Category Archives: Technology
Under Tobacco Control Act Authority, FDA Orders Stop to Sale, Distribution of Four Tobacco Products
For the first time the U.S. Food and Drug Administration (FDA) has used its authority under the Family Smoking Prevention and Tobacco Control Act to order a stop to the continued sale and distribution of four tobacco products. The FDA ruled that Sutra Bidis Red, Sutra Bidis Menthol, Sutra Bidis Red Cone, and Sutra Bidis Menthol Cone were not “substantially equivalent” to products commercially available as of Feb. 15, 2007. The FDA determined that Jash International did not identify a product by which to assess substantial equivalence, as well as other required information. “Companies have an obligation to comply with the law—in this case, by providing evidence to support an SE application,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products, in a release. “Because the company failed to meet the requirement of the Tobacco Control Act, the FDA’s decision means that, regardless of when the products were manufactured, these four products can no longer be legally imported or sold or distributed through interstate commerce in the United States.” Read more on tobacco.
NGA Releases Report on Prescription Drug Abuse Epidemic
As part of the National Governors Association’s (NGA) 2014 Winter Meeting, NGA Vice Chair Colorado Gov. John Hickenlooper and Alabama Gov. Robert Bentley have released a report, Reducing Prescription Drug Abuse: Lessons Learned from an NGA Policy Academy, detailing their year-long look on how to reduce the growing epidemic; prescription drug abuse is the United States’ fastest growing drug problem and the second most-common type of drug abuse for youth ages 12-17. Among the findings:
- Leadership matters
- Prescribing behavior needs to change
- Disposal options should be convenient and cost-effective
- Prescription drug monitoring programs are underused
- Public education is critical
- Treatment is essential
- Data, metrics and evaluation must drive policy and practice
“The abuse of prescription drugs continues to be seen in communities across the nation,” said Hickenlooper. “This initiative helped states develop effective strategies to help decrease the number of individuals who are misusing or abusing prescription drugs and the resulting number of people who are harmed or die.” Read more on prescription drugs.
HHS Issues Proposals for Next Edition of EHR Technology Certification Criteria
The U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) has issued proposals for the next edition of the electronic health record (EHR) technology certification criteria. “The proposed 2015 Edition EHR certification criteria reflect ONC’s commitment to incrementally improving interoperability and efficiently responding to stakeholder feedback,” said Karen DeSalvo, MD, MPH, national coordinator for health IT. “We will continue to focus on setting policy and adopting standards that make it possible for health care providers to safely and securely exchange electronic health information and for patients to become an integral part of their care team.” Compliance with the 2015 Edition would be voluntary (if EHR developers are in compliance with the 2014 Edition, they would not need to recertify) and the final rule will be issued later this summer. Read more on technology.
CDC: H1N1 Flu Killing at Epidemic Levels
The H1N1 flu virus has been killing at epidemic levels since mid-January, according to new data from the U.S. Centers for Disease Control and Prevention (CDC). While flu is known to disproportionately affect the very young and very old, this strain—also known as the swine flu and the cause of the 2009 global pandemic that killed tens of thousands—has so far caused 243 deaths of residents younger than 65 this year in California alone, with an additional 41 unconfirmed cases. In the 2012-13 season there were 26 deaths at this point and in the 2011-12 season there were nine. According o the CDC the average age of someone diagnosed with flu this season is 28.5 years. “These severe flu outcomes are a reminder that flu can be a very serious disease for anyone, including young, previously healthy adults,” CDC spokesman Jason McDonald said to The Washington Post. Read more on influenza.
