The newsroom is your comprehensive source for what is happening at CHPR, including the latest policy and research news and stories.
Researchers are studying how to prevent high rates of suicide among middle-aged men and provide them mental health treatment. Anthony Jerant, interim director of CHPR, is quoted in an article in The Wall Street Journal about preventing suicide. He discusses findings from CHPR research on treating and preventing suicide among middle-aged men. Jerant also serves as a professor and chair of the Department of Family and Community Medicine.
The American Cancer Society’s Great American Smokeout – a day set aside to challenge people who smoke to give up cigarettes for 24 hours – marks its 45th anniversary this year. By observing this single day, many tobacco users take their first step towards quitting with the help and support of others.
“This is a great time to quit for everyone, especially those that use menthol cigarettes or vape. California voters recently confirmed the state law to stop the sale of flavored tobacco products, which is anticipated to start on December 21. We can all support our patients, friends, and families by telling them about free resources to help stop for good,” said CHPR researcher Elisa Tong. Tong is UC Davis internist and leads CHPR’s CA Quits program.
UC Davis Health’s Department of Emergency Medicine has been awarded two National Institutes of Health (NIH) grants totaling over $5 million to improve emergency patient care. One grant will support a study on the use of ultrasound in the evaluation of pediatric trauma patients.
The grant was awarded to CHPR researchers Nathan Kuppermann, chair of the Department of Emergency Medicine, and James Holmes, executive vice chair of the Department of Emergency Medicine, to perform a randomized, controlled trial to compare the rates of abdominal computed tomography (CT) scanning of children for suspected intra-abdominal injuries when they do and do not receive an ultrasound during emergency department evaluation. Holmes serves on CHPR’s leadership team.
According to the Centers for Disease Control and Prevention, trauma is the leading cause of death in children in the United States. Among pediatric traumatic deaths, torso trauma (intra-abdominal injuries) accounts for 30% of cases.
How can we improve the early detection of breast cancer and better identify women at higher risk for an advanced or second breast cancer and who need additional screening?
This is the mission of a national research team co-led by CHPR affiliate Diana Miglioretti. Thanks to a $15 million 5-year grant renewal from the National Cancer Institute (NCI), the team will use artificial intelligence (AI) to make breast cancer screening and surveillance more accurate and equitable.
“The U.S. Preventive Services Task Force recommends screening every two years, which is sufficient for most women. But some women could benefit from screening every year or with supplemental imaging,” Miglioretti said. She is the dean’s professor and division chief of biostatistics at the UC Davis Department of Public Health Sciences and a researcher at UC Davis Comprehensive Cancer Center. “Still, we need to be very careful about the impact of additional screening on women.”
CHPR affiliate David Tom Cooke is being recognized by Physicians for a Healthy California (PHC) with the 2022 Ethnic Physician Leadership Award. Cooke is a UC Davis oncology surgeon and chief of the Division of General Thoracic Surgery.
PHC, formerly the California Medical Association Foundation, is dedicated to improving community health, growing a diverse workforce and promoting health equity. Its annual awards program celebrates the commitment, compassion and contributions of doctors who are improving community health and reducing health disparities in California.
“The Ethnic Physician Leadership Award recognizes an individual physician’s contribution toward improving the health of ethnic communities,” said PHC President and CEO Lupe Alonzo-Diaz. “Dr. Cooke earned the award by showing great success in helping eliminate health disparities, addressing access to care and improving cultural competency and patient advocacy.”
The purpose of the Ethnic Physician Leadership Award, Alonzo-Diaz said, is to honor an ethnic physician, inspire other physicians, and promote leadership, caring and compassion in medicine.
A team of UC Davis Health researchers led by CHPR affiliate Joshua Fenton received a 3-year $1.05 million grant from the Centers for Disease Control and Prevention (CDC) to identify risk and protective factors linked to the combined use of opioids and benzodiazepines, a group of drugs used to treat anxiety and insomnia.
Millions of patients prescribed opioids for chronic pain are co-prescribed benzodiazepines, commonly referred to as “benzos.” However, the combined use may increase overdose risk for patients on long-term opioid therapy.
Benzodiazepines are depressants with a sedative effect that reduces the activity of nerves in the brain. Two common benzos are the prescription drugs Valium® and Xanax®.
