineering, and health policy advice to the federal government and other organizations.


News Article | December 7, 2016
Site: www.eurekalert.org

TORONTO, Dec. 7, 2016 - As many as 19 per cent of Ontario adults aged 18 to 29 experience moderate to severe problematic use of electronic devices, which includes smartphones and tablets as well as computers and video game consoles, according to the latest CAMH Monitor survey. It's the first time the ongoing survey has measured the impact of our increasing reliance on electronic devices. "Today's young adults entered their adolescent or adult years with a wide range of social media, apps, videos and other information and entertainment available to them 24/7," says Dr. Hayley Hamilton, Scientist in CAMH's Institute for Mental Health Policy Research and co-principal investigator of the CAMH Monitor. Although problematic use was most prevalent among young adults, it affected all ages. Overall, seven per cent of all Ontario adults -- representing an estimated 716,100 people -- experienced moderate to severe problematic use, defined as experiencing three or more out of six symptoms related to problematic use. "It's clear that, for most of us, our use of electronic devices has skyrocketed over the past five to 10 years, which is why it's important to study if this use can be problematic," says Dr. Nigel Turner, Scientist in CAMH's Institute for Mental Health Policy Research and an expert in gambling and behavioural addictions. "While our understanding of problematic use is evolving, we know that some people do end up harming their career or educational opportunities by excessive use." These results from the 2015 CAMH Monitor are based on responses from 3,007 adults aged 18 and older across the province. The survey asked about personal device use, other than for work or school. Questions about problematic use asked whether individuals or their family members believed they had a problem, if they tried to cut back on their use, if they experienced anxiety that could only be relieved by using electronic devices, or if they missed school, work or important social activities because of device use, for example. "Research has shown that high use of electronic devices, as well as social media, are linked to problems with mental health, including increased psychological distress and poorer self-rated mental health," says Dr. Hamilton. "Our new findings underscore the need for each of us to define healthy limits, and to monitor our use of electronic devices before it becomes a problem." A high number of drivers reported texting while driving, another new question on this year's survey. More than one in three drivers -- 37 per cent -- confirmed texting while driving at least once in the past year, and 11 per cent of drivers had texted while driving 30 or more times in the past year. "An estimated 3.3 million adult drivers in Ontario are involved in this hazardous behaviour on the road," says Dr. Robert Mann, Senior Scientist in CAMH's Institute for Mental Health Policy Research and co-principal investigator of the survey. "The province's stronger penalties for distracted driving came into effect in the fall of 2015, so we don't yet know the effects of these penalties -- we'll be watching this closely in future years." Over the past year, the percentage of people who experienced frequent mental distress days rose significantly, from six per cent in 2014 to nearly 10 per cent in 2015. Frequent mental distress days are defined as 14 or more days, out of the last 30 days, in which a person rated his or her mental health as not good, which included stress, depression and problems with emotions. "Generally, frequent mental distress days and self-rated fair or poor mental health have climbed over the last decade, which is concerning," says Dr. Hamilton. During the past year, 11 per cent of Ontario adults used e-cigarettes, a significant increase from seven per cent in 2013, which was the first year that the CAMH Monitor asked about e-cigarette use. By comparison, 13 per cent of people said they currently smoke tobacco cigarettes, down from 17 per cent in 2013 and a sharp drop from nearly 27 per cent in 1996. Cannabis use has increased over the past 20 years, from nine per cent in 1996 to more than 14 per cent in 2015. An important change in cannabis use over the past decade has been the aging of cannabis users. Among Ontarians aged 50 and older, past-year use of cannabis increased significantly from about three per cent in 2005 to seven per cent in 2015. "In 2015, 23 per cent of cannabis users were 50 years of age and older, a substantial increase from six per cent in 2005," says Dr. Mann. The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital and a world leading research centre in this field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental illness and addiction. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit http://www. or follow @CAMHnews and @CAMHResearch on Twitter. The CAMH Monitor, first conducted in 1977, is the longest ongoing addiction and mental health survey of adults in Canada. The survey is designed to serve as the primary vehicle for monitoring substance use and mental health problems among Ontario adults. The CAMH Monitor provides epidemiological trends in alcohol, tobacco, and other drug use, problem use, and mental health among Ontarians. The survey is conducted on behalf of CAMH by the Institute for Social Research at York University. About 3,000 Ontario adults are interviewed by telephone each year using random digit dialing. The sample is considered representative of most Ontarians aged 18 years and older (about 10 million Ontarians).


