|ACPM Headlines 1/11/14|
In this Issue
Research and Reports
1. ACPM MEETS WITH HHS OFFICIALS TO URGE SUPPORT FOR PMR PROGRAMS
ACPM senior staff met with Department of Health and Human Services (HHS) officials on December 24th to request increased funding to the Health Resources and Services Administration (HRSA) to support preventive medicine residency (PMR) training programs. ACPM executive director Mike Barry and associate executive director for policy, advocacy and external affairs Paul Bonta touted the unique dual population-based and clinical medicine training provided to preventive medicine residents and urged for an FY14 allocation from the Prevention and Public Health Fund to support PMR training programs as well as enhanced funding for PMR programs in President Obama’s FY15 budget request to Congress.
HHS is in the midst of developing its FY15 budget and reports indicate that FY14 allocations from the Prevention and Public Health Fund will be announced soon after the January 15 continuing resolution expires. ACPM will continue to identify opportunities to promote the needs of PMR training programs during key intervals of the legislative process in order to realize support for an enhanced training pipeline.
As active members of the Injury and Violence Prevention Network (IVPN), ACPM hosted a meeting with Centers for Disease Control and Prevention (CDC) director Tom Frieden, MD, MPH, and members of the IVPN to discuss the need to boost the injury and violence prevention portfolio at CDC. The IVPN is a broad-based coalition of national organizations working to build support for the CDC’s National Center for Injury Prevention and Control.
ACPM urged for greater collaboration between CDC and IVPN’s efforts to maximize opportunities aimed at promoting CDC’s injury and violence prevention agenda. Furthermore, the meeting provided an opportunity for ACPM to urge support for President Obama’s proposal to expand the National Violent Death Reporting System (NVDRS) to all 50 states. Nationwide expansion of NVDRS is one of ACPM’s legislative priorities, as NVDRS data is used by public health officials to direct and inform state violent death prevention activities.
The global death toll from the 2009 outbreak of the H1N1 virus is estimated to be ten times higher than the World Health Organization’s count, according to a study by a global research team led by the George Washington University School of Public Health and Health Services. The study, published inPLOS Medicine, suggests that the pandemic virus caused up to 203,000 respiratory deaths around the world, compared to the original WHO report of 18,449 laboratory-confirmed deaths from the 2009 flu pandemic. That estimate has been widely regarded as a low number because it is based only on people with confirmed cases of H1N1, and most infected people never got an H1N1 lab test.
To conduct the study, the research team obtained weekly virology data from the World Health Organization (WHO), which funded this study, and actual mortality data from 21 countries accounting for about 35 percent of the world’s population. They used the information to estimate the number of deaths due to the H1N1 virus. They then used a novel statistical procedure to project those results to the rest of the countries in the world.
4. ARCHIVE OF ACPM CO-SPONSORED MILLION HEARTS WEBINAR AVAILABLE
An archive of the ACPM co-sponsored webinar, "Implementing Team-Based Care: Public Health Agency and Health System Perspectives,” is now available for viewing. ACPM joined with the Association of State and Territorial Health Officials (ASTHO) in organizing the December 19th webinar touting the national Million Hearts™ initiative and Community Preventive Services Task Force recommendations on team based care for cardiovascular disease prevention. The webinar discusses the importance of implementing team-based care for cardiovascular disease management and prevention from public health, health systems and provider perspectives.
ACPM Fellow Randall Stafford, MD, PhD, FACPM, presented the health systems perspective and provided recommendations on how best to overcome barriers that inhibit widespread adoption of preventive services in primary care settings through use of case management strategies in team based care.
ACPM is pleased to announce the completion of core integrative medicine competencies to help Preventive Medicine residency (PMR) programs incorporate evidence-based integrative medicine curricula into their training. The competencies were developed by the Integrative Medicine in Preventive Medicine Education (IMPriME) Steering Committee, in collaboration with the 12 Integrative Medicine Program (IMP) Grantees funded by the Health Resources and Services Administration (HRSA).
In addition to the competencies, the IMPriME Website provides links to each of the 12 IMP Grantees, the IMPriME Community of Learning (an interdisciplinary body open to all who wish to follow the project more closely), the continuing medical education IMPriME Faculty-Development Webinar Series featuring the IMP Grantees, and other integrative medicine resources including funding opportunities.
