Tuesday, September 30, 2025

THE BOTTOM LINE

Hospitals with resuscitation care units save lives, shorten stays and cut costs




First study to show that an emergency-department RCU's not only benefits patients, but improves ED efficiency, how care is documented, and reimbursed




Boston University School of Medicine





(Boston)—Resuscitation Care Units (RCUs) provide intensive, comprehensive and immediate medical care for critically ill patients with life-threatening conditions, such as cardiac arrest, requiring specialized monitoring and rapid intervention from a multidisciplinary team. Many studies have shown that creating these special high-acuity areas in an emergency department, can save lives and improve patient outcomes. However, questions about financial sustainability have slowed adoption of these units.

 

A new study by researchers at Boston University Chobanian & Avedisian School of Medicine and UMass Chan Medical School has found these dedicated units not only benefitted patients, but resulted in improved efficiency, documentation and reimbursement costs for the hospital.

 

“For patients, RCUs mean that the sickest people in the emergency department receive faster, more focused care from specially trained teams. For the health system, it means this approach can pay for itself, because the billing better matches the real work being done; which makes it more likely that hospitals will be willing to adopt these units, which in turn can improve emergency care for everyone,” explains corresponding author Michael Sherman, MD, MA, FACEP, assistant professor of emergency medicine & critical care medicine at the school.

 

The researchers performed a retrospective review of approximately 75,000 emergency visits at

UMass Memorial Medical Center, a busy urban hospital. They compared the 35 weeks before and after the institution opened a nine-bed RCU in July 2019. They reviewed the billing codes (which reflect the intensity of care) and revenue from those visits and then compared the patterns with a nearby hospital in the same system that didn’t have an RCU. This novel study showed a strong association with RCU’s and improved ED efficiency and coding, representing more accurate reimbursement for these units and demonstrating the fiscal sustainability of the model.

 

According to the researchers, RCU’s are known to decrease the need for ICU admission, shorten hospital and intensive care unit stays and cut direct costs by preventing illness from worsening. “By centralizing care for the sickest patients, RCUs help doctors and nurses deliver antibiotics, fluids and other lifesaving treatments faster, while freeing ICU beds for patients who need longer-term care,” adds Sherman who also is an emergency & critical care physician at Boston Medical Center.
 

Beyond money and coding, the study suggests that changing how emergency departments are organized can improve care and efficiency.  “It shows that small changes in workflow (like staffing ratios and dedicated space) can have a big impact without building a whole new department or building,” says Sherman.

 

These finding appear online in the Western Journal of Emergency Medicine.

 

 

Soldiers deployed to a war zone adversely affects intimate partners, long after the service member has returned home



Mental health prevention and treatment for at risk populations should include the health and well-being of family members.



Boston University School of Medicine





(Boston)—Military conflict has led to heightened risk of cognitive problems in performing day-to-day activities among some war zone Veterans, which can result in increased burden on family members.

 

In a new study, researchers have found deployment to a combat zone may adversely affect not only service members but their intimate partners, with such effects enduring long after the service member has returned home. Specifically, this finding was attributable to posttraumatic stress disorder (PTSD) with symptoms including difficulty with memory and concentration among other symptoms.

 

“Prolonged stress may contribute to the later development of caregiver burden, negative mental health outcomes for the intimate partner and poor relationship quality with their partners. Understanding risk factors for partner stress, including changes over time in war zone Veteran’s cognitive functioning, is therefore warranted,” explains corresponding author Jennifer Vasterling, PhD, chief of psychology at VA Boston Healthcare System and professor of psychiatry at Boston University Chobanian & Avedisian School of Medicine.

 

The researchers followed a nationally dispersed sample of U.S. Army soldiers from before their first deployment to the Iraq War across a period that spanned an average of eight years from when they returned administering a four-item version of the Medical Outcomes Study Cognitive Functioning scale to measure self-perception of cognitive-related functioning. Their partners were administered the Everyday Stressors Index—a 20-item self-report measurement that has been used within military deployment contexts to evaluate the impact of the day-to-day stressors experienced by family members of deployed individuals.  These stress indicators include role overload, employment problems and parenting worries five years after their return from deployment.

