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Study: Mean Devices Approved for Pediatric Use Never Tested on Kids
The majority of medical devices recently approved for pediatric use were never actually tested on kids, but rather only on people ages 18 and older, according to a new study in the journal Pediatrics. Researchers analyzed the clinical data used to get each device approved, finding that 11 of 25 examined devices were not tested on any patient age 21 and younger, and that only four had been tested on patients under the age of 18; three devices were specifically approved for patients under age 18, while the test were approved for people ages 18 to 21. "Children are not simply 'small adults,' and a device found to be safe and effective in adults may have a very different safety and effectiveness profile when used in a pediatric population," said Brigham and Women's Hospital and Harvard Medical School research fellow Thomas J. Hwang, one of the study’s authors, according to Reuters. "Without this data, it is difficult for clinicians and parents to make informed treatment decisions that weigh the risks and benefits of a particular treatment.” Read more on pediatrics.
Kaiser Report Examines Employer-Sponsored Retiree Health Benefits
A new report from the Kaiser Family Foundation on employer-sponsored retiree health benefits for pre-65 and Medicare-eligible retirees finds that the percentage of employers sponsoring retiree health coverage has declined, while employers that offer coverage are redesigning their plans almost annually in response to rising health care costs. The report, Retiree Health Benefits At the Crossroads, also examines the effect of recent legislation on retiree health coverage, such as the Medicare drug benefit and the Affordable Care Act. Read more on aging.
Study: Fewer Blood Transfusions Would Mean Fewer Infections
The increased use of blood transfusions in hospitals also leads to the increased risk of infection, according to a new study in the Journal of the American Medical Association. In a review of 21 randomized control trials, researchers from the University of Michigan School of Public Health determined that for every 38 patients considered for a red blood cell transfusion, the reduction of transfusions would mean one patient did not develop a serious infection, with the elderly undergoing hip and knee surgeries benefiting the most. “The fewer the red blood cell transfusions, the less likely hospitalized patients were to develop infections, “ says lead author Jeffrey M. Rohde, MD, assistant professor of internal medicine in the division of general medicine at the U-M Medical School, in a release. “This is most likely due to the patient’s immune system reacting to donor blood (known as transfusion-associated immunomodulation or TRIM). Transfusions may benefit patients with severe anemia or blood loss; however, for patients with higher red blood cell levels, the risks may outweigh the benefits.” Read more on prevention.
At this year’s Preparedness Summit, which met last week in Atlanta, the American Red Cross was a first-time partner for the annual event which brings together more than 1,000 preparedness experts from around the country.
“It was important for us to partner with the American Red Cross because they have a major role and responsibility in disasters,” said Jack Herrmann, the Summit chair and Chief of Public Health Preparedness at the National Association of County and City Health Officials (NACCHO), the lead partner for the Summit. “We felt that it was important that the public health and health care communities understand the Red Cross’ role and authority during a disaster and look for ways to foster and build partnerships [among] local health departments, state health departments and American Red Cross chapters across the country.”
Just prior to the Summit, NewPublicHealth conducted an interview by email with Russ Paulsen, Executive Director, Community Preparedness and Resilience Services of the American Red Cross.
NewPublicHealth: What are the key issues that communities should focus on now to get themselves better prepared for a disaster should it occur?
Russ Paulsen: Everyone has a role to play in getting communities better prepared for disasters.
As a first step, individuals, organizations and communities should understand the problem: What hazards are in their area? How likely are any of these hazards to become actual disasters? What have people already put in place to deal with them? Local Red Cross chapters can help with this assessment.
Once people understand the problem, the next step is to make a plan. Plan what to do in case you are separated from your family or household members during an emergency, and plan what to do if you must evacuate your home. Coordinate your household plan with your household members’ schools, daycare facilities, workplaces and with your community’s emergency plans.
CDC: Calls to Poison Centers for E-Cigarettes Has Jumped Dramatically Since 2010
Calls to poison centers involving e-cigarette liquids containing nicotine jumped from just one per month in September 2010 to 215 per month in February 2014, according to a new U.S. Centers for Disease Control and Prevention (CDC) study in the Morbidity and Mortality Weekly Report. There was no similar increase for conventional cigarettes. The study found that 51.1 percent of the e-cigarette calls involved children under age 5 and about 42 percent involved people ages 20 and older. “This report raises another red flag about e-cigarettes—the liquid nicotine used in e-cigarettes can be hazardous,” said CDC Director Tom Frieden, MD, MPH, in a release. “Use of these products is skyrocketing and these poisonings will continue. E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.” Read more on the FDA.
