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RPS Newsletter July 2010
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In This Issue:
The State of Sodium in Our Diets: A Review of Recent Action
ACGME Releases New Duty Hour Proposal
Funding Prevention in Health Reform
New National Prevention, Health Promotion, and Public Health Council
ACPM Mentoring Program
Upcoming Events
The State of Sodium in Our Diets:
A Review of Recent Action
By Samuel Peik

In the last several months, there have been many reports, guidelines, and initiatives reported which tackle the subject of salt in the American diet. Below is a summary of the major recent items with some helpful resources.

New York City Health Department: National Salt Reduction Initiative

On January 11, the NYCHD announced a partnership of over 40 cities, states, and health organization nationwide for a voluntary reduction of sodium in packaged and restaurant foods. This public-private collaboration provides a comprehensive framework and method for monitoring progress with an overall goal of reducing Americans' salt intake 20% by 2014. To date 16 companies have signed onto the initiative including Au Bon Pain, Heinz, Kraft, Mars, Starbucks, and Subway.

Institute of Medicine Report: Strategies to Reduce Sodium Intake in the United States

On April 20, the IOM released a report with a goal "reduce the sodium content of the food supply in a way that goes unnoticed by most consumers as individuals' taste sensors adjust to the lower levels of sodium." The IOM proposed five strategies to accomplish this:
  1. FDA set mandatory national standards for sodium content
  2. Food industry act voluntarily to reduce sodium content of foods
  3. Other agencies and organizations support reduction of sodium levels
  4. Public-private partnerships conduct augmenting activities
  5. Enhance monitoring and surveillance, ensure timely release of data
Report of the DGAC on the Dietary Guidelines for Americans, 2010

On June 10, the USDA Dietary Guidelines Advisory Committee released a preliminary report on new dietary guidelines for the US. In 2005 the DGAC recommended daily sodium intake of less than 2,300 mg for adults and 1,500 mg for targeted population. However, since these targeted groups (hypertensives, blacks, middle-age and older adults) comprise nearly 70% of the US population, the new recommendation is to use 1,500 mg as the goal for the general adult population.
 
Sodium Intake Among Adults - US 2005-2006

On June 25, the CDC MMWR published data from the NHANES survey that estimated only 9.6% of adults met their recommendation for sodium intake during this period. They estimated that 77% of dietary sodium comes from processed and restaurant foods. The top 5 contributors to sodium intake were: 1) yeast breads, 2) chicken and mixed chicken dinners, 3) pizza, 4) pasta dishes, and 5) cold cuts.

For more information visit the following websites:

NYCHD: http://www.nyc.gov/html/doh/html/cardio/cardio-salt-initiative.shtml





ACGME Releases New Duty Hour Proposal
By Samuel Peik

The Accreditation Council for Graduate Medical Education (ACGME) recently published new recommendations for resident duty hours in the June 24th edition of NEJM. While the actual changes are quite detailed, a summary of the five most interesting and important changes to the current guidelines is listed below. In general, the guidelines decrease call length and provide graduated responsibility, but not all of them meet the recommendations set by the 2008 IOM report. Changes, if approved, will go into effect July 2011.
  1. No change to the weekly maximum 80 work hours (averaged over 4 wks)
  2. Change in maximum length of duty period

a) Continuity clinic is no longer allowed after 24 hour call
b) 'Protected nap time' recommended by IOM not included
  1. Time off between duty periods changed slightly, but generally still 10 hours
  2. Can still average days off over 4 wks (IOM: no averaging and add one golden weekend)
  3. Creation of graduated resident roles with three levels of supervision
The full article, which compares the current and proposed standards with the IOM report, can be read at http://content.nejm.org/cgi/content/full/NEJMsb1005800?query=TOC.

The official ACGME website on the proposed standards can be visited at http://acgme-2010standards.org/. You can comment on the changes by selecting Proposed Standards and commenting in the desired category. The comment period is open until August 2010.

RPS will be officially commenting on the new duty hour proposals after a thorough review of the recommendations.


Funding Prevention in Health Reform
by Charlie Preston

The new health law, the Affordable Care Act (ACA), created a Prevention and Public Health Fund. As the name suggests, the fund will dedicate $15 billion to prevention and public health activitiesover the next 10 years, with $500 million to be disbursed in 2010.

This month, HHS released more details about how that money will be spent. $250 million will go to prevention and public health activities in four core areas:community and clinical preventive services, public health infrastructure, research and tracking, and public health training (see chart below).