Teens Who Text About Condoms, Birth Control More Likely to Use Them
Teens who talk about condoms and other types of birth control over text message and other technology are more likely to use them, according to a new study in the Journal of Adolescent Health. Researchers studied 176 high school juniors and seniors, finding that half of the 64 who reported being sexually active also failed to use condoms consistently. According to the U.S. Centers of Disease Control and Prevention, close to 40 percent of the 47 percent of high school students who reported having sex did not use a condom the last time. However, the study found that students who texted or used other private electronic technology to discuss condoms or other forms of birth control were approximately four times more likely to use them. It also found that the odds of consistently using condoms doubled among students reporting discussions of pregnancy or sexual limits. "Although prior research and media attention has focused on the risks of technology use, like sexting, we found that adolescents might also use electronic tools to communicate about ways they might promote their sexual health," said study lead author Laura Widman, who studies adolescent sexuality at the University of North Carolina at Chapel Hill. "It's not all about risky behavior. It might be another way that teens can have these conversations that can be a little bit awkward.” Read more on sexual health.
Study: Average Obese Woman Gets Only One Hour of Vigorous Exercise Each Year
The average obese woman in the United States gets only one hour of vigorous exercise each year, and the average obese man gets only 3.6 hours, according to a new study in Mayo Clinic Proceedings. The study utilized the results of a 2005-2006 government survey of adults aged 20 to 74, which covered areas such as weight, diet and sleep patterns of the nearly 2,600 adults and use accelerometer devices to track their movements. The study defined "vigorous" exercise as fat-burning activities such as jogging and jumping rope. “They're living their lives from one chair to another," said Edward Archer, a research fellow with the Nutrition Obesity Research Center at the University of Alabama at Birmingham. "We didn't realize we were that sedentary. There are some people who are vigorously active, but it's offset by the huge number of individuals who are inactive." According to the U.S. Centers for Disease Control and Prevention (CDC), approximately one in three U.S. adults is obese, which increases the risk of cardiovascular problems such as heart disease and stroke, diabetes and some cancers. Read more on obesity.
On a busy night at the Stamford (CT) Hospital ER on the snowy East Coast this past holiday weekend, wait times for emergencies were just minutes thanks to a system that has a technician take vital signs within moments of patients walking through the entrance. Those metrics are passed to the medical staff to review in a room just a couple of steps from the reception area which, through a back door, opens onto several emergency suites where treatment can begin almost instantaneously. Contrast that with recent reports of hours-long waits, reduced staff and insufficient equipment at many rural hospitals, which often face budget, staff and equipment constraints.
One solution may be sharing those resources, according to a new study in Health Affairs by researchers at the University of Iowa College of Public Health. The researchers evaluated a tele-emergency service in the upper Midwest that provides 24/7 connection between an urban “hub” emergency department and 71 remote hospitals. At any time, clinical staff at the remote hospitals can press a button for an immediate audio/video connection to the tele-emergency hub Emergency Department.
A survey of the staff members at the rural hospitals found that 95 percent of those responding found that that the relationship significantly improve care for their patients in several ways:
- Improved quality of care
- Provided clinical second opinions for the rural medical staff
- Increased the use of evidence based treatment
“Tele-emergency improves patient care through integrated services that deliver the right care at the right time and the right place,” says Keith Mueller, PHD, head of the Department of Health Management and Policy and lead author of the report. “Our country’s health care system is in a massive state of change, and it’s through services such as this that we’ll be able to address patient need and assist in the financial concerns of smaller medical care units.”
Read the Health Affairs abstract.
In reaching teens, crisis hotlines have had to adapt not only to what they say, but how they say it. While counseling teens by phone is still the dominant method of communication, texting has become a popular way for teens to contact crisis centers in their times of need. A recent story in The New York Times takes a look at what Crisis Text Line and other centers have accomplished in the field of helping teens using their preferred medium of communication.
For troubled teens, texting offers a critical element of privacy if they feel threatened by someone nearby and allows them to look and feel more natural if they are in a public space. Benefits for crisis counselors include the ability to deal with more than one person at a time and to introduce experts into the conversation without a lapse in contact. Organizations such as Crisis Text Line that offer text counseling report receiving messages from teens who might not have otherwise contacted the hotline by phone. People who text hotlines for help receive the same services as callers—risk assessment, emotional validation and problem solving—but the interactions are often longer and more direct than phone calls.
In addition to offering an effective way to communicate with teens, texting provides data and trends about people in different types of crises. “My dream is that public health officials will use this data and tailor public policy solutions around it,” says Nancy Lublin, founder of Crisis Text Line. The organization plans to compile the data and make it available to the public this spring.