“Benzodiazepines are prescribed to about 25% of patients on long-term opioids. They magnify the risks of overdose considerably,” said Fenton, professor and vice chair of research in the Department of Family and Community Medicine at UC Davis School of Medicine and principal investigator of the study.
New findings published in Nicotine & Tobacco Research show a simple, but valuable approach can help engage low-income smokers to try quitting tobacco. The study tested a proactive, phone-based outreach strategy using local vs. generic caller area codes. Researchers called English and Spanish-speaking smokers with Medicaid insurance who had not received tobacco treatment at previous clinic visits.
The trial proved that using a local caller area code to proactively call patients who smoke could help address care gaps and improve health equity.
“A proactive outreach strategy to engage low-income smokers increased connections to the quitline by using a local area code when we called them,” said CHPR’s Cindy Valencia, lead author of the study. “The strategy was particularly helpful for engaging Spanish-speakers, proving it is a highly effective health equity tool.”
Valencia and Elisa Tong, a CHPR affiliate and UC Davis internist, lead CHPR’s CA Quits program. CA Quits hosts a statewide learning collaborative and workgroup for health systems and health plans that serve Medi-Cal patients.
Cancer treatment commonly requires the involvement of clinicians from multiple disciplines. It may encompass, for example, diagnostic and interventional radiology, medical oncology, surgical oncology, hematology, immunology, neurology, psychology, pain medicine, physical therapy and other areas of specialization. But the electronic health record (EHR) systems that clinicians are required to use often complicates interprofessional teamwork and coordination of patient care.
A research team is tackling the problem by studying and determining how interprofessional teamwork affects the quality of patient outcomes. The researchers will focus on how information sharing occurs among interprofessional clinical team members in EHR systems. They hope to identify ways medical team members can more fluidly synthesize and communicate information as they coordinate care of individual patients.
Shin-Ping Tu, a CHPR affiliate who also serves as an advisory board member, initiated the five-year research project. She brought together a team that includes multiple principal investigators. Tu is chief of the Division of General Internal Medicine and the Hibbard E. Williams, Endowed Professor of Medicine.
The Behavioral Health Center of Excellence (BHCOE) at UC Davis has awarded six 2022 pilot grants to advance mental health research. One grant was awarded to CHPR affiliate Elizabeth Magnan, associate professor in the Department of Family and Community Medicine, who aims to understand how the health outcomes of patients seeking treatment for opioid use disorder are affected by the stigma they experience. CHPR will manage the pilot grant.
A clinician, Magnan will bridge her expertise treating patients with research to better understand how patients experience stigma and develop targeted interventions. The pilot aims to expand the field, which has historically focused on stigma held by health care providers rather than the patient experience of stigma and the related health outcomes.
The California Department of Public Health awarded UC Davis Health a $15.7 million grant to help run the California Cancer Registry, a program that collects information about all cancers diagnosed in California. This three-year grant is the second renewal for UC Davis to manage the registry.
State law requires all invasive cancers diagnosed in California to be reported to the California Cancer Registry. The registry collects and analyzes cancer data and performs quality control.
A team overseen by CHPR affiliate Theresa Keegan and advisory board member Ted Wun provides statewide surveillance and IT functions. The team also collaborates with three regional registries funded by grants from the state and the National Cancer Institute and provides support for the national, regional and state Cancer Center Registry initiatives.
Do pediatric kidney transplant patients have better long-term outcomes when their kidney comes from living, biologically unrelated donors compared to deceased donors?
A new UC Davis Health study finds that they do. The study reviewed data from the Organ Procurement & Transplantation Network database. Researchers compared the rates of graft failure (when the organ is rejected by the recipient) and death, as well as long-term outcomes of children who received kidney transplants from living related donors, living unrelated donors and deceased donors. It is the largest study of its kind and was published in Pediatric Transplantation.
“Our analysis suggests that living unrelated donor organ transplants are not inferior to deceased donor organs,” said CHPR affiliate Daniel Tancredi, the study’s coauthor and professor in the Pediatrics Department at UC Davis Health. “This is especially important for children who are the most vulnerable of all and have much to benefit from receiving the best possible available donor organ.”
A new study found that a current cancer diagnosis posed a significant risk for severe outcomes during the first two years of the COVID-19 pandemic, including ICU admission and death. UC Davis Comprehensive Cancer Center researchers took part in the study, which was published this week in Cancer Epidemiology, Biomarkers & Prevention.
