New York, U.S.A. – Elsevier, a provider of scientific, technical and medical information products and services, is pleased to announce the launch of Health Care: The Journal of Delivery Science and Innovation.

“Health Care” provides a vehicle for communicating important advances in the study of cutting edge research on innovation in health care delivery, including improvements in systems, processes, management, payment, and applied information technology. The United States health care system is undergoing unprecedented reform; “Health Care” builds on examples to demonstrate how change happens in real-world settings, disseminating important ideas that inform and improve clinical practice by publishing innovative, high-quality research, reviews and opinions.

The leadership of the journal comes under three Senior co-Editors-in-Chief, all renowned experts on health care transformation: Arnold Milstein, Professor of Medicine at Stanford and Medical Director of the Pacific Business Group on Health; Richard Shannon, the Frank Wister Professor of Medicine and Chair of the Department of Medicine at the University of Pennsylvania; and Ashish Jha, C. Boden Gray Associate Professor of Medicine at the Harvard School of Public Health.

“This is a critical time for the U.S. health care system,” said Dr. Jha. “The need for thoughtful, high-quality empirical work to guide us has never been greater. “Health Care” will combine data-driven evaluations of current efforts with insightful commentary from the most innovative thinkers in the U.S.  We aim to make it an important force for fresh ideas on how to improve the healthcare delivery system.”

Founders of the journal and co-Editors-in-Chief are Amol Navathe, MD, PhD, a physician at the Brigham and Women’s Hospital who holds appointments at Harvard Medical School and The Wharton School of theUniversity of Pennsylvania, and Sachin H. Jain, MD, MBA, a physician at the Boston Veteran’s Administration Medical Center, Lecturer in Health Care Policy at Harvard Medical School, and Chief Medical Information and Innovation Officer at Merck.

Christine Cassel, the President of the American Board of Internal Medicine and a member of the journal’s editorial board, stated, “Health care delivery systems are advancing at an incredible pace. Physicians and other members of the health care team need help in translating these changes in health care delivery into broader practice. This new launch will provide the community with a high-quality journal in which to publish these advances and drive change.”

“Elsevier is pleased to work with the distinguished leadership of this journal to publish scholarly communication at the nexus of healthcare and technology,” said Ann Gabriel, Publishing Director at Elsevier. “The launch of this journal is very timely given the rapidly evolving landscape of health care delivery in the U.S.”

For more information or to submit an article, go to Health Care: The Journal of Delivery Science and Innovation.

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Pennsylvania, U.S.A. — Department of Health Secretary Dr. Eli N. presented on August 21 nearly $4 million in Commonwealth Universal Research Enhancement Program, or CURE, grants to support two research projects focused on esophageal cancer treatment and advancing detection of abdominal aortic aneurysms.

The CURE program funds health research with the purpose of discovering new scientific knowledge to help improve the health of all Pennsylvanians.

These competitive grants focus on specific research priorities established and reviewed by the Department of Health in conjunction with the Health Research Advisory Committee, a panel made up of universities and research institutes.

The funds, allocated in the 2011-12 fiscal year, focus on projects that translate the information found within the human genome and support research that commercializes and brings to market new, proven cancer diagnostics or therapeutics.

Twelve projects statewide are receiving CURE grant awards totaling $15.3 million. Since the grant program’s inception, Geisinger Clinic has received nearly $5.2 million in CURE funding, part of the more than $750 million in total CURE awards.

“This is an exciting time in health research and we are confident this research will improve public health and help Pennsylvanians to live longer, healthier lives,” said Avila.

More information about the CURE program is found at the Department of Health’s website at www.health.state.pa.us/cure.

Overview of the funded projects and awards announced on August 21:

• Geisinger Clinic: Utility of Genomic Data in Population Screening for Abdominal Aortic Aneurysm ($2,909,969):

The project is using knowledge of genetic risk factors to improve screening for abdominal aortic aneurysm (AAA), the 13th leading cause of death in the United States.