The use of texting has extended beyond crisis centers. The four largest phone companies in the United States recently promised to make 911 texting possible by May for local response services that request the option.
Read more at The New York Times.
A nine-year-old girl staying with her mother and siblings in a hotel room in Texas last month was unable to reach 911 to save her mother from an attack by the woman’s estranged husband because the child didn’t know to press “9” in the hotel room before “911” in order to reach an outside line. That death has led to a Federal Communications Commission (FCC) inquiry into how wide that problem is at U.S. hotels and is just one of many facets of the 911 response system that experts say needs updating. Other pressing issues include:
- Call 911 from a land line and responding operators can usually track your location, which is crucial if a person is being attacked or collapses before completing a call. However, most centers don’t yet have the technology to track 911 calls placed from a cell phone. Current FCC rules call for wireless phones to have the needed GPS technology to allow 911 centers to track call locations by 2018.
- While many people assume they can and do send 911 requests by text message, few 911 centers can access text messages currently and so most of those texts go unanswered. The four largest wireless telephone companies—AT&T, Sprint, T-Mobile and Verizon—have voluntarily committed to make texting to 911 available by May 15, 2014 in areas where the local 911 center is prepared to receive the texts. The FCC maintains a list of communities that can respond to 911 text messages which includes all of Iowa, Maine and Vermont, and some counties in a few other states.
“Our 911 systems today are pretty much voice-centric, last-century technology,” says Brian Fontes, CEO of the National Emergency Number Association (NENA). Fontes says that “the ability to have 911 communicate in the manner in which the public is communicating among itself today, is critically important.”
In addition, according to emergency experts new technologies would enhance the 911 response in many ways, including letting first responders see video and photos of an accident victim; demonstrate a needed emergency action, such as CPR, to responding laypersons; and even access medical records such as a victim’s medications, which could improve the response
HHS: Guides, Tools to Improve Safe Use of EHRs
The U.S. Department of Health and Human Services (HHS) has released a new set of guides and interactive tools to assist health care providers in more safely using and managing electronic health information technology products, such as electronic health records (EHRs). The resources—which include checklists, practice worksheets and recommended practices to assess and optimize the safe use of EHRs—are available at HealthIT.gov. Each guide is available as an interactive online tool or a downloadable PDF. The new tools are part of HHS’s plan to implement its Health IT Patient Safety Action and Surveillance Plan, released last July. Read more on technology.
Traumatic Brain Injury Linked to Higher Risk of Early Death
Traumatic brain injury (TBI) is linked to a higher risk of premature death, according to a new study in the journal JAMA Psychiatry. Researchers from the University of Oxford, United Kingdom, analyzed the records of all patients born in 1954 or later in Sweden who were diagnosed with TBI from 1969 to 2009, finding an increased risk of dying among patients who survived six months after TBI compared to those without TBI, with the risk remaining for years afterward. In particular, the study found an increased risk of death from external causes such as suicide, injury and assault, also was higher. “Current clinical guidelines may need revision to reduce mortality risks beyond the first few months after injury and address high rates of psychiatric comorbidity and substance abuse,” wrote the study authors. Read more on mental health.
Heavy Drinking During Middle Age Can Cause Earlier Memory Loss in Men
Heavy drinking during middle age can bring on earlier deterioration of memory, attention and reasoning skills in men, according to a new study in the journal Neurology. Researchers studied data on 5,000 men and 2,000 women whose alcohol consumption was assessed three times over a 10-year period before also taking three tests of memory, attention and reasoning, with the first test happening at the average age of 56. They found that men who drank at least 2.5 servings of alcohol a day experienced mental declines between 1.5 and 6 years earlier than the other participants. "Heavy alcohol consumption is known to be detrimental for health, so the results were not surprising...they just add that [it's] also detrimental for the brain and the effects can be observed as [early] as 55 years old," said study author Severine Sabia, a research associate in the department of epidemiology and public health at University College London. Read more on alcohol.