 

In studying war zone Veterans from pre-deployment to an assessment eight years later, researchers found that a decline in Veterans’ self-reported cognitive functioning in day-to-day activities was associated with higher levels of stress among their intimate partners.

 

According to the researchers, better understanding of the nature of war zone Veterans’ psychological symptoms, cognitive-related functional difficulties, and partner stress will help mitigate difficulties for both war zone Veterans and their partners. “While this research was built around a military sample, it speaks to the broader potential negative impacts of trauma exposure, not only to the person experiencing PTSD, but also on their family and suggests the need to provide support to family members of people experiencing PTSD.”

 

These findings appear online in the journal Psychological Trauma: Theory, Research, Practice, and Policy.

 

Funding for this study was provided by the National Institute of Mental Health, National Institutes of Health

(Grant 1R01MH094422-01A1), awarded to Jennifer J. Vasterling. Support for previous collection of archived data used in the study analyses was provided by the U.S. Army Medical Research and Materiel Command (Grant

DAMD17-03-0020) and the U.S. Department of Veterans Affairs Clinical Science Research and Development awarded to Jennifer J. Vasterling.

 

Misinformation/disinformation leads to US couples’ divorces, breakups



How divisiveness in the public sphere is affecting Americans' private lives



 

University of Illinois at Urbana-Champaign, News Bureau

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image: 

People interviewed in a new study by communication professor Emily Van Duyn said that online misinformation/disinformation, conspiracy theory groups and their former partners’ rabbit-holing behaviors caused insurmountable rifts in their relationships that ultimately led to their divorces or breakups.

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Credit: Photo by L. Brian Stauffer




 

Many older adults – especially Gen X women – show signs of addiction to ultra-processed foods




Adults age 50 to 80 who meet criteria for an addiction to ultra-processed foods are far more likely to report being overweight, or being in fair or poor mental or physical health



Michigan Medicine - University of Michigan






They were the first generation of Americans to grow up with ultra-processed foods all around them – products typically loaded with extra fat, salt, sugar and flavorings. They were children and young adults at a time when such products, designed to maximize their appeal, proliferated.

Now, a study shows, 21% of women and 10% of men in Generation X and the tail end of the Baby Boom generation, now in their 50s and early 60s, meet criteria for addiction to these ultra-processed foods.

That rate is far higher than it is among adults who grew up just a decade or two earlier, and only encountered ultra-processed foods in adulthood. Among adults age 65 to 80, just 12% of women and 4% of men meet criteria for ultra-processed food addiction.

The study, published in the journal Addiction by a team from the University of Michigan, is based on nationally representative data from more than 2,000 older Americans surveyed by the U-M National Poll on Healthy Aging.

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by Michigan Medicine, U-M’s academic medical center. The new paper builds on a previous poll report by diving deeper into generational differences and correlations with health.

Measuring food addiction in an under-studied group

The researchers used the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), a standardized tool adapted from the criteria used to diagnose substance use disorders. The scale asks about 13 experiences with ultraprocessed foods and drinks that define addiction, such as strong cravings, repeated unsuccessful attempts to cut down, withdrawal symptoms, and avoiding social activities because of fear of overeating.

In this case, the “substance” is not alcohol or nicotine, but highly rewarding ultra-processed foods such as sweets, fast food, and sugary beverages. By applying clinical addiction criteria to ultra-processed foods, the study highlights the ways in which such foods can “hook” people.

“We hope this study fills a gap in knowledge about addiction to ultra-processed foods among older adults, as measured by a well-studied and standardized scale,” said Lucy K. Loch, a graduate student in the U-M Department of Psychology. “Today’s older adults were in a key developmental period when our nation’s food environment changed. With other research showing clear links between consumption of these foods and risk of chronic disease and premature death, it’s important to study addiction to ultra-processed foods in this age group.”