On behalf of the ACPM leadership, President Halley Faust, MD, MPH, MA, FACPM, cordially invites all ACPM members to participate in the College’s annual business meeting to be held February 21 in conjunction with Preventive Medicine 2014 in New Orleans, LA. Hear brief reports from the ACPM President, Treasurer, Secretary, and Executive Director and engage in a town hall-style discussion about ACPM’s strategic direction, initiatives, programs, and any other issues of interest to members. Also, participate in the membership vote to adopt ACPM’s "Amended and Restated Articles of Incorporation” as presented by the Board of Regents in December. We hope to see you there!
ACPM members are invited to attend the Integrative Medicine in Preventive Medicine Education (IMPriME) Workshop, scheduled for Tuesday, February 18, 2014, from 1:00 to 5:00 pm, in conjunction with Preventive Medicine 2014 in New Orleans. The workshop, which is offered at no charge and provides 4.0 CME/MOC credit hours, will feature nine nationally and internationally recognized integrative medicine experts from across the country.
IMPriME is a two-year, HRSA-funded project focusing on the incorporation of evidence-based integrative medicine curricula into 12 accredited Preventive Medicine residency training programs funded by HRSA, known as Integrative Medicine Program (IMP) grantees. The IMPriME Center, housed within ACPM, works with HRSA and the IMPriME Steering Committee to support the work of the 12 IMP grantees, many of whom will be speaking at the Workshop.
The Workshop will be followed by a post-Workshop Meet-and-Greet at Hilton’s Drago’s Restaurant. Workshop space is limited and filling fast so please take a moment to register by going to www.imprime.org and clicking on the Workshop link. Other IMPriME/Preventive Medicine 2014 events can be found on the IMPriME website, including IMPriME’s Thursday Concurrent Session featuring National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM) Director Dr. Josephine Briggs, IMPriME Steering Committee Chair Dr. David Katz, and IMP Grantee Dr. Eden Wells.
For additional information please contact IMPriME at IMPriME@acpm.org.
The ACPM Resident Physician Section (RPS) will host its second ACPM Residency Fair on Saturday, February 22, 2014, from 12:00 pm-1:30 pm in conjunction with Preventive Medicine 2014 in New Orleans, LA.
All residency program directors, medical students, and other physicians considering or interested in residency training in Preventive Medicine are encouraged to attend. This event will provide an opportunity for residency programs to network and share program information with prospective applicants.
Residency programs may participate in the fair for only $150, which includes registration for two program representatives, one skirted, six-ft. exhibit table, and lunch. The fair is free to medical students and non-PM residents, however, registration is required. Registration is open, but space is limited so don’t miss this unique opportunity. Visit the PM 2014 website to register online today!
9. USPSTF ISSUES CANCER-RELATED RECOMMENDATION STATEMENTS AND PRODUCTS
The United States Preventive Services Taskforce (USPSTF) closed out 2013 by releasing two cancer-related final recommendation statements and one cancer-related modeling paper.
USPSTF recommends against (D recommendation) routine genetic counseling or BRCA testing in women that do not have a family history associated with an increased risk of mutations in the BRCA1 or BRCA2 genes.
On December 24, the Centers for Disease Control and Prevention’s (CDC) Health Alert Network (HAN) issued a CDC Health Advisory, Notice to Clinicians: Early Reports of pH1N1-Associated Illnesses for the 2013–14 Influenza Season. From November through December 2013, CDC received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A (H1N1) pdm09 (pH1N1) virus. Multiple pH1N1-associated hospitalizations, including many requiring intensive care unit (ICU) admission, and some fatalities were reported.
The HAN notes that, "While annual vaccination is the best tool for prevention of influenza and its complications, treatment with antiviral drugs (oral oseltamivir and inhaled zanamivir) is an important second line of defense for those who become ill to reduce morbidity and mortality. Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who is hospitalized; has severe, complicated, or progressive illness; or is at higher risk for influenza complications.”
The Centers for Disease Control and Prevention (CDC) is closely following reports of the mosquito-borne chikungunya virus among residents of a number of Caribbean islands, including Martinique, St. Martin, Saint Barthelemy, French Guiana and Guadeloupe.