News Article | December 14, 2016
Site: www.eurekalert.org

DALLAS, Dec. 14, 2016 -- People who were in a stable marriage, and had never been divorced or widowed, had the best prospects of survival after having a stroke, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association. "Our research is the first to show that current and past marital experiences can have significant consequences for one's prognosis after a stroke," said Matthew E. Dupre, Ph.D., lead author and associate professor in the Department of Community and Family Medicine and the Clinical Research Institute at Duke University in Durham, North Carolina. "We hope that a greater recognition and understanding of these associations may enable healthcare providers to better identify and treat patients who may be at a potentially high risk of dying after suffering a stroke." Stroke, one of the leading causes of disability and death in the United States, affects nearly 800,000 adults each year. The risk factors associated with stroke -- high blood pressure, smoking and diabetes -- are well established, as are the factors related to recovering from stroke and improving survival, such as access to quality healthcare, reducing risk factors, and adhering to treatment plans. While studies have shown that social support, such as marriage, can have a significant impact on treatment of cardiovascular disease, the influence of marital status on stroke survival in adults remains poorly understood. To determine whether one's marital history plays a role in survival after suffering a stroke, Dupre and Renato D. Lopes, M.D., Ph.D., professor of medicine at Duke University Medical Center, used data from a nationally representative sample of older U.S. adults. The sample was collected as part of the Health and Retirement Study (HRS), an ongoing, prospective, study of older U.S. adults sponsored by the National Institute on Aging and the Institute for Social Research at the University of Michigan. The HRS includes marital histories from more than 50 years of prospective and retrospective interview data. For this study, the researchers selected respondents who reported a stroke from 1992 to 2010. The final sample included 2,351 adults aged 41 and older who were observed an average of 5.3 years over the 18-year study period. The researchers found: The risks of dying after a stroke were 71 percent greater for adults who never married than for adults who were continuously married. For patients who were divorced or widowed, the risks of dying after a stroke were 23 percent and 25 percent greater, respectively, than continuously married adults. In patients who were divorced or widowed more than once, the risks of dying after a stroke were 39 percent and 40 percent greater, respectively, than for continuously married adults. There was no evidence that the findings significantly differed between men and women or by race or ethnicity. Analysis of the data suggests that some of these risks are affected by differences in psychological and social factors, such as lack of children, limited social support and depressive symptoms that may have impeded recovery after a stroke. Multiple marital losses in one's lifetime were especially detrimental to recovery, regardless of one's current marital status. Unexpectedly, the researchers found that remarriage did not reduce the risks from past divorce or widowhood. A limitation of the study is that it only included adults who survived to hospital discharge and did not include those who died shortly after having a stroke. The results of this study have possible implications for public health awareness and practice, Dupre said. "More research is needed to know the full clinical implications of our findings. Greater knowledge about the risks associated with marital life and marital loss may be useful for personalizing care and improving outcomes for those who are recovering from a stroke." Author disclosures are on the manuscript. The National Institute on Aging funded the study. Stroke images are located in the right column of this release link http://newsroom. After Dec. 14, 2016, view the manuscript online. About Stroke Follow AHA/ASA news on Twitter @HeartNews. For updates and new science from JAHA, follow @JAHA_AHA. Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at http://www. .