Differences by gender

Unlike traditional substance use disorders — which historically have been more common in older men — ultra-processed food addiction shows the opposite pattern: higher prevalence in older women.

One explanation may be the aggressive marketing of “diet” ultra-processed food to women in the 1980s.

Low-fat cookies, microwaveable meals, and other carbohydrate-heavy products were promoted as weight-control solutions, but their engineered nutrient profiles may have reinforced addictive eating patterns.

Women now aged 50 to 64 may have been exposed to ultraprocessed foods during a sensitive developmental window, which may help explain the poll’s findings for this age group, said senior author Ashley Gearhardt, Ph.D., a professor of psychology at U-M and member of IHPI. Gearhardt leads the U-M Food and Addiction Science & Treatment Lab.

“The percentages we see in these data far outpace the percentages of older adults with problematic use of other addictive substances, such as alcohol and tobacco,” said Gearhardt. “We also see a clear association with health and social isolation, with much higher risks of ultra-processed food addiction in those who call their mental or physical health status fair or poor, or say they sometimes or often feel isolated from others.”

Key findings related to overweight, health status and social isolation

  • Overweight self-perception:
    • Women aged 50 to 80 who said they are overweight were more than 11 times as likely to meet criteria for ultra-processed food addiction than women who say their weight is about right. Men who reported being overweight were 19 times as likely.
    • No matter what their age, 33% of women who described themselves as overweight, 13% of women who described themselves as slightly overweight and 17% of men who described themselves as overweight met criteria for addiction to ultra-processed foods. Of the total sample, 31% of women and 26% of men in the sample said they were overweight and 40% of women and 39% of men said they were slightly overweight.
  • Health status:
    • Men reporting fair or poor mental health were four times as likely to meet criteria for ultra-processed food addiction; women were nearly three times as likely.
    • For physical health, men reporting fair or poor health were three times as likely to meet criteria for ultra-processed food addiction, and women were nearly two times as likely.
  • Social isolation: Men and women who reported feeling isolated some of the time or often were more than three times as likely to meet criteria for ultra-processed food addiction as those who did not report isolation.

The researchers suggest that individuals who perceive themselves as overweight may be particularly vulnerable to “health-washed” ultra-processed foods – those marketed as low-fat, low-calorie, high-protein or high-fiber, but still formulated to amplify their appeal and maximize craving.

“These products are sold as health foods – which can be especially problematic for those trying to reduce the number of calories they consume,” Gearhardt said. “This especially affects women, because of the societal pressure around weight.”

Looking Ahead

The generation of older adults now in their 50s and early 60s is the first to live most of their lifespan in a food environment dominated by ultra-processed foods, Geahardt noted.

“These findings raise urgent questions about whether there are critical developmental windows when exposure to ultra-processed foods is especially risky for addiction vulnerability,” she said. “Children and adolescents today consume even higher proportions of calories from ultra-processed foods than today’s middle-aged adults did in their youth. If current trends continue, future generations may show even higher rates of ultra-processed food addiction later in life.”

She added, “Just as with other substances, intervening early may be essential to reducing long-term addiction risk across the lifespan.”

About the study

The study was funded by a National Science Foundation Graduate Research Fellowship Program (DGE-2241144) and the National Institute on Drug Abuse of the National Institutes of Health (5R01DA055027).

In addition to Loch and Gearhardt, the study’s co-authors are Matthias Kirch, M.S., Dianne C. Singer, M.P.H, Erica Solway, Ph.D., M.S.W., M.P.H., J. Scott Roberts, Ph.D. and poll director Jeffrey T. Kullgren, M.D., M.P.H., M.S. Roberts is a member of the faculty at the U-M School of Public Health, and Kullgren is a member of the faculty in the U-M Medical School and a primary care physician at the VA Ann Arbor Healthcare System.

Learn more about the National Poll on Healthy Aging, including methodology, at https://www.healthyagingpoll.org/

 

Citation: Ultra-processed food addiction in a nationally representative sample of older adults in the USA, Addiction, DOI: 10.1111/add.70186, https://doi.org/10.1111/add.70186