HHS Draft Report Would Strengthen Innovative Health IT, Help Patients
The U.S. Department of Health and Human Services (HHS) has released a draft report that includes a proposed strategy for a health information technology (health IT) framework to help promote product innovation while also ensuring patent protections and avoiding regulatory duplication. The congressionally mandated report was developed by the U.S. Food and Drug Administration in consultation with HHS’ Office of the National Coordinator for Health IT (ONC) and the Federal Communications Commission (FCC). “The diverse and rapidly developing industry of health information technology requires a thoughtful, flexible approach,” said HHS Secretary Kathleen Sebelius. “This proposed strategy is designed to promote innovation and provide technology to consumers and health care providers while maintaining patient safety.” Improved health IT could help lead to greater prevention of medical errors; reductions in unnecessary tests; increased patient engagement; and faster identifications of and response to public health threats and emergencies. Read more on technology.
Study: Fewer Cases of Smoking on TV Screens May Be Tied to Overall Drop in U.S. Smoking Rates
Fewer scenes of cigarette use in prime-time television shows may be linked to an overall reduction in the U.S. smoking rate, according to a new study in the journal Tobacco Control. Analyzing 1,800 hours of popular U.S. prime-time dramas broadcast between 1955 and 2010, researchers from the Annenberg Public Policy Center at the University of Pennsylvania in Philadelphia determined that scenes involving cigarette use on such shows fell from nearly five scenes per hour of programming (excluding commercials) in 1961 to about 0.3 scenes per hour in 2010. Based on this data they concluded that one less depiction of smoking per hour over two years of prime-time programming was associated with an overall drop of almost two packs of cigarettes, or 38.5 cigarettes, a year for every adult. The new findings support previous research showing that seeing other people smoke prompts cigarette cravings in adult smokers. Read more on tobacco.
NewPublicHealth will be on the ground in Atlanta next week for the 2014 Preparedness Summit, an annual event since 2006 convened by the National Association of County and City Health Officials (NACCHO) and other partners including the U.S. Centers for Disease Control and Prevention (CDC) and the American Red Cross. Summit attendees include preparedness professionals working in local, state and federal government, emergency management, volunteer organizations and health care coalitions.
Goals of the summit include opportunities to connect with colleagues, share new research and learn to implement model practices that enhance capabilities to prepare for, respond to and recover from disasters and emergencies.
Additional partners include the American Hospital Association; the Association of State and Territorial Health Officials (ASTHO); the Association of Schools and Programs of Public Health (ASPPH); the Council of State and Territorial Epidemiologists (CSTE); the Association of Public Health Laboratories (APHL); the Office of the Assistant Secretary for Preparedness and Response (ASPR); the U.S. Food and Drug Administration (FDA); the Medical Reserve Corps (MRC); the U.S. Department of Homeland Security (DHS); the National Association of Community Health Centers (NACHC); and the Veterans Emergency Management Evaluation Center (VEMEC).
In advance of the summit, NewPublicHealth spoke with Jack Herrmann, Senior Adviser and Chief of Public Health Preparedness at NACCHO.
NewPublicHealth: What are some important issues going on in disaster preparedness in the United States right now that make the Summit especially important this year?
Jack Herrmann: There have been significant budget cuts to the ASPR Hospital Preparedness Program, and that is going to impact local and state public health departments and health care facilities pretty significantly across the country. Hopefully the summit will provide a venue to better understand what those impacts might be and allow us as a community to voice our concerns to our political leaders around the impacts of those budget cuts. It will also provide some very substantive evidence for organizations such as NACCHO , ASTHO and others to advocate on behalf of our constituents.
NPH: What are some of the key plenary talks?
Herrmann: Sheri Fink, a correspondent at The New York Times, who is also the author of the Pulitzer Prize-winning book “Five Days at Memorial” about her experience during Hurricane Katrina, will be a keynote speaker. What we’re having her do during the session is look back to her experience during Hurricane Katrina and researching what happened during that time from a health care preparedness perspective—and the lives that were lost and the issues and challenges that health care facilities faced in the aftermath of that disaster—and looking at where we are now.
