Jan Dyer

This should not come as much of a surprise, but health care made the top-5 list of occupations whose workers are getting too little sleep, according to a study by The National Institute for Occupational Safety and Health (NIOSH) researchers.

The researchers analyzed data from 179,621 working adults who responded to the 2013 or 2014 Behavior Risk Factor Surveillance System annual surveys. Among the 22 major occupation groups, health care support (40.1%) and health care practitioners and technical (40.0%) ranked second and third in “short sleep duration,” after production (42.9%). Among the occupational subgroups, nursing, psychiatric, and home health aides had a high adjusted prevalence of short sleep duration.

Workers in occupations where alternative shiftwork is common were more likely to have a higher adjusted prevalence of short sleep duration.  More than 35% of health care practitioners work shifts. Workers in other occupation groups such as teachers, farmers, or pilots, were more likely to report getting enough sleep.

Time at work also is on the rise in the US where workers have the longest annual working hours among workers in all wealthy industrialized countries, which reduces the time available for sleep, NIOSH says. The researchers point out that lack of sleep has been linked to negative health outcomes including cardiovascular disease, obesity, and depression, as well as safety issues related to drowsy driving and injuries.

To help people get more sleep or improve the quality of the sleep they get, NIOSH offers training and resources about sleep, shiftwork, and fatigue for a variety of audiences including health care workers and emergency responders. Free downloadable materials are available at www.cdc.gov/niosh/topics/workschedules/education.html.

This should not come as much of a surprise, but health care made the top-5 list of occupations whose workers are getting too little sleep, according to a study by The National Institute for Occupational Safety and Health (NIOSH) researchers.

The researchers analyzed data from 179,621 working adults who responded to the 2013 or 2014 Behavior Risk Factor Surveillance System annual surveys. Among the 22 major occupation groups, health care support (40.1%) and health care practitioners and technical (40.0%) ranked second and third in “short sleep duration,” after production (42.9%). Among the occupational subgroups, nursing, psychiatric, and home health aides had a high adjusted prevalence of short sleep duration.

Workers in occupations where alternative shiftwork is common were more likely to have a higher adjusted prevalence of short sleep duration.  More than 35% of health care practitioners work shifts. Workers in other occupation groups such as teachers, farmers, or pilots, were more likely to report getting enough sleep.

Time at work also is on the rise in the US where workers have the longest annual working hours among workers in all wealthy industrialized countries, which reduces the time available for sleep, NIOSH says. The researchers point out that lack of sleep has been linked to negative health outcomes including cardiovascular disease, obesity, and depression, as well as safety issues related to drowsy driving and injuries.

To help people get more sleep or improve the quality of the sleep they get, NIOSH offers training and resources about sleep, shiftwork, and fatigue for a variety of audiences including health care workers and emergency responders. Free downloadable materials are available at www.cdc.gov/niosh/topics/workschedules/education.html.

This should not come as much of a surprise, but health care made the top-5 list of occupations whose workers are getting too little sleep, according to a study by The National Institute for Occupational Safety and Health (NIOSH) researchers.

The researchers analyzed data from 179,621 working adults who responded to the 2013 or 2014 Behavior Risk Factor Surveillance System annual surveys. Among the 22 major occupation groups, health care support (40.1%) and health care practitioners and technical (40.0%) ranked second and third in “short sleep duration,” after production (42.9%). Among the occupational subgroups, nursing, psychiatric, and home health aides had a high adjusted prevalence of short sleep duration.

Workers in occupations where alternative shiftwork is common were more likely to have a higher adjusted prevalence of short sleep duration.  More than 35% of health care practitioners work shifts. Workers in other occupation groups such as teachers, farmers, or pilots, were more likely to report getting enough sleep.

Time at work also is on the rise in the US where workers have the longest annual working hours among workers in all wealthy industrialized countries, which reduces the time available for sleep, NIOSH says. The researchers point out that lack of sleep has been linked to negative health outcomes including cardiovascular disease, obesity, and depression, as well as safety issues related to drowsy driving and injuries.

