|ACPM Headlines 2/4/11|
Policy and Practice
Research and Reports
ACPM President’s Column
When I was in college I had the good fortune of living in Tanzania, East Africa, for a year. While there, I was occasionally asked to "guide” visitors through some of the world-famous national parks and game reserves in that area, including Serengeti, Lake Manyara, Amboseli (actually in Kenya) and the Ngorongoro Crater. Having the opportunity to observe the many varieties and species of animals in their natural habitat was an experience I will always treasure!
Serengeti National Park is famous for its vast plains covered with herds of migrating grassland antelopes, including wildebeests (gnus), hartebeests and various gazelle species. Several times while observing these animals we saw lions attack and kill one or two of the young or straggling members of the herds. What fascinated me at the time was how other antelope would watch curiously from a fairly close distance or nonchalantly graze near the kill site while the lions finished off their recently deceased colleagues. They seemed to sense that in this game of chance they were now safe.
I was reminded of this later when I lived in Los Angeles. The daily commute to work on the L.A. freeway system was also a community game of chance. We would all drive as fast as we could, sensing that sooner or later someone would get into a crash and we’d all have to stop and probably be late to our appointments. Then we’d curiously crawl empathetically around the crash site and speed off again on our important business, thankful, for the moment that we were safe.
With a highly probable impending disaster, no individual antelope or Angelino ever seemed to feel that they were going to be the next victim. There was no need to change behavior. After all, what are the odds of getting killed when there are thousands of other wildebeests around or 10 million other crazy drivers on the freeway? (While it is well known in the animal kingdom that antelope are very poor at performing the Mantel-Haenszel test, I believe that at a primitive gut level they are pretty good at figuring out odds ratios.)
It seems that we’ve built risk denial into many of our cultural rituals and even base public policy on it. For example, we know that there are individuals among us who cannot tolerate the use of alcohol, but we bet that it won’t be us or one of our family members, and therefore we joke about how much college students drink, glorify the use and abuse of alcohol on television and in the movies, and set policies around its sale and distribution that we know won’t really keep it away from the kids. Similar arguments could be made for such things as cigarettes, handguns, marijuana use, unprotected sexual activity and the use of bicycle or motorcycle helmets. We curiously, and perhaps empathetically, watch as the young or the stragglers are destroyed, but quickly speed off again on our important business as soon as we can.
1. UPDATED DIETARY GUIDELINES FOR AMERICANSRELEASED
The U.S. Department of Agriculture (USDA) and Department of Health and Human Services (HHS) have announced the release of the2010 Dietary Guidelines for Americans. The guidelines serve as the federal government’s recommendations for nutrition and physical activity and represent the 7thedition, updating recommendations from 2005. A congressional mandate requires the guidelines to be updated every five years.
The 2010 edition of theDietary Guidelinesencompass two broad themes: 1) "Maintain calorie balance over time to achieve and sustain a healthy weight,” and 2) "Focus on consuming nutrient-dense foods and beverages.” The current guidelines have placed a greater emphasis on reduced calorie consumption and physical activity, encouraging Americans to consume more healthy foods and less sodium, solid fats, added sugars, and refined grains.
A "next generation” Food Pyramid is planned for release in the next few months, along with several other consumer tools. For more information on the newDietary Guidelines, you can view the full report athttp://www.cnpp.usda.gov/DietaryGuidelines.htm.
2. ACPM LAUNCHES TIME TOOL ON PRESCRIPTION PAIN MEDICATION USE, ABUSE, AND DISPOSAL
To address a gap in physician knowledge and education on use and abuse of pain medications, ACPM has launched its latest Time ToolTMfor clinicians, "Use, Abuse, Misuse and Disposal of Prescription Pain Medication." Developed with an unrestricted grant from Purdue Pharma, the tool provides concise, easily digestible, evidence-based provider and patient education on a topic of rapidly growing importance.As many as 7 million people abuse or misuse prescription drugs every month, including 5.3 million who abuse/misuse pain relievers.
The Time Tool describes the risks of prescription medications, providing examples of abuse, the impact of the problem, and how the clinician can work with the patient to ensure proper storage, use, disposal, and abuse avoidance. To access the Time Tool, visit http://www.acpm.org/timetools/ and click on "Other Time Tools."
This Time Tool is the first in a series of three related tools ACPM is developing on medication adherence and abuse, including both prescription and over-the-counter medications. Look for release of the upcoming tools on medication adherence and use, misuse, abuse, and storage of OTC medications—supported by unrestricted grants from PhRMA and the Consumer Healthcare Products Association, respectively—in the coming weeks.
3. ACPM ASKS FOR $20 MILLION TO SUPPORT PMR PROGRAMS
ACPM presidentMark Johnson, MD, MPH, FACPM,recently sent a letter to Health and Human Services Secretary Kathleen Sebelius urging the administration allocate $20 million from the Prevention and Public Health Fund to expand support at the Health Resources and Services Administration (HRSA) for preventive medicine residency (PMR) training programs. Last year, HRSA disbursed $9 million to PMR training programs by combining the $7 million received through the American Recovery and Reinvestment Act (ARRA) and the $2.3 million in FY 2010 baseline funding provided to HRSA.
