FEDERAL HEALTH UPDATE
Apr 24, 2009Produced by Kate Connelly Theroux in collaboration with the Institute of Federal Health Care (IFHC) To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. Sponsored by
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Executive
and Congressional News
Kevin Concannon was
appointed Iowa Department of Human Services director in March 2003.
He was re-appointed as DHS director by Governor Culver and Lt. Governor
Judge in January 2007. Mr. Concannon also served as president of the
American Public Welfare Association (APWA) and previously served as
president of the National Association of State Mental Health Program
Directors.
Ray Jefferson is
a leadership consultant with more than 20 years of experience. From
2006 to 2008, he served with McKinsey & Company in Southeast Asia,
where he created and delivered leadership training and development programs
for clients and offices throughout Asia. Mr. Jefferson graduated from
the U.S. Military Academy at West Point with a major in leadership.
He served as an army officer with the infantry, Rangers and Special
Forces, with leadership positions in the U.S. Presidential Honor Guard,
3rd Ranger Battalion and 1st Special Forces Group. He attended Harvard's
Kennedy School of Government, earning an MPA in Strategic Management
with Distinction as a Littauer Fellow. He then earned an MBA from Harvard
Business School and was recognized with the Dean's Award for exceptional
leadership and service. Mr. Jefferson served as the deputy director
for the State of Hawaii’s Department of Business, Economic Development
and Tourism (DBEDT).
Duckworth will direct
the Office of Public Affairs and Intergovernmental Communications.
Among other things, she will oversee VA's public affairs operations,
as well as programs for homeless veterans.
Military Health Care News
The study will identify the most effective means to support servicemembers who return from deployment with combat injuries and their families. Returning servicemembers may need assistance reintegrating into their communities. Initially, the grant, funded by the Office of the Congressionally Directed Medical Research Program (DRMRP), will support efforts associated with Walter Reed Army Medical Center, Washington, D.C.; Brooke Army Medical Center, San Antonio; and Madigan Army Medical Centers, Tacoma, Wash. The program will seek to identify
psychological and physical needs of servicemembers, families and children
and take appropriate actions to fill the gap in existing comprehensive
medical care. The goal of the grant is to improve understanding of psychological
health, including post-traumatic stress disorder, and other areas relevant
to the DRMRP. http://mhs.osd.mil/Press/
Maj. Gen. Green is currently the Air Force deputy surgeon general, a position he has held since August 2006. Pending approval by the Senate, General Green will become the Air Force's 20th surgeon general and will succeed Lt. Gen. (Dr.) James G. Roudebush, who is retiring. Green was commissioned through the Health Professions Scholarship Program and entered active duty in 1978 after completing his MD degree at the Medical College of Wisconsin in Milwaukee. He completed residency training in family practice at Eglin Regional Hospital, Eglin Air Force Base, Fla., in 1981, and in aerospace medicine at Brooks AFB, Texas, in 1989. He is board certified in aerospace medicine. An expert in disaster relief operations, he planned and led humanitarian relief efforts in the Philippines after the Baguio earthquake in 1990 and in support of Operation Fiery Vigil following the 1991 eruption of Mount Pinatubo. Green has served as commander of three hospitals and Wilford Hall Medical Center. As command surgeon for three major commands, he planned joint medical response for operations Desert Thunder and Desert Fox, and oversaw aeromedical evacuation for operations Enduring Freedom and Iraqi Freedom. Prior to assuming his current position, he served as assistant surgeon general for health care operations. He also holds a rating of chief flight
surgeon, with a total of 1,200 hours in 16 different aircraft.