“This was the second-largest study of COVID-19 patients in the United States, and it was funded by the National Cancer Institute (NCI),” said CHPR affiliate Elisa Tong, UC Davis internist and cancer prevention researcher. “The results showed that getting the COVID-19 vaccine significantly reduces the risk of death for cancer patients who develop COVID-19.”
The study was led by researchers from the University of Wisconsin and included 104,590 patients at 21 health systems across the United States. The sample included hospitalized patients who were diagnosed with COVID-19 from February 1, 2020, through September 30, 2021. A total of 7,141 (6.8%) had a current diagnosis of cancer while 6,749 (6.5%) had a past history of cancer.
Suicide prevention is a pressing concern for physicians and healthcare researchers, but obstacles have impaired researchers’ ability to conduct effective clinical trials and collect evidence. A new paper calls for innovation and reform to the research process to overcome these obstacles.
The Centers for Disease Control and Prevention (CDC) says over 45,000 deaths from suicide occur in the United States each year. A disproportionate 80% of those deaths are men, particularly middle-aged men (aged 35-64 years). Men often will not disclose suicidal thoughts making it difficult to get them needed treatment, even though half of adults who die by suicide visit a primary care physician in the month before their death.
This uniquely positions primary care physicians to prevent unnecessary deaths. Yet primary care settings have not been a focus of clinical suicide prevention efforts, leaving specialty mental health care providers like psychiatric facilities and metal health clinics—or emergency departments after an attempted suicide—as the primary setting for treatment.
The Centers for Disease Control and Prevention says reducing the number of patients who are prescribed opioids and later transition to long-term use, which can lead to opioid use disorder and overdose, is a critical step toward solving the opioid crisis in the United States.
A $170,000 award from the National Institute on Drug Abuse at the National Institutes of Health will support CHPR researchers in developing a model to help predict the risk of long-term opioid use.
Led by CHPR researcher Iraklis Erik Tseregounis, a substance use epidemiologist and assistant project scientist in the UC Davis Department of Internal Medicine, a research team will develop a prediction model that is clinically useful and serves as a foundation for administrators of prescription drug monitoring programs (PDMP) to develop future tools.
A recent study found people who had COVID-19 were at increased risks of cardiovascular conditions in the year after being infected. In an interview with Nature, CHPR affiliate Dan Tancredi, a professor of pediatrics at UC Davis, discussed the study and its design.
Tancredi highlighted a source of potential bias stemming from one of the study’s control groups that went through at least a year without catching COVID-19, which could mean physiological differences made members of the control group less likely to be infected with COVID-19. This could also affect how prone they were to cardiovascular issues. But Tancredi still felt the study design was well done and that any potential bias isn't likely to change the study's conclusions.
“I wouldn’t say that these numbers are exactly right, but they’re definitely in the ballpark,” Tancredi told Nature.
A new international study conducted in eight countries and published in JAMA Network Open offers a clearer picture of the risks associated with long COVID in children.
The study was co-led by a team of researchers from UC Davis Health, the University of Calgary’s Cumming School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago. It showed nearly 6% of children who presented to the emergency department with COVID-19 reported symptoms of long COVID 90 days later.
The study included 1,884 children with COVID-19 who had 90-day follow-up visits. Long COVID was found in nearly 10% of hospitalized children and 5% in children discharged from the emergency department.
“Reported rates of long COVID in adults are substantially higher than what we found in children,” said co-principal investigator and CHPR affiliate Nathan Kuppermann, chair of the Department of Emergency Medicine at UC Davis. “Our findings can inform public health policy decisions regarding COVID-19 mitigation strategies for children and screening approaches for long COVID among those with severe infections.”
Dean Stephen J. Cavanagh announced the appointment of CHPR affiliate Deb Bakerjian as interim associate dean of practice at the Betty Irene Moore School of Nursing at UC Davis.
In this role, Bakerjian provides oversight of clinical faculty practice development and implementation and UC Davis Health and community strategic partnerships and advocacy. She’ll also assist with interprofessional practice and clinical partnerships and strategies for the school’s contribution to the Healthy Aging Clinic.
“Dr. Bakerjian brings nearly three decades of experience as an advanced practice provider, interprofessional team builder and educator and a policy advocate for the nursing profession,” Cavanagh said. “In this new role, she advances the school’s clinical mission and serves as a catalyst for the development and refinement of new models of care delivery and for the development of future clinical nurse practitioners and leaders hoping to innovate the profession.”