• Geisinger Clinic: Diagnostic-Prognostic Testing in Patients at High Risk for Esophageal Cancer ($1 million):

The project is developing a test that predicts the risk of developing esophageal cancer in patients with chronic gastro-esophageal reflux disease (GERD) and Barrett’s Esophagus.

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Colorado Springs, U.S.A. – In an effort to improve national health, reduce dramatic rises in healthcare costs, and reduce drowning tragedies, the non-profit, National Swimming Pool Foundation is launching the Step Into Swim Campaign. The 10-year campaign will initially partner with nine organizations that teach children, adults, and minority populations to swim. Beyond the personal pain caused by poor health, the financial burden of obesity is estimated to be $147 billion/year. In addition, the tragic incidences of drowning will cost society about $100 billion for the next 20 years.

Obesity trends are likely to continue based on increased childhood obesity rates and Census Bureau estimates that there will be about 24 million more 65+ year olds in the next 10 years. Aquatic activity is one of the best activity options available for aging and out-of-shape people. Unfortunately, about half of Americans are afraid of deep water or cannot swim. “Becoming a swimmer is the first step to opening a spectrum of fun and healthy activities for the entire family — grandparents, grandkids and everyone in between,” says John Puetz, President of the NSPF Board of Directors.

The Step Into Swim campaign asks private and public sectors to sponsor or donate to organizations that teach people to swim. The National Swimming Pool Foundation issued a White Paper to explain how teaching more people to swim is imperative to address skyrocketing healthcare costs and prevent troubling drowning rates.

“There is a lot of bad health, drowning, and economic news! Here is good news. One simple step will provide a primary prevention practice to improve public health, prevent drowning and help keep our country economically sound and competitive,” declares Thomas M. Lachocki, Ph.D., CEO with NSPF. “What’s better? People will have more year-round fun with friends and family.”

Public and private sector organizations can download the white paper, learn more about the partner organizations and donate to the cause at www.StepIntoSwim.org. The first major campaign event is theStep Into Swim Congress, scheduled for October 10, 2012 from 1:00-5:00 pm, in the Nauticus Museum, beside the Battleship Wisconsin in Norfolk, Virginia. “Today, we have rolled out www.StepIntoSwim.org, where potential donors and sponsors can learn more and make a tax deductible donation. We will also share more about the upcoming Step Into Swim Congress,” explains Dr. Lachocki.

Nine Step Into Swim partners will present proposals at the Congress describing their plan to teach more people to become swimmers. The proposals will focus on swim programs for children, adults who are fearful in the water, and minority populations.

The nine partners are: YMCA of the USA, Jewish Community Centers, U.S. Swim School Association, World’s Largest Swim Lesson, Miracle Swimming Institute, Strategies for Overcoming Aquatic Phobias, American Red Cross, Make a Splash Campaign, and Swim America. “We are thrilled to organize this event and align with and support these organizations,” adds Lachocki. “In addition to organizing the Step Into Swim Campaign and Congress, the National Swimming Pool Foundation also plans to donate on an annual basis,” reinforces Puetz.

“The problem is defined. The solution is clear. The better we work together, the more impact we will make,” summarizes Puetz. “I dream of the day we help a million MORE people take the step to become swimmers,” he adds. Dr. Lachocki agrees, urging public and private organizations, “Please, take the first step by making a donation.”

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Merck (known as MSD outside the United States and Canada) announced that three-time Grammy award-winning Cuban-American recording artist and songwriter Jon Secada is adding his voice to the Tune In to Hep C public health campaign to help raise awareness of chronic hepatitis C virus (HCV) infection.

Secada revealed for the first time that his father recently passed away from complications associated with chronic HCV infection, a disease that disproportionately affects the Hispanic community. He hopes that sharing his family’s personal experience through this bilingual awareness campaign will activate Hispanic Americans with chronic HCV to take action and speak to their doctors about their options.

Secada joins Merck, the American Liver Foundation (ALF) and fellow Grammy winners Gregg Allman of The Allman Brothers Band and Natalie Cole on the Tune In to Hep C initiative, which Merck and ALF launched last year.