News Article | December 13, 2016
Site: www.eurekalert.org

The 2016 Monitoring the Future (MTF) annual survey results released today from the National Institutes of Health (NIH) reflect changing teen behaviors and choices in a social media-infused world. The results show a continued long-term decline in the use of many illicit substances, including marijuana, as well as alcohol, tobacco, and misuse of some prescription medications, among the nation's teens. The MTF survey measures drug use and attitudes among eighth, 10th, and 12th graders, and is funded by the National Institute on Drug Abuse (NIDA), part of the NIH. Findings from the survey indicate that past year use of any illicit drug was the lowest in the survey's history for eighth graders, while past year use of illicit drugs other than marijuana is down from recent peaks in all three grades. Marijuana use in the past month among eighth graders dropped significantly in 2016 to 5.4 percent, from 6.5 percent in 2015. Daily use among eighth graders dropped in 2016 to 0.7 percent from 1.1 percent in 2015. However, among high school seniors, 22.5 percent report past month marijuana use and 6 percent report daily use; both measures remained relatively stable from last year. Similarly, rates of marijuana use in the past year among 10th graders also remained stable compared to 2015, but are at their lowest levels in over two decades. The survey also shows that there continues to be a higher rate of marijuana use among 12th graders in states with medical marijuana laws, compared to states without them. For example, in 2016, 38.3 percent of high school seniors in states with medical marijuana laws reported past year marijuana use, compared to 33.3 percent in non-medical marijuana states, reflecting previous research that has suggested that these differences precede enactment of medical marijuana laws. The survey indicates that marijuana and e-cigarettes are more popular than regular tobacco cigarettes. The past month rates among 12th graders are 12.4 percent for e-cigarettes and 10.5 percent for cigarettes. A large drop in the use of tobacco cigarettes was seen in all three grades, with a long-term decline from their peak use more than two decades ago. For example, in 1991, when MTF first measured cigarette smoking, 10.7 percent of high school seniors smoked a half pack or more a day. Twenty-five years later, that rate has dropped to only 1.8 percent, reflecting the success of widespread public health anti-smoking campaigns and policy changes. There has been a similar decline in the use of alcohol, with the rate of teens reporting they have "been drunk" in the past year at the survey's lowest rates ever. For example, 37.3 percent of 12th graders reported they have been drunk at least once, down from a peak of 53.2 percent in 2001. Although non-medical use of prescription opioids remains a serious issue in the adult population, teen use of prescription opioid pain relievers is trending downwards among 12th graders with a 45 percent drop in past year use compared to five years ago. For example, only 2.9 percent of high school seniors reported past year misuse of the pain reliever Vicodin in 2016, compared to nearly 10 percent a decade ago. "Clearly our public health prevention efforts, as well as policy changes to reduce availability, are working to reduce teen drug use, especially among eighth graders," said Nora D. Volkow, M.D., director of NIDA. "However, when 6 percent of high school seniors are using marijuana daily, and new synthetics are continually flooding the illegal marketplace, we cannot be complacent. We also need to learn more about how teens interact with each other in this social media era, and how those behaviors affect substance use rates." "It is encouraging to see more young people making healthy choices not to use illicit substances," said National Drug Control Policy Director Michael Botticelli. "We must continue to do all we can to support young people through evidence-based prevention efforts as well as treatment for those who may develop substance use disorders. And now that Congress has acted on the President's request to provide $1 billion in new funding for prevention and treatment, we will have significant new resources to do this." The MTF survey, the only large-scale federal youth survey on substance use that releases findings the same year the data is collected, has been conducted by researchers at the University of Michigan at Ann Arbor since 1975. Other highlights from the 2016 survey: Overall, 45,473 students from 372 public and private schools participated in this year's MTF survey. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th graders nationwide. Eighth and 10th graders were added to the survey in 1991. Lloyd D. Johnston, Ph.D., who has been the principal investigator at the University of Michigan's Institute for Social Research for all 42 years, is retiring from that position this year, but the survey of teens will continue under the leadership of Richard A. Miech, Ph.D., who is currently a member of the MTF scientific team. "The declining use of many drugs by youth is certainly encouraging and important," said Dr. Johnston. "But we need to remember that future cohorts of young people entering adolescence also will need to know why using drugs is not a smart choice. Otherwise we risk having another resurgence of use as was seen in the 90s." "We want to thank Dr. Johnston for his lifetime of work building this survey into the important public health tool it is today," added Dr. Volkow. MTF is funded under grant number DA001411. Additional information on the MTF Survey, as well as comments from Dr. Volkow, can be found at http://www. . The University of Michigan press release can be found at http://monitoringthefuture. . MTF is one of three major surveys sponsored by the U.S. Department of Health and Human Services that provide data on substance use among youth. The others are the National Survey on Drug Use and Health and the Youth Risk Behavior Survey. The MTF website is: http://www. . Follow Monitoring the Future 2016 news on Twitter at @NIDANews, or join the conversation by using: #MTF2016. Additional survey results can be found at http://www. or http://www. . Information on all of the surveyed drugs can be found on NIDA's Web site: http://www. . The National Survey on Drug Use and Health, sponsored by the Substance Abuse and Mental Health Services Administration, is the primary source of statistical information on substance use in the U.S. population 12 years of age and older. More information is available at: http://www. . The Youth Risk Behavior Survey, part of the Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System, is a school-based survey that collects data from students in grades nine-12. The survey includes questions on a wide variety of health-related risk behaviors, including substance abuse. More information is available at http://www. . Additionally, the National Youth Tobacco Survey, a school-based survey of U.S. students in grades six-12 conducted by the CDC in collaboration with the Food and Drug Administration, collects data on the use of multiple tobacco products, including e-cigarettes. More information is available at http://www. . The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found at http://www. , which is now compatible with your smartphone, iPad or tablet. To order publications in English or Spanish, call NIDA's DrugPubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or email requests to drugpubs@nida.nih.gov. Online ordering is available at http://drugpubs. . NIDA's media guide can be found at http://drugabuse. , and its easy-to-read website can be found at http://www. About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www. .