In the letter Dr. Johnson noted, "Prevention is increasingly mentioned as a vital strategy to combat the current health care issues, and preventive medicine training support is essential to ensure the public health needs of the nation are adequately addressed. Proper implementation of health reform, deliverance of Health People 2020 goals, implementation of the National Prevention Strategy and realizing the goal established by the Department of Health and Human Services (HHS) that calls on "all Americans to live healthier, more prosperous, and more productive lives” could be greatly enhanced by ensuring the proper expertise and workforce is available to tackle these profound challenges.”
To view the ACPM letter please visit, http://www.acpm.org/HHS-NHSC-Ltr.pdf
4. ACPM CONVENES SUCCESSFUL WEBINAR ON LIFESTYLE MEDICINE AND EMPLOYEE WELLNESS
ACPM on January 26 hosted a highly successful webinar, Lifestyle Medicine Approaches to Effective Employer Health and Wellness Initiatives, which drew over 275 registrants from across the country.
The session featured presentations by ACPM Lifestyle Medicine Task Force Chair Dr. Liana Lianov, ACPM member Dr.Dexter Shurney of Vanderbilt University and Medical Center, and Shawn Leavitt of Safeway. The program, supported by an unrestricted grant from EHE International, focused on the lifestyle medicine definition, competencies, and rationale for development of the competencies; how such competencies can translate to or be integrated with employee wellness programs; actionable steps employers can take to promote the physician-patient dialog around lifestyle interventions, prescriptions, and action plans as a first line of therapy; and resources employers and others can use and share with their constituents to improve medical care, disease prevention, and health promotion practices. Dr. Lianov engaged the audience and moderated a stream of insightful comments and questions.
If you missed the live event, you can still view the archived version and earn free CME/MOC credit. The archive will be available soon on ACPM’s website, so stay tuned for an announcement in an upcoming edition of ACPM Headlines.
5. ACPM TO RELEASE UPDATED MOC PART IV TOOLS AND GUIDELINES
If you are a recertifying ABPM Diplomate, keep an eye out for the newly updated MOC Part IV tools, guidelines and schedule due to be released in late February. The updated tools have been designed for greater convenience and clarity for those seeking recertification.
Find out more about ACPM’s MOC Program at http://www.acpm.org/education/moc_descr.htm
If you have questions about the MOC Part IV process, please email firstname.lastname@example.org check out the two dedicated sessions atPreventive Medicine 2011.
Policy and Practice
6. PRESIDENT NAMES MEMBERS OF ADVISORY GROUP ON PREVENTION, HEALTH PROMOTION, AND INTEGRATIVE AND PUBLIC HEALTH
ACPM past-president Jonathan Fielding, MD, MPH, FACPM was recently appointed by President Obama to the federal Advisory Group on Prevention, Health Promotion, and Integrative and Public Health. The group, created as part of the Patient Protection and Affordable Care Act (ACA), will advise the National Prevention, Health Promotion, and Integrative and Public Health Council in its charge to draft a National Prevention Strategy. The Council is chaired by Surgeon General, RADM Regina Benjamin, MD, who will be addressing and engaging with preventive medicine physicians around the Strategy at Preventive Medicine 2011 in San Antonio this month as part of the ACPM Town Hall forum.
ACPM successfully advocated for a provision that was included in the ACA calling for inclusion of a preventive medicine physician on the advisory group.
To view a full roster of the advisory group please visit http://bit.ly/fRPtoQ.
7. USPSTF ISSUES FINAL RECOMMENDATIONS FOR VISION SCREENING IN CHILDREN
The U.S. Preventive Services Task Force (USPSTF) has released a final recommendation for vision screening in children ages 1-5. The task force now recommends, with a "B” rating, screening for all children at least once between the ages of 3-5 to detect amblyopia or its risk factors (including strabismus). The task force also concluded, with an "I” rating, that current evidence is insufficient to assess the balance of benefits and harms of vision screening in children <3 years of age. This updates the USPSTF 2004 recommendation, which recommended screening for all children <5 years of age.
The recommendation is available on the USPSTF website at http://www.uspreventiveservicestaskforce.org/uspstf/uspsvsch.htm.
8. HOUSE ENDORSES NON-SECURITY SPENDING CUT
The House of Representatives adopted a resolution (H.Res. 38) requiring House Budget Committee Chair Paul Ryan (R-WI) to publish in the Congressional Recorda spending ceiling for the remainder of FY 2011 that assumes non-security spending at or below FY 2008 levels.
Although the resolution does not define non-security spending, the Administration and various lawmakers have used the term to exclude funding for defense, homeland security, and veterans affairs. House Republican leaders informally have suggested reducing non-security spending to FY 2008 levels for the remainder of the current fiscal year, which could net $55 billion to $60 billion in savings.