Chikungunya is an illness caused by a virus that spreads through mosquito bites. The virus is not spread person-to-person. As of January 3, 2014, there had been 123 confirmed cases in the Caribbean, according to the French Health Ministry.
CDC estimates that about 9 million U.S. residents travel to the Caribbean each year. Given the volume of travelers, chikungunya could occur more frequently in returning U.S. mainland travelers if the virus expands in the region. There currently is no vaccine or medicine to prevent chikungunya. CDC recommends that travelers use appropriate insect repellants, wear long-sleeved shirts, long pants and hats, use a bed net, and stay and sleep in air-conditioned rooms.
12. USE OF BREAST MRI NEARLY TRIPLES
The number of women using magnetic resonance imaging (MRI) nearly tripled from 2005 to 2009, according to a new study in JAMA Internal Medicine led by researchers at Group Health Research Institute in Seattle and the University of Washington School of Public Health. The study is believed to be the first large-scale report of its kind on how women are using breast MRI.
Researchers collected data on nearly 9,000 breast MRIs and more than 1.2 million screening mammograms from five national Breast Cancer Surveillance Consortium registries. They found the overall rate of breast MRI for the four-year-period increased from 4.2 to 11.5 examinations per 1,000 women.
Breast MRI is recommended in addition to x-ray mammography to screen women at high risk for developing breast cancer during their lifetimes. The vast majority of women at high lifetime risk are using only mammography for screening. Meanwhile, the study found that many women at average risk for breast cancer were screened using breast MRI, even though mammography still is considered the best screening test for them.
Fast food consumption is not independently associated with overweight and obesity rates among children in the United States, according to a study by researchers at the University of North Carolina at Chapel Hill. "The Association of Fast Food Consumption with Poor Dietary Outcomes and Obesity Among Children: Is it the Fast Food or the Remainder of Diet?” found that a child’s diet outside of his/her consumption of fast food is independently associated with his/her health outcomes.
Using National Health and Nutrition Examination Survey (NHANES) data, researchers found that western dietary patterns, poor in fresh fruits and vegetables, are more likely to contribute to poor overall intake than the amount of fast food consumption. Despite these findings, the authors recognize that more studies are needed to confirm these hypotheses.
About a quarter (24.8%) of U.S. youth 12-15 years of age engage in 60 minutes of daily moderate to vigorous physical activity, meeting federal physical activity guidelines, according to new data from the Centers for Disease Control and Prevention’s National Center for Health Statistics. Data in the report, Physical Activity in U.S. Youth Aged 12-15, 2012, are based on findings from a new data collection—the NHANES National Youth Fitness Survey—conducted in conjunction with the National Health and Nutrition Examination Survey (NHANES) in 2012 to obtain data on physical activity and fitness levels in children and teens.
Although not a statistically significant difference, 27.0% of boys and 22.5% of girls engaged in moderate-to-vigorous physical activity for 60 minutes or more on every day of the week in 2012.
U.S. youth engaged in a wide range of physical activities outside of school-based physical education and gym classes, including basketball, football, running, and dancing. In fact, almost one-half of all U.S. boys aged 12–15 years who reported activities outside of gym classes reported playing basketball during the previous week.
15. AHRQ TO HOST WEBINAR ON IMPLEMENTING HEALTH ASSESSMENTS IN PRIMARY CARE
The Agency for Healthcare Research and Quality’s (AHRQ) Prevention and Chronic Care Program and Practice-Based Research Network Resource Center are hosting a live webinar, "Implementing Health Assessments in Primary Care: A How-to Guide,” Wednesday, January 15, 12:30-2:00 pm EST. During this webinar, the presenters will discuss a new evidence-based guide, released byAHRQ, which was developed for primary care doctors, nurse practitioners and physician assistants on how to successfully select, adopt and implement health assessments (HA) in primary care settings.
The presenters will describe how this new guide,Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff,may be used to help clinicians decide which health assessments to use, how to integrate them into their daily workflow, and how to engage patients. The presenters alsowill illustrate how this guide may be used to facilitate the effective implementation and use of HA in primary care. This guide is especially useful in the context of the implementation of the Affordable Care Act (ACA): the ACA authorizes Medicare coverage of annual wellness visits and specifies that a health risk assessment be included as part of those visits.
Click here to register. Registration does not guarantee webinar attendance. Please join the webinar early to ensure your attendance.