To help people get more sleep or improve the quality of the sleep they get, NIOSH offers training and resources about sleep, shiftwork, and fatigue for a variety of audiences including health care workers and emergency responders. Free downloadable materials are available at www.cdc.gov/niosh/topics/workschedules/education.html.

About 3.5 million U.S. adults are chronically infected with hepatitis C (HCV), and 80% of those are baby boomers. As many as 3 out of 4 infected people are not aware of it, according to the CDC, putting them at risk for liver disease, cancer, and death. And most baby boomers aren’t getting tested for the HCV virus.

Between 2013 (when the U.S. Preventive Services Task Force issued a recommendation that all people born between 1945 and 1965 be tested) and 2015, the rate of testing among baby boomers rose only from 12.3% to 13.8%. About 10.5 million of the 76.2 million baby boomers have been tested for HCV, say American Cancer Society researchers who analyzed data from the CDC’s National Health Interview Survey.

Half of Americans identified as ever having had HCV received follow-up testing showing they were still infected, suggesting that even among those who receive an initial antibody test, half may not know for sure whether they still carry the virus.

“Hepatitis C has few noticeable symptoms,” says John Ward, MD, director of the CDC’s Viral Hepatitis Program, and left undiagnosed it threatens the health not only of the person with the virus, but those the disease might be transmitted to. Identifying those who are infected is important, he adds, because new treatments can cure the infection and eliminate the risk of transmission.

About 3.5 million U.S. adults are chronically infected with hepatitis C (HCV), and 80% of those are baby boomers. As many as 3 out of 4 infected people are not aware of it, according to the CDC, putting them at risk for liver disease, cancer, and death. And most baby boomers aren’t getting tested for the HCV virus.

Between 2013 (when the U.S. Preventive Services Task Force issued a recommendation that all people born between 1945 and 1965 be tested) and 2015, the rate of testing among baby boomers rose only from 12.3% to 13.8%. About 10.5 million of the 76.2 million baby boomers have been tested for HCV, say American Cancer Society researchers who analyzed data from the CDC’s National Health Interview Survey.

Half of Americans identified as ever having had HCV received follow-up testing showing they were still infected, suggesting that even among those who receive an initial antibody test, half may not know for sure whether they still carry the virus.

“Hepatitis C has few noticeable symptoms,” says John Ward, MD, director of the CDC’s Viral Hepatitis Program, and left undiagnosed it threatens the health not only of the person with the virus, but those the disease might be transmitted to. Identifying those who are infected is important, he adds, because new treatments can cure the infection and eliminate the risk of transmission.

About 3.5 million U.S. adults are chronically infected with hepatitis C (HCV), and 80% of those are baby boomers. As many as 3 out of 4 infected people are not aware of it, according to the CDC, putting them at risk for liver disease, cancer, and death. And most baby boomers aren’t getting tested for the HCV virus.

Between 2013 (when the U.S. Preventive Services Task Force issued a recommendation that all people born between 1945 and 1965 be tested) and 2015, the rate of testing among baby boomers rose only from 12.3% to 13.8%. About 10.5 million of the 76.2 million baby boomers have been tested for HCV, say American Cancer Society researchers who analyzed data from the CDC’s National Health Interview Survey.

Half of Americans identified as ever having had HCV received follow-up testing showing they were still infected, suggesting that even among those who receive an initial antibody test, half may not know for sure whether they still carry the virus.

“Hepatitis C has few noticeable symptoms,” says John Ward, MD, director of the CDC’s Viral Hepatitis Program, and left undiagnosed it threatens the health not only of the person with the virus, but those the disease might be transmitted to. Identifying those who are infected is important, he adds, because new treatments can cure the infection and eliminate the risk of transmission.