Louis W. Sullivan, MD, former U.S. Secretary of Health and Human Services under President George H.W. Bush, recently wrote a memoir, Breaking Ground: My Life in Medicine, that offers a wide view of Sullivan’s experiences as a medical student in Boston, the founding dean of the Morehouse School of Medicine in Atlanta and as the country’s chief health officer. NewPublicHealth recently sat down with Sullivan to discuss the book and his thoughts on the history and future of improving the nation’s health.
NewPublicHealth: Looking back, what can you share about the highlights of your career in medicine and health promotion?
Louis Sullivan: Highlights would certainly include my time at the Boston University School of Medicine. That had many significant points. It was my first time living in an integrated environment because up until that time I spent all of my life in the South. Working in an environment without concerns about discrimination and bias, that was a great experience; my classmates and the faculty at Boston University were all welcoming.
Another highlight was later when I was a research fellow in hematology in the Harvard unit at Boston City Hospital. I had a paper accepted for presentation at a major research conference in Atlantic City. It was a paper showing that heavy drinking suppressed the production of red blood cells by the bone marrow.
And of course a tremendous highlight was going back to Morehouse College, my alma mater, to start the Morehouse School of Medicine. I was returning home in a sense. I had gained experience as a faculty member at Boston University, had been steeped in medicine and now I was in the process of establishing a new institution to train young people for the future.
NewPublicHealth: What changes have you created and supported to improve population health.
Sullivan: Well, certainly becoming Secretary of Health and Human Services was indeed an honor and a great opportunity for me, and it was also a very challenging experience.
In the late ‘80s, when I became Secretary, AIDS was a new disease. There were many demonstrations by various advocacy groups, groups that didn’t trust the government, and we had to work to develop a relationship with them. I convinced President Bush to put $1.6 billion in his budget to be used for research on this new disease, to develop mechanisms for treating the disease and to educate the public. And as a result of that initial investment and ones that followed, this disease has been transformed from a virtual death sentence to a chronic disease which is controlled by medication. And people, rather than living a few months, which was the case once the diagnosis was made in 1989, are now living for decades with the virus suppressed on medication, raising their families, working, earning wages, paying taxes. So that has been really a very satisfying outcome from that experience. And we hopefully are close to finding a cure for this disease as well.
“College is certainly a different experience today than it was in my day,” said an audience participant at a panel discussion late last week on campus health initiatives at the Partnership for a Healthier America summit in Washington, D.C. The partnership is a nonprofit that includes health leaders working on childhood obesity issues.
The college health panel, moderated by former U.S. Health and Human Services Secretary Donna Shalala, who is the president of the University of Miami and co-chair of the Bipartisan Policy Center’s Nutrition and Physical Activity Initiative, included Lynn R. Goldman, dean of the George Washington School of Public Health and Health Services; Beverly Daniel Tatum, president of Spelman College, a historically Black college in Atlanta; and Michael Goldstein, Associate Vice-Provost for the Healthy Campus Initiative, at the University of California, Los Angeles (UCLA).
A driving force behind health and wellness improvement initiatives on campus—including bike and walking paths, more staircases and smoking bans—is the opportunity to help students make changes that will last their lifetimes.
- At Spelman several years ago, Tatum canceled the schools’ competitive sports program—which was benefitting less than 5 percent of the 2,000-person student body—and replaced it with a “wellness revolution.” The campus-wide programs include “Body Fat Tuesday” weekly checks, new exercise equipment and a “PE for life” initiative that includes integrating such things as lunges and squats for students waiting for tennis courts to encourage greater physical activity.
- Changes at UCLA include a new restaurant, the Bruin Plate. Entrees—none more than 400 calories each—include root-vegetable tagine; a red-quinoa-and-sweet-potato burger with pineapple salsa; and chicken with dates, polenta and spinach. Side dishes have no more than 200 calories each and there are no French fries, traditional desserts, cured meats or heavily processed foods. The restaurant serves only calorie-free sodas and house-made infused waters with flavors such as pineapple-mango-hibiscus, vanilla-peach and butternut squash. Desserts have been overhauled and include seasonal fruit with balsamic sauces and lower-calorie quick breads.