Chronic HCV is a viral infection of the liver that is potentially serious and can damage the liver over time and lead to cirrhosis, end-stage liver disease and liver cancer. Of the approximately 3.2 million Americans who have chronic HCV, an estimated one million are Hispanic.

Research has shown that complications due to chronic HCV develop more quickly and result in more health issues in Hispanics when compared to other ethnic groups, especially considering many people infected with chronic HCV, Hispanic or non-Hispanic, do not know that they have the virus – approximately 70 to 80 percent of people newly infected with the virus do not have symptoms.

“My father chose not to tell anyone about his disease for a long time, and he chose not to take action against it for reasons I may never understand. Before he passed away, he told me that he wanted me to share his story to help other people like him who have chronic hepatitis C but aren’t taking action,” said Secada, who was unaware of his father’s diagnosis for more than a decade.

“You can’t be silent with a silent disease that has consequences like chronic hepatitis C — you need to talk to your doctor and talk to your family. Take it from me, the people who love you want to be there to help you, and want you to be there for them.”

The American Liver Foundation partnered with Merck on the Tune In to Hep C campaign to help address barriers that can keep people from managing their disease, including lack of awareness and social stigma.  The American Liver Foundation is a national organization advocating for those living with liver disease and their families, and provides education, support and research for the prevention, treatment and cure of liver disease.

“Chronic hepatitis C disproportionately affects the Hispanic community but, unfortunately, there is stigma and low awareness of the disease and its potential complications, so it is not widely discussed among Hispanics in the U.S.,” said Newton Guerin, president and chief executive officer, American Liver Foundation. “We hope Jon’s desire to turn his family’s loss into a positive message for those who face this disease will encourage them to take action.”

“For more than 30 years, Merck has been committed to fighting chronic HCV. That commitment extends beyond science and is part of our overall mission to help people around the world be well,” said Mark Timney, president, Global Human Health – U.S. Market, Merck.  ”We believe Jon’s message is an important one that will motivate Hispanic Americans with hepatitis C to take action and speak with their doctors, and we applaud him for his efforts in this campaign.”

Image Courtesy of   https://www.facebook.com/jonsecada

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Save Babies Through Screening Foundation (SBTS), the only national volunteer-run nonprofit organization devoted exclusively to the advocacy of newborn screening (NBS), reaffirmed its commitment to the public health value of retention and appropriate use of residual dried blood spot specimens.

SBTS will increase its efforts to raise awareness and disseminate vital information in order to better educate the public on this issue of growing visibility and importance. ”Recent litigation efforts in Texas and Minnesota dried blood spot specimens make clear the abundance of misinformation in circulation regarding the privacy and protection related to the use of newborn blood spots,” said Jill Levy-Fisch, SBTS President.

“Now more than ever, a public education campaign is needed to provide greater clarity about the benefits of retaining these samples as well as the privacy protections already in place in all states and afforded by the Genetics Information Nondiscrimination Act of 2008.”

Many components in a properly stored blood spot can last for decades, enabling doctors to make use of samples for health-related testing of patients, long after the NBS process has concluded. In addition, the retention of de-identified samples allows researchers to develop new and more refined screening tests as well as conduct quality control assessments of screening methods already in use.

Currently, laws regulating the retention and use of blood spot specimens differ from state to state. All states, however, have patient privacy protections in place. Strict state and federal rules and regulations govern the use of these specimens for research. Specimens can only be used for research without patient consent if all identifying information has been removed.

Researchers must work through an Institutional Review Board (IRB) and state health institutions. Once approval is granted, researchers receive de-identified samples in order to ensure that privacy is protected.

“Newborn screening is one of the most successful public health efforts of the last 50 years,” notes Dr. Jerry Vockley, Professor of Pediatrics and Human Genetics at the University of Pittsburgh School and Chief of Medical Genetics at the Children’s Hospital of Pittsburgh of UPMC.