Ten IHS sites will take part in a new year-long pilot project to integrate trauma-informed care for children through a partnership between IHS, Johns Hopkins Center for Mental Health Services in Pediatric Primary Care, and Johns Hopkins Center for American Indian Health. “The quality of care for our youngest patients is important…” said Rear Admiral Chris Buchanan, acting director of the IHS. The collaboration is designed to reduce the effects of childhood traumatic stress due to poverty, physical or sexual abuse, community and school violence, and neglect.

 The IHS and tribal pilot sites will receive virtual technical assistance through webinars, virtual learning communities, technical assistance calls, and metrics collection and analysis. IHS is working with the Pediatric Integrated Care Collaborative (PICC), part of the Johns Hopkins Center for Mental Health Services in Pediatric Primary Care. PICC works with national faculty, pediatric primary care providers, mental health professionals, and families to integrate behavioral and physical health services in Native communities.

The project uses a “learning collaborative” method in which newly learned processes are implemented and then evaluated to find out what works well and what does not and what changes might be needed. Staff are encouraged to test practical, sustainable approaches of integrating trauma/chronic stress prevention, detection, and early intervention into primary care for young children. Identified approaches may include providing primary and secondary prevention, screening for trauma-related problems, or treating trauma-related problems, the IHS says.

“We are honored to be able to work with a group of tribal communities and the IHS on trauma-informed integrated care,” said Lawrence Wissow, MD, professor, Division of Child and Adolescent Psychiatry at Johns Hopkins School of Medicine. “[W]e know that the larger integrated care world will learn from solutions that incorporate Native American traditions of healing and collaboration.”

Ten IHS sites will take part in a new year-long pilot project to integrate trauma-informed care for children through a partnership between IHS, Johns Hopkins Center for Mental Health Services in Pediatric Primary Care, and Johns Hopkins Center for American Indian Health. “The quality of care for our youngest patients is important…” said Rear Admiral Chris Buchanan, acting director of the IHS. The collaboration is designed to reduce the effects of childhood traumatic stress due to poverty, physical or sexual abuse, community and school violence, and neglect.

 The IHS and tribal pilot sites will receive virtual technical assistance through webinars, virtual learning communities, technical assistance calls, and metrics collection and analysis. IHS is working with the Pediatric Integrated Care Collaborative (PICC), part of the Johns Hopkins Center for Mental Health Services in Pediatric Primary Care. PICC works with national faculty, pediatric primary care providers, mental health professionals, and families to integrate behavioral and physical health services in Native communities.

The project uses a “learning collaborative” method in which newly learned processes are implemented and then evaluated to find out what works well and what does not and what changes might be needed. Staff are encouraged to test practical, sustainable approaches of integrating trauma/chronic stress prevention, detection, and early intervention into primary care for young children. Identified approaches may include providing primary and secondary prevention, screening for trauma-related problems, or treating trauma-related problems, the IHS says.

“We are honored to be able to work with a group of tribal communities and the IHS on trauma-informed integrated care,” said Lawrence Wissow, MD, professor, Division of Child and Adolescent Psychiatry at Johns Hopkins School of Medicine. “[W]e know that the larger integrated care world will learn from solutions that incorporate Native American traditions of healing and collaboration.”

Ten IHS sites will take part in a new year-long pilot project to integrate trauma-informed care for children through a partnership between IHS, Johns Hopkins Center for Mental Health Services in Pediatric Primary Care, and Johns Hopkins Center for American Indian Health. “The quality of care for our youngest patients is important…” said Rear Admiral Chris Buchanan, acting director of the IHS. The collaboration is designed to reduce the effects of childhood traumatic stress due to poverty, physical or sexual abuse, community and school violence, and neglect.

 The IHS and tribal pilot sites will receive virtual technical assistance through webinars, virtual learning communities, technical assistance calls, and metrics collection and analysis. IHS is working with the Pediatric Integrated Care Collaborative (PICC), part of the Johns Hopkins Center for Mental Health Services in Pediatric Primary Care. PICC works with national faculty, pediatric primary care providers, mental health professionals, and families to integrate behavioral and physical health services in Native communities.