The conference will bring together national leaders from within the Department of Defense, White House, Office of Management and Budget (OMB), Congress, industry and academic circles to discuss the strategic direction of the Military Health System (MHS) and U.S. health care related to national security. Participants will discuss the importance
of health care to national security, how to apply innovative healthcare
concepts to the military’s health system to deliver excellent care,
and the potential impact on civilian healthcare reform. Efforts
to manage costs while maintaining access to highest quality healthcare
will be a significant area of focus of the discussion. http://www.health.mil/Press/
Veterans Health Care News
The Golden Age Games are open to all U.S. military veterans age 55 or older who receive care at a VA medical facility. The games give participants the opportunity to compete in ambulatory, visually impaired and wheelchair divisions, according to their ages. VA anticipates as many as 700 veterans will participate in events that include swimming, bicycling, bowling, croquet, air rifle, golf, shuffleboard, horseshoes, discus and shot put. The 23rd National Veterans Golden Age Games are co-sponsored by VA, Help Hospitalized Veterans (HHV) and the Veterans Canteen Service (VCS). This year’s event is hosted by the VA medical center in Birmingham. The games are designed to improve
the quality of life for all older veterans, including those with a wide
range of abilities and disabilities. Through a partnership with the National
Senior Games Association, a member of the U.S. Olympic Committee, the
games serve as a qualifier for the National Senior Games held every
other year. http://www1.va.gov/opa/
The study, published in the May issue of British Journal of Urology International, followed 1,495 veterans who underwent radical prostatectomy to remove their cancerous prostates. Researchers found that the 206 exposed to Agent Orange had nearly a 50 percent increased risk of their cancer recurring, despite the fact that their cancer seemed relatively nonaggressive at the time of surgery. Further, their cancer came back with a vengeance: the time it took the prostate specific antigen, or PSA, level to double – an indicator of aggressiveness – was eight months versus more than 18 months in non-exposed veterans. The PSA of prostate cancer patients is typically measured every three months for two years after surgery then every six months for life. After surgery to remove the diseased prostate, the PSA should be zero, but any prostate cancer cells left behind continue to make PSA, a red flag of recurrence. The PSA often "percolates along," so physicians tend to watch it for a while to determine if additional therapy is needed. However in patients with Agent Orange exposure, radiation or hormone therapy to kill remaining cells may need to be done sooner rather than later. Increasing evidence is emerging that exposure to Agent Orange, a herbicide and defoliant used during the Vietnam War, increases risk for a variety of health problems, including prostate cancer, although the exact mechanism is unclear. Dioxin, a known carcinogen, also is found in herbicides and pesticides used by U.S. farmers and forestry and chemical plant workers. Studies have shown them to have an increased cancer risk. Scientists suspect dioxin activates regulatory regions of genes to enable the uncontrolled cell division that is a cancer hallmark. A separate study of 1,653 veterans at VA medical centers in five cities between 1990 and 2006 also showed recurrence rates were higher and recurring cancers were more aggressive with Agent Orange exposure. Prostate cancer is the most common cancer in men and trails lung cancer as the second leading cause of cancer death. The study was funded by the Department
of Veterans Affairs, the National Institutes of Health, the Georgia
Cancer Coalition, the Department of Defense Prostate Cancer Research
Program and the American Urological Association/Astellas Rising Star
in Urology Award.
This Web site was designed to welcome home veterans of the Iraq and Afghanistan conflicts with a social, veteran-centric Web site focusing on their needs and questions. The Web features videos, veteran
stories and a blog where veterans are encouraged to post feedback. The
site also will restructure the traditional index-of-benefits format
found on other VA pages into question-based, categorized, and easily
navigated links by topic. This will allow veterans to find benefits
of interest easily and discover related benefits as they explore.