- Changes on the George Washington University campus, which is just blocks from the White House, include indoor and outdoor bike racks, four bike rental stations, widened pathways and changes at the Food Court to include many healthier options. Goldman says that since the school is in the middle of the city, rather than a closed campus, many of the changes were also aimed at benefitting the community residents.
“A lot has changed since campuses were filled with cigarette smoke and offered just a single dining hall with a set menu,” said Shalala. “We have a captive audience, and campuses are good places to learn healthy habits.” Recent changes at the University of Miami include more visible staircases and signage pointing to the stairs; widened walkways for walking and biking; bike repair stations; outdoor fitness equipment; and farmer’s markets.
NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to firstname.lastname@example.org.
Recent dental surveys find that less than half of children in America brush their teeth twice a day and research shows that dental decay is the most common chronic childhood disease in the United States.
To encourage kids to brush their teeth, the Ad Council recently launched a neat mobile app aimed at bringing public service announcements (PSAs) right to where they can be most useful—in this case, the bathroom sink. The new PSA is called “Toothsavers” and it's designed to encourage kids to brush their teeth for two minutes, twice a day.
The back story of Toothsavers is that an evil sorceress has cast a wicked spell, leaving everyone’s mouths to rot and be overrun by cavities. Now it's up to little toothbrushers to help Toothy and the Toothsavers save everyone's teeth!
Kids use the app to swipe and tab in order to brush and scrub away the spell for each of the kingdom’s denizens, including the Dragon, Little Red Riding Hood and the Pirate. And for every few days a child brushes their own teeth for two minutes, twice a day, they unlock a new character on the Toothsaver game. Brush for 30 days and kids get the chance to defeat the evil sorceress herself.
Features of the app include:
- 10 different two-minute animations to add some fun to daily tooth brushing
- 10 cartoon teeth that move on the screen when activated by a voice
- An interactive map to chart daily tooth brushing
- Parents can connect on Facebook and post whenever their child reaches a brushing milestone
Toothsavers is a program of the Partnership for Healthy Mouths, Healthy Lives, a coalition of 36 oral health organizations including the American Dental Association. The campaign’s goal is to motivate parents to take action to reduce their children’s risk of oral disease by making sure their kids are brushing their teeth for two minutes, twice a day. Toothsavers is the first mobile app to be entirely created by the Ad Council. “The game represents a huge milestone for us in our efforts to use gaming and mobile technology to effect social change,” said Ellyn Fisher, Vice President, Public Relations and Social Media.
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.
Survey: Half of U.S. Adult Smokers Plan to Quit for New Year
More than half of adult smokers in the United States made quitting tobacco a New Year’s resolution for 2014, according to a new survey from Legacy, a national public health nonprofit. These findings are especially significant today, on the eighth day of the new year, as the eighth day of a quit attempt is when a smoker is most vulnerable to a relapse. This month also marks the 50th anniversary of the first Surgeon General’s report on tobacco. Among the survey’s other findings:
- 41 percent planned to quit smoking "cold turkey" for New Years, which is largely ineffective for the majority of smokers
- 12 percent planned to switch to electronic cigarettes, an unregulated product whose safety risks remain unknown
- 37 percent plan to quit to save money
- 31.7 percent want to quit because they don’t want their clothes and hair to smell
Read more on tobacco.
ACS: Cancer Death Rates Fell 20 Percent Over Two Decades
The combined cancer death rate for men and women fell 20 percent in the two decades from 1991 to 2010, with better prevention, screening and treatment critical to continuing this positive trend, according to a new report from the American Cancer Society. The drop translates to approximately 1,350,400 fewer deaths. The report estimates that the United States will see a total of 1,665,540 new cancer cases and 585,720 deaths from cancer in 2014. From 2006 to 2010, cancer death rates decreased by 1.8 percent annually in men and by 1.4 percent in women. Lung, colon, prostate and breast cancers are the most common causes of cancer death, with lung cancer accounting for approximately one in four deaths. Read more on cancer.
‘Green’ Labels for Healthy, ‘Red’ for Unhealthy Foods Improve Nutritional Selections
The “stop” and “go” colors of traffic signals may be able to improve healthy eating choices in cafeterias, according to a new study in the American Journal of Preventive Medicine. A redesign of the cafeteria at Massachusetts General Hospital combined better locations for health food items with red, yellow and green labels marking the nutritional quality of different foods, with junk foods being red. Over two years, green-labeled items sold at a 12 percent higher rate and sales of red-labeled items dropped by 20 percent. "Our current results show that the significant changes in the purchase patterns...did not fade away as cafeteria patrons became used to them," said study lead author Anne Thorndike, MD, of the division of general medicine at the Boston hospital. "This is good evidence that these changes in healthy choices persist over time." To learn more about the study and concept, go to "Traffic-Light Labels and Choice Architecture: Promoting Healthy Food Choices" at RWJF.org. Read more on nutrition.