The project uses a “learning collaborative” method in which newly learned processes are implemented and then evaluated to find out what works well and what does not and what changes might be needed. Staff are encouraged to test practical, sustainable approaches of integrating trauma/chronic stress prevention, detection, and early intervention into primary care for young children. Identified approaches may include providing primary and secondary prevention, screening for trauma-related problems, or treating trauma-related problems, the IHS says.

“We are honored to be able to work with a group of tribal communities and the IHS on trauma-informed integrated care,” said Lawrence Wissow, MD, professor, Division of Child and Adolescent Psychiatry at Johns Hopkins School of Medicine. “[W]e know that the larger integrated care world will learn from solutions that incorporate Native American traditions of healing and collaboration.”

Studies have shown that African Americans have higher incidences of cancer than that of other racial/ethnic groups. They also are more likely to be diagnosed later and to die of the cancer. Compared with whites, African Americans have poorer survival rates for the 4 most common types of cancer (lung, breast, prostate, and colorectal). The ready-to-launch Detroit Research on Cancer Survivors study, funded by the National Cancer Institute (NCI), is “uniquely poised” to find out why, said Douglas Lowy, MD, acting director of NCI.

The largest such study to date will include 5,560 African American cancer survivors and 2,780 family members and will look at cancer progression, recurrence, mortality as well as quality of life for survivors and their families. The researchers will investigate the “myriad factors that may affect cancer survival,” including type of treatment, coexisting disease, genetics, social structure, support, neighborhood context, poverty, stress, racial discrimination, and literacy.

The participants are drawn from 3 counties around Detroit where about 21,000 people are diagnosed with cancer every year. The study also uses data from the Detroit area population-based cancer registry, part of NCI’s Surveillance, Epidemiology and End Results (SEER) Program. Joanne Elena, PhD, MPH, scientific program director for the grant funding the study, calls it a “great example of an efficient use of an existing structure to rapidly recruit cancer survivors into research studies.”

The grant is for $9 million over 5 years. “Investigating the complex factors that lead to disparities in cancer among underserved populations should lead to a greater understanding of the social and biologic causes of such differences,” said Robert Croyle, PhD, director of NCI’s Division of Cancer Control and Population Sciences. “And our hope is that this knowledge will lead to better outcomes.”

Studies have shown that African Americans have higher incidences of cancer than that of other racial/ethnic groups. They also are more likely to be diagnosed later and to die of the cancer. Compared with whites, African Americans have poorer survival rates for the 4 most common types of cancer (lung, breast, prostate, and colorectal). The ready-to-launch Detroit Research on Cancer Survivors study, funded by the National Cancer Institute (NCI), is “uniquely poised” to find out why, said Douglas Lowy, MD, acting director of NCI.

The largest such study to date will include 5,560 African American cancer survivors and 2,780 family members and will look at cancer progression, recurrence, mortality as well as quality of life for survivors and their families. The researchers will investigate the “myriad factors that may affect cancer survival,” including type of treatment, coexisting disease, genetics, social structure, support, neighborhood context, poverty, stress, racial discrimination, and literacy.

The participants are drawn from 3 counties around Detroit where about 21,000 people are diagnosed with cancer every year. The study also uses data from the Detroit area population-based cancer registry, part of NCI’s Surveillance, Epidemiology and End Results (SEER) Program. Joanne Elena, PhD, MPH, scientific program director for the grant funding the study, calls it a “great example of an efficient use of an existing structure to rapidly recruit cancer survivors into research studies.”

The grant is for $9 million over 5 years. “Investigating the complex factors that lead to disparities in cancer among underserved populations should lead to a greater understanding of the social and biologic causes of such differences,” said Robert Croyle, PhD, director of NCI’s Division of Cancer Control and Population Sciences. “And our hope is that this knowledge will lead to better outcomes.”

Studies have shown that African Americans have higher incidences of cancer than that of other racial/ethnic groups. They also are more likely to be diagnosed later and to die of the cancer. Compared with whites, African Americans have poorer survival rates for the 4 most common types of cancer (lung, breast, prostate, and colorectal). The ready-to-launch Detroit Research on Cancer Survivors study, funded by the National Cancer Institute (NCI), is “uniquely poised” to find out why, said Douglas Lowy, MD, acting director of NCI.