The case involves two veterans whose benefits claims were denied. The US Court of Appeals for the Federal Circuit held that the burden was on the VA to prove that notice was not prejudicial. To read the ruling, please visit: http://www.supremecourtus.gov/ Health Care News
Led by Bradford Wood, M.D., a CC senior investigator, the Center offers new and expanded opportunities to investigate cancer therapies that use imaging technology to diagnose and treat localized cancers in ways that are precisely targeted and minimally or non-invasive. The center is a collaboration involving the CC, NIH’s clinical research hospital in Bethesda, Md., the National Cancer Institute and the National Heart, Lung, and Blood Institute. The Center for Interventional Oncology will help foster advances in an emerging field for minimally invasive, image-guided methods for treating localized cancers. The goal is to bridge the gap between emerging technology and the everyday practice of medicine. The new center is intended to provide a forum for and encourage collaborations among research and patient-care experts in medical, surgical, and radiation oncology and interventional radiology. The new center’s goal is localized treatment and drug delivery by use of advanced imaging technologies located at the Clinical Center, including cutting-edge magnetic resonance imaging (MRI), positron emission tomography (PET), and computed tomography (CT) — combined with the capability to use all three technologies simultaneously to navigate a therapeutic device through the body. David Bluemke, MD, PhD, director
of Clinical Center Radiology and Imaging Sciences, will head the Center
for Interventional Oncology steering committee that comprises two NCI
appointees and one each from NHLBI and the CC. http://www.nih.gov/news/
The study, “Antigenic Fingerprinting of an H5N1 Avian Influenza Using Convalescent Sera and Monoclonal Antibodies reveals Potential Vaccine and Diagnostic Targets,” appears in the April 20, 2009, edition of the online journal PLoS Medicine. The findings by FDA scientists and collaborators better explain what part of the “bird flu” virus is seen by the immune system once a person becomes infected. As one result of this research, a protein of the bird flu virus called PB1-F2 was identified as a potentially potent target for attack by immune systems to stop the spread of the virus. Since 2003, more than 400 people worldwide have been infected with the bird flu virus. About 60 percent of them have died. No cases of avian flu have been reported in the United States. Most of the avian flu infections in humans involve people who have had direct contact with infected poultry. However, there is a potential risk for a global influenza pandemic should the virus acquire the ability to spread directly from person to person. The researchers adapted an existing technique using genetically modified viruses to create a library of fragments representing all of the proteins found in the H5N1 virus. Scientists mixed these fragments with antibodies from five Vietnamese patients recovering from the H5N1 infection and observed which fragments attracted the patient’s antibodies. Several targets that are likely to
trigger strong antibody responses to the H5N1 virus were identified,
including PB1-F2, a protein that researchers believe contributes significantly
to the virus’s ability to cause disease.
The American Recovery and Reinvestment Act required publication of the guidance by April 18. This builds on the existing requirements of the HIPAA Privacy and Security Rules, which are unchanged. The guidance provides steps entities can take to secure personal health information and establishes the trigger for when entities must notify that patient data has been compromised. This guidance is related to “breach notification” regulations, which will be issued by HHS and the Federal Trade Commission (FTC), respectively. The HHS regulations will apply to entities covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the FTC regulation will apply to vendors of personal health records and certain others not covered by HIPAA. The Recovery Act requires that these regulations be published within 180 days of enactment. The guidance was developed through
a joint effort by the HHS Office for Civil Rights (OCR), Office of the
National Coordinator for Health Information Technology (ONC), and Centers
for Medicare & Medicaid Services (CMS). To read the entire guidance,
please visit www.hhs.gov/ocr/privacy
The tools will give researchers more power to compare data from multiple studies, accelerating efforts to understand the complex genetic and environmental factors that cause cancer, heart disease, depression and other common diseases. The toolkit, which is available at https://www.phenxtoolkit.org/, is the first product of the Consensus Measures for Phenotypes and eXposures (PhenX) initiative. Supported by a $6.8 million cooperative agreement from NHGRI and conducted by RTI International in Research Triangle Park, N.C., PhenX is a three-year project to develop a set of standard measures across 20 research categories related to health and common diseases. Cross-study comparisons can help researchers refine estimates of disease risk and extend the findings of one study to other population groups. Theoretically, by comparing studies that utilize the standard measures in the PhenX Toolkit, researchers could more easily combine the results for each measurement from an obesity study with a diabetes study to examine the overlap of genetic factors in the two health conditions. The first release of the PhenX toolkit contains standard measures selected by experts in three categories. They include demographics, with information on measurements such as current age, ethnicity, gender and current educational attainment; anthropometrics, or measurements of the human body and its proportions such as height, weight and waist circumference; and alcohol, tobacco and other substances, with measures such as maximum drinks in 24 hours and nicotine dependence. The toolkit also includes information about each measure, such as the rationale for its selection, standard data collection protocols and a summary of research personnel and required training. Other categories of measures such as cardiovascular and nutrition and dietary supplements will be added in the next several months. The process used to develop the measures is being driven by the scientific community through the PhenX steering committee, working groups and surveys. Additional categories and measures will be added to the PhenX Toolkit over the next few months. Along with its goal of listing 20 standardized measures, the toolkit will include supplemental information about each measure, such as current scientific thinking about its significance and influences upon health status. The process used to develop the measures is being driven by the scientific community through the PhenX steering committee, working groups and surveys. For more information about PhenX,
please visit: www.phenx.org.