9. FDA WITHDRAWS MENU LABELING DRAFT GUIDANCE
The Food and Drug Administration (FDA) has withdrawn its draft guidance for industry regarding the menu labeling provisions in the Patient Protection and Affordable Care Act (ACA). Section 4205 of the ACA authorized federal menu labeling requirements, and requires the FDA to issue regulations by March 23, 2011. The draft guidance was intended to create nonbinding recommendations to assist restaurants and retail food establishments in complying with the law. However, draft guidance only represents the agency’s "current thinking” on a topic and differs from official regulations.
The agency stated it wants to "minimize uncertainty and confusion” by focusing on finalizing the enforceable regulations before providing official guidance on how to meet the ACA requirements. This stems at least in part from the results of comments on the draft guidance, and signals intent to focus instead on the rulemaking process. The withdrawal does not change the statutory requirements on menu labeling contained in the ACA.
The official statement from the FDA along with the withdrawn comments can be viewed at http://ow.ly/3PWl7.
Research and Reports
10. SURGEON GENERAL ISSUES CALL TO ACTION TO SUPPORT BREAST FEEDING
Surgeon General Regina M. Benjamin has releasedThe Surgeon General's Call to Action to Support Breastfeeding,which provides a list of 20 key action steps to improve support for breastfeeding.
The strategies aim to reduce inequities in the quality of health care and health information mothers and babies receive, and improve the support and accommodations families receive in employment and community settings.
The full report is available here: http://ow.ly/3PWpe.
Be sure to catch the Surgeon General at the ACPM Town Hall forum atPreventive Medicine 2011on Friday, February 18th at 12pm. Haven’t registered? There is still time—visit www.preventivemedicine2011.org for more information.
11. BRIDGING THE GAP: RESEARCH INFORMING PRACTICE FOR HEALTHY YOUTH BEHAVIOR
The Robert Wood Johnson Foundation has released the latest in a series of reports from Bridging the Gap: Research Informing Practice for Healthy Youth Behavior, a multisite, multidisciplinary research program. The program is dedicated to improving health outcomes by increasing knowledge of how laws, policies, practices, programs and other environmental influences at the state, community and school levels affect youth behaviors.
The current report, focused on substance abuse, found:
·Higher cigarette prices and strong smoke-free air policies reduce smoking by youth.
·Exposure to anti-smoking advertising sponsored by tobacco companies is associated with increases in youth smoking.
·Zero-tolerance laws targeting underage drinking and driving reduce that combination of behaviors, but they do not reduce youth drinking.
·Drug testing in schools does not reduce drug use among students.
To read the full report, please visit http://www.rwjf.org/files/research/BTG.final.pdf.
12. EPA SEEKING NOMINATIONS FOR NATIONAL ASTHMA AWARD
The U.S. Environmental Protection Agency currently is accepting applications for the 2011 National Environmental Leadership Award in Asthma Management. If you are a health plan, health care provider or community in action that has demonstrated leadership in managing environmental asthma triggers as part of your comprehensive asthma management program, apply to receive recognition for your important work. Applications are due March 1, 2011. For more information, visit www.AsthmaAwards.info.
13. APPLICATIONS BEING ACCEPTED FOR PHYSICIAN TRAINING AWARD IN CANCER PREVENTION
The American Cancer Society invites applications for the Physician Training Award in Cancer Prevention. This award is designed to support the training of physicians in preventive medicine with an emphasis on cancer prevention and control. The objective of the award is to increase the number of preventive medicine residency programs offering high quality training in cancer prevention and control, and, ultimately, the number of preventive medicine specialists engaged in cancer prevention and control. Awards are for four years in the total amount of $300,000, based on an average of $50,000 per resident training year. These grants are renewable.
Applications can be submitted on the ACS website at www.cancer.org/research. The deadline is April 1. If you have program-specific questions, please contact Virginia Krawiec, MPA / Danielle Alsander at 404-329-5734 or email@example.com.
14. ACADEMIC MEDICINE POSES "QUESTION OF THE YEAR”
The journalAcademic Medicine’seditor-in-chief, Steven L. Kanter, MD, has put forth the 2011 Question of the Year:What improvements in medical education will lead to better health for individuals and populations?
Responses to the question will be accepted in the form of a 750-word (maximum) essay. Submissions about new ideas or existing approaches implemented anywhere in the world are welcome. The most outstanding essays will be published in the Journal later in the year.
For more information on how to submit your answer and how the essays will be judged please visit: http://ow.ly/3PX2B.
15. FEBRUARY IS AMERICAN HEART MONTH
February is American Heart Month and today, Friday, February 4, is National Wear Red Day—a day when Americans nationwide are taking women’s health to heart by wearing red to show their support for women’s heart disease awareness. Heart disease is the #1 killer of American women, and although significant progress has been made in increasing awareness among women, most fail to make the connection between risk factors and their personal risk for developing heart disease.