The largest such study to date will include 5,560 African American cancer survivors and 2,780 family members and will look at cancer progression, recurrence, mortality as well as quality of life for survivors and their families. The researchers will investigate the “myriad factors that may affect cancer survival,” including type of treatment, coexisting disease, genetics, social structure, support, neighborhood context, poverty, stress, racial discrimination, and literacy.

The participants are drawn from 3 counties around Detroit where about 21,000 people are diagnosed with cancer every year. The study also uses data from the Detroit area population-based cancer registry, part of NCI’s Surveillance, Epidemiology and End Results (SEER) Program. Joanne Elena, PhD, MPH, scientific program director for the grant funding the study, calls it a “great example of an efficient use of an existing structure to rapidly recruit cancer survivors into research studies.”

The grant is for $9 million over 5 years. “Investigating the complex factors that lead to disparities in cancer among underserved populations should lead to a greater understanding of the social and biologic causes of such differences,” said Robert Croyle, PhD, director of NCI’s Division of Cancer Control and Population Sciences. “And our hope is that this knowledge will lead to better outcomes.”

In 2015, the Texas Department of State Health Services was notified that a hospital telemetry unit nurse had been reusing saline flush prefilled syringes in patients’ IV lines. Mistakenly believing that it was safe and that she was saving the hospital money, she had been reusing syringes for 6 months.  This was not the hospital’s practice.

Because she had been putting patients at risk for bloodborne pathogens,  the state, regional, and local health departments with consultation from the CDC worked with the hospital to investigate. The hospital notified 392 patients, advising them of potential exposure and offering them free testing for hepatitis B (HBV), hepatitis C (HCV), and HIV. A year after the exposure, 262 had completed initial screening and 182 had completed all recommended testing.

Two patients had newly diagnosed HBV and 2 had HCV. A patient with known preexisting chronic HCV infection had been hospitalized on the telemetry unit on the same day as one of the patients with newly diagnosed HCV. That second patient did not share overlapping days with any patient with known HCV infection, nor did the 2 with newly diagnosed HBV infection share with each other or any other patient with a known HBV infection. No epidemiologic evidence linked the patients with newly diagnosed infections to a potential source patient. But when specimens were tested, the results indicated transmission linkage between the patient with chronic HCV infection and one of the patients with newly diagnosed HCV infection.

Taken together, the CDC concluded, the findings indicated that at least 1 HCV infection was “likely transmitted” in the telemetry unit as a result of the inappropriate reuse and sharing of syringes. The investigation, the CDC adds, illustrates a need for ongoing education and oversight of health care providers regarding safe injection practices.

In 2015, the Texas Department of State Health Services was notified that a hospital telemetry unit nurse had been reusing saline flush prefilled syringes in patients’ IV lines. Mistakenly believing that it was safe and that she was saving the hospital money, she had been reusing syringes for 6 months.  This was not the hospital’s practice.

Because she had been putting patients at risk for bloodborne pathogens,  the state, regional, and local health departments with consultation from the CDC worked with the hospital to investigate. The hospital notified 392 patients, advising them of potential exposure and offering them free testing for hepatitis B (HBV), hepatitis C (HCV), and HIV. A year after the exposure, 262 had completed initial screening and 182 had completed all recommended testing.

Two patients had newly diagnosed HBV and 2 had HCV. A patient with known preexisting chronic HCV infection had been hospitalized on the telemetry unit on the same day as one of the patients with newly diagnosed HCV. That second patient did not share overlapping days with any patient with known HCV infection, nor did the 2 with newly diagnosed HBV infection share with each other or any other patient with a known HBV infection. No epidemiologic evidence linked the patients with newly diagnosed infections to a potential source patient. But when specimens were tested, the results indicated transmission linkage between the patient with chronic HCV infection and one of the patients with newly diagnosed HCV infection.