More Than One Million People Now Enrolled for Health Insurance Coverage under the Affordable Care Act
The Centers for Medicare and Medicaid Services (CMS), which administers the health insurance provisions of the Affordable Care Act (ACA) reported late last week that more than one million people have now enrolled for coverage under the ACA.
CMS also reported that December enrollment as of December 27 was seven times that of October and November. Open enrollment will continue through March, with rolling dates for first day of coverage. Read more on the Affordable Care Act.
U.S. Flu Cases on the Rise
The Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota reported last week that rates of flu are on the rise in the United States, with the 2009 H1N1 virus the predominant strain. The good news is that this year’s flu vaccine is protective against H1N1.
According to CIDRAP, officials from the Centers for Disease Control and Prevention have said that the 2009 H1N1 virus has a greater impact on younger adults and older children than seasonal flu strains typically do.
The numbers of U.S. flu cases are usually highest January through March, which means that people who have not had flu shots yet still have time to protect themselves. Full immunity from the vaccine can take up to two weeks from the time of the injection. Use the CDC’s Flu Vaccine Finder to find a flu shot in your neighborhood. Read more on outbreaks.
New Orleans Health Commissioner to become Federal Health IT Administrator
New Orleans Health Commissioner Karen DeSalvo, MD, has been appointed the new National Coordinator for Health Information Technology (IT), replacing Farzad Mostashari, who left the position earlier this year. In a memo to employees of the U.S. Department of Health and Human Services (HHS), which oversees the office of the National Coordinator, HHS Secretary Kathleen Sebelius noted that Dr. DeSalvo boosted the use of health IT as "a cornerstone of [New Orleans’s] primary care efforts and a key part of the city's policy development, public health initiatives and emergency preparedness." Dr. DeSalvo will begin her post in mid-January. Under Dr. DeSalvo's leadership, New Orleans also received the inaugural Robert Wood Johnson Foundation Roadmaps to Health Prize.
How does public health take care of the communities it serves during a foodborne illness or infectious disease outbreak? Through a series of sophisticated steps, most choreographed long before an emergency occurs. Every minute of every day, U.S. and global health experts monitor reports that could indicate a disease or foodborne illness outbreak, as well as review samples of food, water, soil and other resources to detect outbreaks. Some of the steps are well laid out and public; others, such as those monitored by the Department of Homeland Security—watchful for terror attacks on food and water supplies—are hidden from view, but supremely vigilant.
Other examples of outbreak preparedness activities:
- Each year the American Public Health Association updates its Control of Communicable Diseases manual, and adds updates as needed to the manual’s mobile platforms.
- Outbreak guidance for new public health officers, as well as refreshers for veterans, are provided by public health official member associations such as the National Association of County and City Health Officials and the Association of State and Territorial Health Officials.
- New public health officers are also invited to the U.S. Centers for Disease Control and Prevention (CDC) for an orientation that includes outbreak guidance.
No, health officials can’t know whether an outbreak might occur next week or next month—or never—and whether it’s going to be a new strain of flu, or tainted ground beef sold at multiple food outlets. But by having a set of continually reviewed steps for alerting the public—and keeping them up to date with real-time guidance—targeted advice for any outbreak can be quickly assessed and disseminated.
Health agencies typically share information and best practices with local and state health departments through conference calls and alerts throughout a crisis. And, with the explosion of social media, just about all health departments continually add communications channels for the people they serve. For example, health officials in Montgomery County, Texas, this week are keeping the public informed about an illness outbreak that may turn out to be a severe form of flu, through dedicated channels that include a telephone hotline and its Facebook page. Read the wealth of posts on preparedness on NewPublicHealth to see the many avenues health departments take to keep residents continually informed when an outbreak occurs.
Outbreaks can spread faster than you think. But luckily the development of new digital tools and technologies to assist with documenting, tracking and alerting the public of the spread of infectious disease is progressing even more rapidly. There are new databases, maps and communications technologies that make tracking down an outbreak and getting it under control a much quicker and more efficient process. Digital developments focusing on emergency preparedness and response can help protect more of the population from the next pandemic.