A new UC Davis Health trial is focusing on behavioral strategies to improve health care among racially and ethnically diverse patients with gestational diabetes.
CHPR affiliate Susan D. Brown, associate professor of internal medicine, recently presented on the SUNRISE trial at a forum hosted by CHPR and the Perinatal Origins of Disparities (POD) Center. Funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the trial aims to identify effective interventions that increase preventive screening for type 2 diabetes after a gestational diabetes diagnosis.
“Gestational diabetes is a common condition that disproportionately affects people of color. It also increases chronic disease risk, which includes type 2 diabetes and cardiovascular disease,” Brown explained. “Health equity motivates much of my work. The long-term goal of this trial is to mitigate barriers that can get in the way of preventive healthcare for diverse patients.”
Postpartum screening for type 2 diabetes after a pregnancy complicated by gestational diabetes mellitus (GDM) is recommended by physicians and groups like the American Diabetes Association. But two recent studies emphasize the need for innovative approaches to encourage screening among populations who may be missing critical care.
GDM is a complication that occurs when the body does not create enough insulin during a pregnancy. It affects up to 10% of all pregnancies in the U.S. and disproportionately impacts certain racial and ethnic groups.
“All patients with GDM could benefit from postpartum diabetes screening, and we need to identify strategies that increase screening uptake,” said the studies' senior author Susan D. Brown, associate professor of internal medicine and a CHPR affiliate.
An interview with Dr. Joy Melnikow on ‘Frontline physician burnout during the COVID-19 pandemic: national survey findings’
Joy Melnikow, a CHPR affiliate and emeritus professor of family and community medicine, was interviewed by Researcher in a recent issue of the Research in Practice in General Medicine interview series, which spotlights leading researchers and how their work can affect medical practice. The interview focused on a study led by Melnikow about increased frontline physician burnout during the first year of the COVID-19 pandemic.
“Physician burnout is really important as it affects the quality of care for patients and physicians’ quality of life,” said Melnikow in the Researcher interview. “Another factor is the increased costs for health care systems because we need to train and recruit new physicians.”
CHPR statistician Andrew Padovani and health policy analyst Marykate Miller coauthored the study published in March 2022 in BMC Health Services Research.
Autism is a neurodevelopment condition affecting 1 in 44 children in the U.S. It has a wide range of characteristics with different intensities and causes. One type of autism is maternal autoantibody–related autism spectrum disorder (MAR ASD).
MAR ASD is marked by the presence of specific maternal immune proteins known as autoantibodies that react to certain proteins found in the fetal brain. The maternal autoantibodies cross the placenta and access the developing brain. Once there, they may cause changes in the way the brain develops in the offspring, leading to behaviors linked to autism.
CHPR affiliate Judy Van de Water and a team of researchers showed in a new study that autoantibody binding to nine specific combinations of proteins (known as MAR ASD patterns) successfully predicts autism in previously diagnosed children. Their study findings were published in Molecular Psychiatry.
“Previously, we identified nine patterns linked to MAR ASD. In this study, we wanted to check the accuracy of these patterns in predicting MAR ASD. To do that, we tested plasma from pregnant mothers, collected by the Early Markers for Autism study,” said Van de Water, professor of immunology and neurodevelopment at UC Davis Health.
Does dose reduction for patients on stable opioid therapy have long-term overdose and mental health risks?
CHPR researchers examined the potential long-term risks of opioid dose tapering. They found that patients on stable but higher-dose opioid therapy who had their doses tapered by at least 15% had significantly higher rates of overdose and mental health crisis in the second year after tapering compared to their pre-tapering period. Their study was published June 13 in JAMA Network Open.
“While patients may struggle during the early tapering period, we reasoned that many may stabilize with longer-term follow-up and have lower rates of overdose and mental health crisis once a lower opioid dose is achieved,” said CHPR affiliate Joshua Fenton, professor and vice chair of research in UC Davis Health's Department of Family and Community Medicine and lead author of the study. “Our findings suggest that, for most tapering patients, elevated risks of overdose and mental health crisis persist for up to two years after taper initiation.”
Fenton's coauthors are CHPR researchers Elizabeth Magnan, Iraklis Erik Tseregounis, Guibo Xing, Alicia Agnoli and Dan Tancredi.