“The blood spots represent a valuable resource that provide us with the ability not only to quality control screening programs but also to develop new tests that play a crucial role in helping diagnose disorders that can lead to death or severe mental disabilities. They enable us to do this early enough to allow therapy and treatment to work before these diseases are able to take their course.”

“These dried spots are invaluable for the development of new life-saving newborn screening tests and increased understanding of the conditions that will lead to better treatments,” added Dr. R. Rodney Howell, Professor of Pediatrics and Chairman Emeritus, Miller School of Medicine at the University of Miami.

“These blood spots must be stored and used under conditions that will maintain the public confidence in the programs. The Secretary’s Advisory Committee on Hereditary Disorders in Newborns and Children (SACHDNC), of which I was the Founding Chairman, has published a report outlining the ideal storage and use of these spots, and I strongly recommend that states follow these suggestions.”

SBTS recognizes the need for state public health departments to address public concerns about privacy and consent while at the same time clearly articulating the importance of NBS and the possible public health benefits of research using dried blood spots. To this end, SBTS supports the recent SACHDNC report and recommendations to the Secretary of Health and Human Services on this subject (see the July 2011 issue of Genetics in Medicine ).

This report clearly reaffirms the need to “improve efforts to educate the public and healthcare providers about NBS and the retention and use of specimens.” It does not encourage the destruction of this very valuable national resource.

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Beyond Pesticides, along with Center for Environmental Health, Farmworker Justice, Healthy Schools Network, The Endocrine Disruption Exchange and over 100 national, state and local grassroots organizations, told the Environmental Protection Agency (EPA) to protect public health and eliminate unnecessary pyrethroid pesticides.

The group criticized EPA’s cumulative risk assessment, which concluded that pyrethroids “do not pose risk concerns for children or adults,” ignoring a wealth of peer reviewed studies linking this class of chemicals to cancer, respiratory and reproductive problems. EPA went as far as to state that it will consider additional uses, opening the flood gates and endangering public health.

EPA is mandated to complete cumulative risk assessments for pesticides, like pyrethroids, that have the same mechanism of toxicity. However, as the commenters point out, EPA’s evaluation ignores various routes of exposure, underestimating the risks.

The agency also chose to reduce the Food Quality Protection Act (FQPA) safety factor from 10 to 3 times for children less than six years of age and eliminate it completely for children over six. The FQPA safety factor is intended to protect infants and children to account for their special vulnerability to pesticides. Given that children are particularly sensitive to certain pyrethroids, this reduction is egregious.

Pyrethroids are used for indoor pest control, mosquito management, in agriculture, and on pets. Exposure has been reported to lead to headaches, dizziness, nausea, irritation, and skin sensations. EPA classifies pyrethroids permethrin and cypermethrin as possible human carcinogens, and permethrin as a suspected hormone disruptor.

Pyrethroids have also been linked to respiratory problems and triggering asthma attacks. Many are persistent and CDC reports that pyrethroids contaminate the bodies of more than half of all U.S. residents.

At the same time, there are clear established methods for managing homes, schools and other buildings without toxic pesticides, including exclusion techniques, sanitation and maintenance practices, as well as mechanical and least toxic, non-volatile pesticides.

Organic agriculture, which now produces yields similar to or greater than chemical-intensive farming, has proven that these chemicals are not necessary on the farm either. And, it is more effective to fight mosquitoes with natural larvicides than it is to fog with pyrethroids. Based on the host of health effects linked to this chemical class, pyrethroid use is hazardous and unnecessary.

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The American Lung Association applauds the Obama Administration for adopting public health safeguards to reduce mercury and toxic air pollution from power plants.  The new Mercury and Air Toxics Standards for Power Plants are long overdue and will reduce the harm from air pollution like mercury, lead, arsenic, and a host of other pollutants.

“Since toxic air pollution from power plants can make people sick and cut lives short, the new Mercury and Air Toxics Standards are a huge victory for public health,” said Albert A. Rizzo, M.D., National Volunteer Chair of the American Lung Association, and pulmonary and critical care physician in Newark, Delaware.