The government will not appeal this decision. In accordance with the court’s order, and consistent with the scientific findings made in 2005 by the Center for Drug Evaluation and Research, FDA announced on April 22, 2009, that it notified the manufacturer of Plan B that it may, upon submission and approval of an appropriate application, market Plan B without a prescription to women 17 years of age and older. Plan B is manufactured by Duramed
Research, Inc. of Bala Cynwyd, Pa.
The selected proposals, representing 11 institutions in eight states, will receive a total of almost $16 million during a three- to four-year period. The Human Research Program provides knowledge and technologies to improve human health and performance during space exploration. The program also develops possible countermeasures for problems experienced during space travel. Goals include the successful completion of exploration missions and preservation of astronauts' health throughout their lives. The program quantifies crew health and performance risks during spaceflight and develops strategies that mission planners and system developers can use to monitor and mitigate health and performance risks. The 12 projects were selected from 54 proposals NASA received in response to a research announcement titled "Research and Technology Development to Support Crew Health and Performance in Space Exploration Missions." NSBRI is a NASA-funded consortium of institutions studying health risks related to long-duration spaceflight. The institute's science, technology and education projects take place at more than 60 institutions across the United States. A complete list of the selected principal
investigators, organizations and proposals is available on the Web at: http://www.nasa.gov/
The study by the university’s Center for Biosecurity was released by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR). The center conducted an independent evaluation of the HHS Hospital Preparedness Program and the program’s impact on health care preparedness for mass casualty disasters. The program was established by the Pandemic and All-Hazards Preparedness Act of 2006 after the Sept. 11, 2001, terrorist attacks to improve hospitals’ preparedness for all types of disasters. The study evaluated the first five years of the program from 2002 to 2007. It found that the most useful indicators for measuring the preparedness of hospitals are ability to surge to accommodate additional patients during disasters, how well hospitals do in training their staff for disasters and realistic exercises, and how well hospitals perform during actual disasters. The study showed that HPP has been the catalyst for new health care coalitions throughout the country. As a result, many communities can now respond more effectively to disasters. Through these coalitions, hospitals are now working collaboratively on disaster preparedness with other hospitals, public health departments and emergency managers. The report also found that health care planning for catastrophic emergencies at the individual hospital level is still in the early stages and that a large-scale emergency could “overwhelm the medical capabilities of communities, regions or the entire country and require drastic departures from customary health care practices.” The report concluded that bridging this gap would require significant changes in the way health care is delivered. The study’s findings are based on a year of research and analysis, including interviews with 133 individuals involved with hospital preparedness in every state and at local levels across the country. The full report is available at www.upmc-biosecurity.org/ Reserve/Guard
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If you need further information on any of the items in the Federal Health Update, please contact Kate Connelly Theroux at (703) 447-3257 or by e-mail at katetheroux@fedhealthinst.org. To subscribe, please visit http://fedhealthinst.org/subscriber.cfm. To unsubscribe, please send an email to newsletter@fedhealthinst.org with UNSUBSCRIBE as the subject. Back issues availiable at Federal Health Update Archives. |
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