Infographics, public health news and innovative efforts to improve community health were the topics of the most widely read posts on NewPublicHealth this year.
Take a look back at our most popular posts:
- The Robert Wood Johnson Foundation’s Commission to Build a Healthier America will release new recommendations on early childhood education and improving community health on Monday January 13. Earlier this year, new city maps to illustrate the dramatic disparity between the life expectancies of communities mere miles away from each other. Where we live, learn, work and play can have a greater impact on our health than we realize.
- Three of the infographics created for the NewPublicHealth series on the National Prevention Strategy, a cross-federal agency emphasis on public health priorities, were among the most popular posts of 2013. Stable Jobs = Healthier Lives, the most widely viewed NPH infographic, tells a visual story about the role of employment in the health of our communities. One example: Laid-off workers are 54 percent more likely to have fair or poor health and 83 percent more likely to develop a stress-related health condition.
- Better Transportation =Healthier Lives, another 2013 infographic, tells a visual story about the role of transportation in the health of our communities. Consider this important piece of the infographic as we head into 2014: The risk of obesity increases 6 percent with every additional mile spent in the car, and decreases 5 percent with every kilometer walked.
- Top Five Things You Didn’t Know Could Spread Disease was the best read of the very well read stories on NewPublicHealth during Outbreak Week—an original series created by NPH to accompany the release in late December of Outbreaks: Protecting Americans from Infectious Disease, a pivotal report released by the Robert Wood Johnson Foundation and Trust for America’s Health.
- Better Education=Healthier Lives, another widely viewed—and shared—infographic on NewPublicHealth, shared the critical information that more education increases life span, decreases health risks such as heart disease and—for mothers who receive more years in school—increases the chance that her baby will die in infancy.
- How Healthy is Your County? In 2014 the Robert Wood Johnson Foundation will release the fifth County Health Rankings, a data set more and more communities rely on to see improvements—and room for change—in the health of their citizens. NewPublicHealth’s 2013 coverage of the County Health Rankings & Roadmaps included posts on the six communities that won the inaugural RWJF Roadmaps to Health Prize for their innovative strategies to create a culture of health by partnering across sectors in their communities.
- The Five Deadliest Outbreaks and Pandemics in History, was our seventh best read post of the year. Read it again and ask: Are we prepared as a nation for the next big outbreak?
- What does architecture have to do with public health? Visit the Apple Store in New York City’s SoHo neighborhood, Texas’ Red Swing project, or....view our post from earlier this year.
- Less than a month after the shootings in late 2012 at Sandy Hook elementary school in Connecticut, the Harvard School of Public Health held a live webcast town hall meeting on gun violence on the legal, political, and public health factors that could influence efforts to prevent gun massacres. And toward the end of 2013, NewPublicHealth sat down with former Surgeon General David Satcher, MD, MPH, to talk about the role of research in preventing gun violence.
- NewPublicHealth covered the release of a report by Trust for America’s Health that found that most states are not implementing enough proven strategies to prevent prescription drug abuse. But the year ended with some better news on the critical public health issue. An NPH news roundup post reported on a study funded by the National Institutes of Health which found that rates of prescription drug abuse by high school students have dropped slightly.
Close runners up included How Do You Transform a Community After a Century of Neglect?, which looked at how Bithlo, Fla. is working to bring much-needed services to its main street through the “Transformation Village” initiative, as well as ‘Unprecedented Destruction’: Ocean County Public Health Continues to Respond to Hurricane Sandy, which brought together a NewPublicHealth video and a Q&A to illustrate how public health officials and departments worked together to help their regions recover from the devastating superstorm. Also in the top 20 for year was an interview with New York State Health Commissioner Nirav R. Shah, MD, MPH, on the release of the 2013-17 Prevention Agenda: New York State’s Health Improvement Plan—a statewide, five-year plan to improve the health and quality of life for everyone who lives in New York State.