“The Lung Association expects all oil and coal-fired power plants to act now to protect all Americans, especially our children, from the health risks imposed by these dangerous air pollutants.”

The Mercury and Air Toxics Standards will reduce toxic emissions from coal- and oil-fired power plants that are found in more than 40 U.S. states and are the largest producers of mercury pollution. Air pollution emitted by coal-fired power plants contains 84 of the 187 hazardous pollutants identified for control by the Clean Air Act.

Many of these pollutants, such as, dioxins, arsenic, and lead, can cause cancer and cardiovascular disease; harm the kidneys, lungs, and nervous system; and even kill. The Mercury and Air Toxics Standards will reduce these pollutants and prevent 130,000 childhood asthma attacks and 11,000 premature deaths each year.

The 1990 Clean Air Act Amendments required the tighter standards on power plants in an effort to reduce toxic emissions in communities across the country. However, big polluters have fought for and won delays for more than 21 years.

“Attempts to delay or dismantle the Clean Air Act, or rules like the Mercury and Air Toxics Standards, reward industry polluters and punish those most vulnerable to dirty air,” said Dr. Rizzo. “These new standards mark a huge step forward in clean air protections and will be responsible for saving thousands of lives each year.”

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As required by the 2009 law granting the U.S. Food and Drug Administration authority over tobacco products, the Institute of Medicine issued a report regarding the type of scientific evidence and research the FDA should require of tobacco companies seeking to make “modified risk” claims about tobacco products.

Modified risk products are defined in the law as “any tobacco product that is sold or distributed for use to reduce harm or the risk of tobacco-related disease associated with commercially marketed tobacco products.” Given the industry’s long and deadly history of deception, the IOM calls for rigorous, comprehensive and independent scientific evidence before any tobacco company will be allowed to claim that any of its products are less dangerous than other products.

This report lays out a comprehensive scientific roadmap for the FDA to follow in reviewing applications for modified risk tobacco products. It demonstrates the need for rigorous science, conducted and evaluated independent of the tobacco industry, before the industry is allowed to market any modified risk products.

It underscores the importance of the FDA considering the broad public health impact of introducing such products and not just the impact on individual tobacco users. And it properly puts the burden on tobacco manufacturers to produce adequate scientific evidence before allowing them to claim that any tobacco product reduces the risk of disease.

The IOM report makes it clear that the FDA must set a high scientific bar for allowing such claims given the industry’s history of deception about its products and of falsifying science. Such a high bar is critical to preventing a repeat of the decades-long fraud in which tobacco companies marketed light and low-tar cigarettes as safer despite knowing from their own research that they were just as harmful as regular cigarettes. This deception discouraged smokers from quitting and encouraged others to start, with devastating results for public health.

Before allowing a modified risk claim, the law requires the FDA to determine based on the scientific evidence that the product “as it is actually used by consumers, will (A) significantly reduce harm and the risk of tobacco-related disease to individual tobacco users; and (B) benefit the health of the population as a whole taking into account both users of tobacco products and persons who do not currently use tobacco products.”

This requires the FDA to consider whether any reduction in harm to an individual tobacco user may be offset by marketing that encourages non-users, including kids, to start using tobacco or discourages current tobacco users from quitting.

To effectively carry out this analysis, the IOM report calls on the FDA to require a wide range of scientific evidence that includes not only evidence and studies about the product’s contents and health effects, but also evidence regarding whether the product will promote initiation and continuation of tobacco use and how its marketing will be perceived by consumers. These are all critical issues that the FDA must consider in order to effectively protect public health.

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The National Academy of Sciences released recently the findings of its 18-month study of the potential public health and environmental impacts of uranium mining in Virginia.

“Virginia Uranium believes this study provides a clear road map for operating the world’s safest uranium mine in Virginia,” said Virginia Uranium, Inc. project manager, Patrick Wales.