The Davis Enterprise published an article about a UC Davis Health study in which new parents with newborns in the Neonatal Intensive Care Unit (NICU) used videoconferencing technology to watch their babies while pumping or expressing milk. The study found parents who used FamilyLink, a videoconferencing technology, to watch their babies in the NICU reported an improved experience relative to parents who did not use the technology when they pumped breast milk. FamilyLink is available to parents at all times through a secure connection on their computer or mobile device.
CHPR-affiliated researchers Laura Kair, James Marcin and Jennifer Rosenthal coauthored the study, published in Breastfeeding Medicine, with UC Davis Health colleagues Iesha Miller, Kara Kuhn-Riordon, Caroline Chantry and Kristin Hoffman. Adrienne Hoyt-Austin, assistant professor of clinical pediatrics at UC Davis Health, was the study's lead author.
A special joint research forum was hosted by CHPR and the UC Davis Perinatal Origins of Disparities (POD) Center on May 25, 2022. The forum featured brief presentations and discussions with CHPR and POD researchers on a variety of topics. Watch a video of the forum below.
The CalBridge Behavioral Health Navigator Program (the Bridge Navigator Program) is expanding access to substance use and mental health services by funding the placement of health navigators in California emergency departments.
Funding for the program, a project of The Public Health Institute’s CA Bridge, under contract with the California Department of Health Care Services, comes as drug overdose deaths doubled from 2017-2021 in California and the Centers for Disease Control and Prevention reported a record 107,000 overdose deaths across the U.S. in 2021.
CHPR faculty member Aimee Moulin, professor of emergency medicine at UC Davis Health, is co-founder of CA Bridge.
A new UC Davis study published in the Journal of General Internal Medicine shows some people may be overlooked for tobacco cessation counseling, putting them at risk for lung cancer. The study attributes the finding to the way health care providers are asking some people about their current tobacco use.
The research was conducted by three population health scientists who were affiliated with CHPR. They found that if people are asked during lung cancer screenings "Do you now smoke cigarettes?" and they answer, "not at all," they might be classified as former smokers when, in actuality, they used tobacco recently.
“Unfortunately, this screening approach can lead to misclassifying 1 in 5 former smokers eligible for lung cancer screening who may be current tobacco users,” said CHPR faculty member and senior author of the study Elisa Tong. “That means nearly 1.5 million Americans may have a missed opportunity for tobacco cessation counseling during lung cancer screening.”
What prevents family medicine physicians from providing medical abortions for patients who need them?
This is a question that UC Davis and UC San Francisco researchers explored in a new study published in the Journal of the American Board of Family Medicine. The study identified multiple barriers – including lack of training and restrictions from federal and state government as well as their institutions – that family physicians must navigate to provide abortion services to their patients.
“Family physicians are the first contact for many patients within the health care system,” said CHPR faculty member Na’amah Razon, assistant professor of family and community medicine at UC Davis Health and lead author of the study. “As such, they play a critical role in promoting better access to safe abortion options.”
CHPR and the UC Davis Comprehensive Cancer Center are co-hosting a special event as part of the CHPR Seminar Series: “Unfinished Business: The Achievable Goal of Eliminating All Tobacco Product Use in the United States by 2030.” Michael Fiore, the nation’s leading expert on smoking cessation and evidence-based guidelines, is the session's featured speaker. Fiore is the director of the Center for Tobacco Research and Intervention and professor at the University of Wisconsin School of Medicine and Public Health.
The May 18, 2022, event will be held both virtually and in person at Lecture Hall 1222 in the UC Davis Health Education Building at 4610 X Street in Sacramento.
A recent study found the odds of starting and continuing breastfeeding is significantly lower among individuals who used a combination of tobacco and illicit substances during pregnancy. Adverse health outcomes for pregnant individuals and their children have been associated with prenatal tobacco and substance use as well as with suboptimal breastfeeding.
The study examined Centers for Disease Control and Prevention data from 2016-2018 in eight U.S. states, finding 42% lower odds of breastfeeding initiation and 39% lower odds of breastfeeding continuation for at least six weeks among people with tobacco and illicit substance use during pregnancy compared to those without tobacco and illicit substance use.
CHPR faculty members Alicia Agnoli, assistant professor of family and community medicine, and Laura Kair, associate professor of clinical pediatrics, along with UC Davis’ Kathleen Groh and colleagues Nichole Nidey, Christine Wilder, Tanya E. Froehlich and Stephanie Weber from University of Cincinnati coauthored the study published in Breastfeeding Medicine.