No patient who just got out of the hospital wants to end up there again soon. Whoever's paying their hospital bills doesn't want that either. That's why the Medicare system has started penalizing hospitals with the highest readmission rates for certain conditions. But a new study suggests that unlike hospital gowns, such penalties should not be one-size-fits-all. In fact, the study shows, certain social, economic, disability and personal-care factors can make a major difference in the readmission risk of people who were recently hospitalized for heart failure, pneumonia or a heart attack. And the factors that make the most difference vary greatly from condition to condition, and are largely not something a hospital can change through treatment. For instance, pneumonia patients who already had trouble with multiple tasks like getting dressed or cooking food, or who needed paid help at home, before their hospital stay were the most likely of all pneumonia patients to be readmitted in the first 30 days after a hospitalization, the study shows. But for patients with heart failure, that kind of functional difficulty didn't matter as much as money, family and race. Those who had a higher wealth level or adult children had a much lower chance of readmission -- while simply being African American increased the risk of another hospital stay. And for heart attack survivors, the most important factors boosting their chance of readmission were whether they had been in a nursing home before their hospital stay, and whether their hospital cared for a high percentage of minority patients. The results, published in the Journal of General Internal Medicine, come from a team from the University of Michigan Medical School and Institute for Healthcare Policy and Innovation, and the VA Ann Arbor Healthcare System. They used data from the Health and Retirement Study, based at the U-M Institute for Social Research, and from Medicare, and looked at 10 measures of disability and what are called "social determinants of health." The resulting model of readmission risk they developed could be used to predict a patient's chances of readmission, and prompt hospitals to offer extra support such as transportation and home visits. At the same time, it could give the agency that runs Medicare a new tool for determining which hospitals truly have high readmission rates given the patients they treat. Currently, Medicare adjusts its penalties based only on how sick a hospital's patients are; the more severely ill, the lower the penalty. The research team started with the existing Medicare adjustments and then added the patient's social determinants of health to assess their incremental value. But the new study looks at factors that the hospital can't control, such as patients' race, education, income, social and family support, difficulty taking care of themselves, and what environment they return to after a hospital stay. Such factors have emerged in other research as crucial to a patient's overall chance of a good outcome. But they've never been studied for how their impact upon readmission risk may vary among people with the same reason for their initial hospitalization. "The relationship between socioeconomic status, functional status and use of health care is not a simple or straightforward as people might think," says Jennifer Meddings, M.D., M.Sc., first author of the new paper and an assistant professor of internal medicine at U-M. "The impact is different depending on condition. We hope these findings will inform future adjustments in the models for readmission." Penalize or reward? Meddings notes that the Centers for Medicare and Medicaid Services, which runs Medicare and pays for the care of tens of millions of seniors and seriously disabled people, has opened the door for socioeconomic status to be considered in its programs. The National Academy of Sciences has convened a committee to evaluate evidence on the topic, and present it to CMS. "In many ways, hospitals these days are being held accountable for the failures of the social safety net, as policies have been developed and implemented to evaluate the performance of hospitals and tie payment to that," says Meddings. "As these programs are refined, understanding the impact of social determinants of health will be crucial." Accounting for the social determinants of health that could be helping or hurting a hospital's specific patient population could go two ways, she notes. Factoring these issues in to reduce or increase penalties is one way. But another would be to provide additional payment for the services that hospitals don't typically get paid for, such as hiring social workers to connect patients with social services and resources that can help them avoid another hospital stay. Patients who are "dual eligible" -- old or disabled enough for Medicare, and poor enough for Medicaid -- present a special challenge. The new study looked at Medicaid status but the sample size wasn't large enough to determine if it played a role in readmission risk. Meddings sees hope for using social determinants of health and disability level in health care payment, based on the fact that many of these measures are now captured in electronic medical records when a person arrives at a hospital or when they're being prepared to leave. CMS has traditionally used Medicare claims data -- how much the hospital billed the system -- but mining EHR data could prove fruitful if it can be done in a standard way, Meddings says. But, she notes, just knowing that a patient has a spouse or adult children doesn't show how helpful those family members will be to the patient. Meddings and her colleagues have started studying this same issue in Medicare patients who have had a joint replacement, since CMS has begun penalizing hospitals for high readmissions after a hip or knee replacement operation.