“The study shows that major technological and regulatory advances over the past 30 years have dramatically improved the environmental and public health performance of the uranium mining and milling industry,” Wales continued. “Virginia Uranium is committed to continuing that process by adopting the best practices and regulatory requirements identified by the NAS as essential to protecting the environment and public health.”

“The concluding chapter of the report, in particular, provides a road map for how Virginia can design a regulatory structure to govern the safest uranium mining program in the world,” said Wales. This chapter identifies a list of best practices that should be required in a regulatory program should Virginia decide to allow uranium mining in the state.

These recommendations rely heavily on the track record of modern uranium mining operations in Canada and Colorado, which have been proven successful at managing many of the environmental and health risks associated with the industry in the 1950′s.

“The NAS study states time and again that best practices now widely adopted by the industry have been effective at protecting water and air quality and overall public health,” said Wales. “In particular, the report singles out the impact of heavily-lined, below-grade tailings disposal and the adoption of underground ventilation as having a significant impact on preserving water quality and worker safety,” Wales added. “We fully intend to use these state-of-the-industry practices at Coles Hill.”

The NAS says that “tailings impoundment sites will be safe for at least 200 years…” “We are fortunate,” Wales added, “that the underlying geology at the Coles Hill site is a very hard granite rock that has largely remained unchanged for the last 400 million years. This kind of setting will help ensure the safety and maintenance of our tailings facilities beyond the 200-1,000 requirement specified by the Nuclear Regulatory Commission.”

The NAS report acknowledges that even if the moratorium were to be lifted in 2012, it will take an additional 5 to 8 years before the Coles Hill project could receive all the necessary permits to begin operating. “Our company is confident that this lengthy timeframe will allow the General Assembly, state and federal agencies and community residents to thoroughly examine every aspect of this issue and make sure that the regulations are in place and best practices are fully adopted to protect the health and well-being of our community,” said Wales.

The study states, “There exists internationally accepted best practices, founded on principles of openness, transparency, and public involvement in oversight and decision-making, that could provide a starting point for the Commonwealth of Virginia were it to decide that the moratorium should be lifted.” They describe the practices in Chapter 8 of the report and emphasize the following:

With respect to all aspects of mining and processing, the NAS study recommends that Virginia’s regulatory program embrace the stringent ALARA standard (as low as reasonably achievable) for impacts on public health and the environment. The report suggests that adopting such a standard would allow the state’s regulations to be continuously updated and improved to reflect the most advanced practices In addition to this broad recommendation, there are 6 specific suggestions made by the study committee:

1. Ensure that the life-cycle costs as well as long term stewardship needs are reflected in the type of, and amount of, the financial surety.
2. Ensure that inspection and enforcement tools are transparent, practical, sufficient, available, independent and sustainable.
3. While the development of this new regulatory structure could be based on existing laws, the optimum approach would be for an entirely new mining, processing and reclamation law or laws be enacted.
4. Effective interagency integration and coordination.
5. Active engagement in the regulatory processes of the U.S. Nuclear Regulatory Commission and the U.S. Environmental Protection Agency to ensure good federal/state coordination. Additionally, considerable international expertise and knowledge in regulatory best practices should be sought.
6. Include the modern best practice of requiring an environmental impact assessment prior to the commencement of any mining activities.

The study findings were presented to the Uranium Mining Subcommittee of the Virginia Coal & Energy Commission by the study committee’s chair, Dr. Paul Locke, Director of the Public Health Program and Department of Environmental Health Sciences at the Johns Hopkins University Bloomberg School of Public Health.

“As a company, we are pleased with the road map this study lays out. It embraces many of the concepts we have advocated as a company.

We have employed many of the same principles in our exploration work, such as ALARA, already.  In fact, one of our guiding principles has been to welcome scrutiny from local, state, and federal regulatory bodies and strive to meet or exceed their standards. We also invite the review and participation of responsible environmental groups, as well as that of citizens. The study emphasizes the importance of public engagement, and as a company we embrace it.”

J Duggan / Shutterstock.com

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