The other $250 million will fund a primary care workforce expansion, including more training of primary care physicians, nurses, and physician assistants.

It should be noted that the primary care workforce appropriation was controversial, as key Members of Congress and public health advocates voiced concern about the use of the Prevention and Public Health Fund for primary care. Henry Waxman, Chairman of Energy and Commerce in the House, said, "Prevention and public health, as well as manpower, are things we need to support, not have them compete against [each] other...". Other legislators voiced similar concerns and preferred separate funding for prevention and primary care workforce initiatives.

For more information on the prevention and public health appropriation, visit: http://www.healthreform.gov/newsroom/acaprevention.html

For workforce, visit: 
http://www.healthreform.gov/forums/blog/workforce.html

And for a link to the story on the controversy, visit: http://www.govexec.com/dailyfed/0610/061710cdam1.htm

New National Prevention, Health Promotion, and Public Health Council
By Charlie Preston

The Affordable Care Act established a National Prevention, Health Promotion, and Public Health Council, chaired by the Surgeon General, and composed of Cabinet Secretaries from relevant agencies like Agriculture, Education, and Transportation. The task of the Council is to coordinate and develop prevention and wellness policy at the federal level. They will do this through annual reports to Congress and through a national strategy. The first report was released in June and can be read here: http://www.healthreform.gov/forums/blog/preventioncouncil.html

The national strategy is to be released no later than March of 2011. In addition to the Council, an advisory group will be formed, and include 25 people who are representative or have expertise in: worksite health promotion, community services (e.g. community health centers), preventive medicine, health coaching, public health education, geriatrics, and rehabilitation medicine.

ACPM Mentoring Program
By Clarence Lam

Finding appropriate mentors in preventive medicine can be particularly challenging because of the diversity of interests and fields within the specialty. However, mentorship in preventive medicine may prove to be more important in physician development than in a clinical specialty precisely because the variety of available career paths can be perplexing and even frightening.

ACPM recognizes these challenges and has created a tool to help link residents with physician mentors. The ACPM Mentoring Program is available to residents who log in to their member accounts on the ACPM website. To find the Mentoring Program, access the ACPM Members-Only section at https://www.acpm.org/members/default.cfm, login-in with your Last Name and Member ID Number, then click the "ACPM Mentoring Program" link. Users of the database can search for mentors by organization, location, gender, board-certified specialty, occupational setting, or areas of interest.

RPS hopes that residents will find the ACPM Mentorship Database to be a useful tool in searching for potential mentors.

Upcoming Events
By Christine David

Conferences:

 

2010 International Conference on Emerging Infectious Diseases (CDC)
July 11 - 14, 2010

Location: Atlanta, GA

To find out more, go to www.iceid.org

National Association of Local Boards of Health (NALBOH) Annual Conference
August 5-7, 2010
Location: Omaha, NE

At the conference, "Journey to the Future: Facing Public Health Challenges Today for a Healthier Tomorrow," attendees will learn the latest developments in public health governance, as well as share their knowledge and network with an enthusiastic group of attendees. The conference features workshops and breakout sessions in board governance, community health, environmental health, emergency preparedness and leadership team.

 

Read more at www.nalboh.org/NALBOH_Conference.htm.

Early Childhood 2010:Innovation for the Next Generation (HHS/USDOED)
August 3 - 4, 2010

Location: Washington, D.C
For more info, go to http://www.earlychildhood2010.org



Call for Abstracts:

Midwest Agricultural Safety and Health Forum Call for Abstracts
Deadline: July 7, 2010

Abstracts are currently being accepted for research, education and outreach presentations at the Midwest Rural and Agricultural Safety and Health Forum, to be held November 17-18 at Hotel Vetro in Iowa City, Iowa.

 

Contact Abby Harper at abbyharper@ uiowa.edu if interested.

Maternal Child Health Epidemiology Conference Call for Abstracts
July 30, 2010

Maternal and Child Health Epidemiology (MCH EPI) conference organizers invite all first year/new fellows, interns, trainees and CDC EIS Officers to join other researchers and professionals working on issues related to improving the health of women, children and families in sharing research, enhancing knowledge and generating new ideas for improved MCH data use and informed policymaking in San Antonio, TX from December 15-17.

For more information, refer to the June 18thASPH Friday Letter the corresponding link.


Lectures:

CDC Public Health Grand Rounds - Child Survival (CDC)
July 15, 2010

Time: 9:00 am - 10:15 am (Eastern Time)

Watch live and archived broadcasts at: www.cdc.gov/about/grand-rounds


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