We’ve brought together a few examples of how the digital world is working to improve emergency response:
- At the University of Pittsburgh School of Public Health, a new initiative called Project Tycho is working to convert 125 years worth of data from paper documents into an open-access database. Project Tycho will save researchers around the world the time of finding reliable historical data from different sources for infectious diseases, which is critical to understanding underlying epidemic dynamics, according to Dr. Willem van Panhuis, an assistant professor of epidemiology at University of Pittsburgh School of Public Health.
- The Advanced Molecular Detection Initiative proposed in the President’s 2014 Budget could help make huge strides in controlling infectious disease. The initiative would bring together experts in laboratory science, epidemiology and bioinformatics to join forces like never before. By using genetic sequencing to examine infectious pathogens, these technologies are on the verge of revolutionizing medical professionals’ abilities to diagnose infectious diseases; investigate and control outbreaks; understand transmission patterns; develop and target vaccines; and determine antimicrobial resistance—all with increased timeliness and accuracy and decreased costs.
- Social media and crowdsourcing technologies have helped medical professionals develop tools to track the spread of disease and where outbreaks are occurring and even make the data available to the general public. HealthMap is one of the original examples of using digital technologies to track outbreaks while keeping the public informed.
- In efforts to spread the skills needed to deal with public health issues such as outbreaks, the CDC has made learning more fun through games such and applications such as CDCology and Solve the Outbreak for the iPad. CDCology is a pilot program through the CDC and supported by HHSIgnite (beta). The pilot website uses CDC staff-created, student-solved, virtual microtasks to tackle public health challenges at CDC. As they complete the short microtasks, the students gain valuable educational experience, insight and exposure to the field of public health. Solve the Outbreak puts you in the shoes of a member of the Epidemic Intelligence Service. Playing the game presents the opportunities to use clues, analyze data, solve the scenario and save lives in this virtual world, but also helps teach the public more about the process behind handling a real outbreak.
AAP Issues Recommendations on Reducing Youth Deaths from Gun Violence
Every day seven U.S. children are killed by gun violence and it remains the second-leading cause of death among youth in the country. The American Academy of Pediatrics (AAP) has issued a list of recommendations on how to keep kids safe and hopefully make an impact on these troubling statistics. “Gun violence is a public health issue that profoundly affects children and their families,” said AAP President Thomas K. McInerny, MD, FAAP. “We know what works—strong laws to enforce background checks and safe storage.” Watch a video on the APP recommendations and read more here. Read more on violence.
Study: African-American Men from Single-Parent Homes More Likely to Suffer from Hypertension
African-American men who grew up in two-parent homes are less likely to suffer from hypertension as adults than are their peers who grew up in single-parent homes, according to a new study in the journal Hypertension. The researchers analyzed data on 515 men enrolled in the Howard University Family Study. Possible explanations for the disparity include the fact that children who live only with their mothers are three times as likely to live in poverty, and socioeconomic status has been linked to higher blood pressure. “Family structure is among a slew of environmental influences that, along with our genes, help determine our health as adults,” said Dan Kastner, MD, PhD, scientific director, National Human Genome Research Institute (NHGRI). “This study makes important observations about home life that may affect susceptibility to complex diseases later on in life.” The National Institutes of Health’s NHGRI and National Institute on Minority Health and Health Disparities conducted the study. Read more on health disparities.
Excessive Cellphone Use Tied to Higher Anxiety, Lower Productivity in College Kids
Excessive cellphone use is linked to higher levels of anxiety, less satisfaction with life and lower grades in college-age adults, according to a new study in the journal Computers in Human Behavior. Researchers examined data on approximately 500 men and women enrolled at Kent State University in 82 different fields of study. The average student spent 279 using their cellphone each day, sending an average of 77 text messages, and researchers believe that a perceived obligation to stay connected on social media may be behind the increased anxiety and decreased productivity. "At least for some students, the sense of obligation that comes from being constantly connected may be part of the problem,” said Andrew Lepp, lead study author and an associate professor at Kent State University. "Some may not know how to be alone to process the day's events, to recover from certain stressors." Read more on technology.