News Article | November 16, 2016
Site: www.eurekalert.org

ANN ARBOR, Mich. - No patient who just got out of the hospital wants to end up there again soon. Whoever's paying their hospital bills doesn't want that either. That's why the Medicare system has started penalizing hospitals with the highest readmission rates for certain conditions. But a new study suggests that unlike hospital gowns, such penalties should not be one-size-fits-all. In fact, the study shows, certain social, economic, disability and personal-care factors can make a major difference in the readmission risk of people who were recently hospitalized for heart failure, pneumonia or a heart attack. And the factors that make the most difference vary greatly from condition to condition, and are largely not something a hospital can change through treatment. For instance, pneumonia patients who already had trouble with multiple tasks like getting dressed or cooking food, or who needed paid help at home, before their hospital stay were the most likely of all pneumonia patients to be readmitted in the first 30 days after a hospitalization, the study shows. But for patients with heart failure, that kind of functional difficulty didn't matter as much as money, family and race. Those who had a higher wealth level or adult children had a much lower chance of readmission -- while simply being African American increased the risk of another hospital stay. And for heart attack survivors, the most important factors boosting their chance of readmission were whether they had been in a nursing home before their hospital stay, and whether their hospital cared for a high percentage of minority patients. The results, published in the Journal of General Internal Medicine, come from a team from the University of Michigan Medical School and Institute for Healthcare Policy and Innovation, and the VA Ann Arbor Healthcare System. They used data from the Health and Retirement Study, based at the U-M Institute for Social Research, and from Medicare, and looked at 10 measures of disability and what are called "social determinants of health". The resulting model of readmission risk they developed could be used to predict a patient's chances of readmission, and prompt hospitals to offer extra support such as transportation and home visits. At the same time, it could give the agency that runs Medicare a new tool for determining which hospitals truly have high readmission rates given the patients they treat. Currently, Medicare adjusts its penalties based only on how sick a hospital's patients are; the more severely ill, the lower the penalty. The research team started with the existing Medicare adjustments and then added the patient's social determinants of health to assess their incremental value. But the new study looks at factors that the hospital can't control, such as patients' race, education, income, social and family support, difficulty taking care of themselves, and what environment they return to after a hospital stay. Such factors have emerged in other research as crucial to a patient's overall chance of a good outcome. But they've never been studied for how their impact upon readmission risk may vary among people with the same reason for their initial hospitalization. "The relationship between socioeconomic status, functional status and use of health care is not a simple or straightforward as people might think," says Jennifer Meddings, M.D., M.Sc., first author of the new paper and an assistant professor of internal medicine at U-M. "The impact is different depending on condition. We hope these findings will inform future adjustments in the models for readmission." Meddings notes that the Centers for Medicare and Medicaid Services, which runs Medicare and pays for the care of tens of millions of seniors and seriously disabled people, has opened the door for socioeconomic status to be considered in its programs. The National Academy of Sciences has convened a committee to evaluate evidence on the topic, and present it to CMS. "In many ways, hospitals these days are being held accountable for the failures of the social safety net, as policies have been developed and implemented to evaluate the performance of hospitals and tie payment to that," says Meddings. "As these programs are refined, understanding the impact of social determinants of health will be crucial." Accounting for the social determinants of health that could be helping or hurting a hospital's specific patient population could go two ways, she notes. Factoring these issues in to reduce or increase penalties is one way. But another would be to provide additional payment for the services that hospitals don't typically get paid for, such as hiring social workers to connect patients with social services and resources that can help them avoid another hospital stay. Patients who are "dual eligible" - old or disabled enough for Medicare, and poor enough for Medicaid - present a special challenge. The new study looked at Medicaid status but the sample size wasn't large enough to determine if it played a role in readmission risk. Meddings sees hope for using social determinants of health and disability level in health care payment, based on the fact that many of these measures are now captured in electronic medical records when a person arrives at a hospital or when they're being prepared to leave. CMS has traditionally used Medicare claims data - how much the hospital billed the system - but mining EHR data could prove fruitful if it can be done in a standard way, Meddings says. But, she notes, just knowing that a patient has a spouse or adult children doesn't show how helpful those family members will be to the patient. Meddings and her colleagues have started studying this same issue in Medicare patients who have had a joint replacement, since CMS has begun penalizing hospitals for high readmissions after a hip or knee replacement operation. In addition to Meddings, the study's authors are Heidi Reichert, M.A., Shawna N. Smith, Ph.D., Theodore Iwashyna, M.D., Ph.D., Kenneth Langa, M.D., Ph.D., Timothy Hofer, M.D., M.Sc., and senior author Laurence McMahon, Jr., M.D., MPH, the chief of the Division of General Medicine in the U-M Department of Internal Medicine who also holds an appointment in the Department of Health Management and Policy in the School of Public Health. Meddings also holds an appointment in the U-M Department of Pediatrics, and Smith, Iwashyna and Langa hold appointments at ISR. The study was funded by the Agency for Healthcare Research and Quality ( HS018334, HS019767) and the HRS is funded by the National Institute on Aging (AG009740).

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