Taken together, the CDC concluded, the findings indicated that at least 1 HCV infection was “likely transmitted” in the telemetry unit as a result of the inappropriate reuse and sharing of syringes. The investigation, the CDC adds, illustrates a need for ongoing education and oversight of health care providers regarding safe injection practices.

In 2015, the Texas Department of State Health Services was notified that a hospital telemetry unit nurse had been reusing saline flush prefilled syringes in patients’ IV lines. Mistakenly believing that it was safe and that she was saving the hospital money, she had been reusing syringes for 6 months.  This was not the hospital’s practice.

Because she had been putting patients at risk for bloodborne pathogens,  the state, regional, and local health departments with consultation from the CDC worked with the hospital to investigate. The hospital notified 392 patients, advising them of potential exposure and offering them free testing for hepatitis B (HBV), hepatitis C (HCV), and HIV. A year after the exposure, 262 had completed initial screening and 182 had completed all recommended testing.

Two patients had newly diagnosed HBV and 2 had HCV. A patient with known preexisting chronic HCV infection had been hospitalized on the telemetry unit on the same day as one of the patients with newly diagnosed HCV. That second patient did not share overlapping days with any patient with known HCV infection, nor did the 2 with newly diagnosed HBV infection share with each other or any other patient with a known HBV infection. No epidemiologic evidence linked the patients with newly diagnosed infections to a potential source patient. But when specimens were tested, the results indicated transmission linkage between the patient with chronic HCV infection and one of the patients with newly diagnosed HCV infection.

Taken together, the CDC concluded, the findings indicated that at least 1 HCV infection was “likely transmitted” in the telemetry unit as a result of the inappropriate reuse and sharing of syringes. The investigation, the CDC adds, illustrates a need for ongoing education and oversight of health care providers regarding safe injection practices.

Veterans who were exposed to contaminated water at Camp Lejeune are now eligible for VA care and benefits if they have been diagnosed with any of 8 diseases: adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder cancer, kidney cancer, liver cancer, multiple myeloma, non-Hodgkin lymphoma, and Parkinson disease. The presumption of service connection regulations went into effect March 14.

The newly effective rule complements the health care already provided for 15 illnesses or conditions as part of the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012. The Camp Lejeune Act requires the VA to provide health care to veterans who served at Camp Lejeune and to reimburse family members or pay providers for medical expenses for those who lived there for ≥ 30 days between August 1, 1953, and December 31, 1987.

The act and new rule relate to 2 on-base water wells that were contaminated with trichloroethylene, perchloroethylene, benzene, vinyl chloride, and other compounds. The wells were shut down in 1985.

The presumption of service connection applies to active-duty, reserve, and National Guard members. The presumption also includes all of Camp Lejeune, Marine Corps Air Station New River, as well as satellite camps and housing areas.

Veterans who were exposed to contaminated water at Camp Lejeune are now eligible for VA care and benefits if they have been diagnosed with any of 8 diseases: adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder cancer, kidney cancer, liver cancer, multiple myeloma, non-Hodgkin lymphoma, and Parkinson disease. The presumption of service connection regulations went into effect March 14.

The newly effective rule complements the health care already provided for 15 illnesses or conditions as part of the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012. The Camp Lejeune Act requires the VA to provide health care to veterans who served at Camp Lejeune and to reimburse family members or pay providers for medical expenses for those who lived there for ≥ 30 days between August 1, 1953, and December 31, 1987.

The act and new rule relate to 2 on-base water wells that were contaminated with trichloroethylene, perchloroethylene, benzene, vinyl chloride, and other compounds. The wells were shut down in 1985.

The presumption of service connection applies to active-duty, reserve, and National Guard members. The presumption also includes all of Camp Lejeune, Marine Corps Air Station New River, as well as satellite camps and housing areas.

Veterans who were exposed to contaminated water at Camp Lejeune are now eligible for VA care and benefits if they have been diagnosed with any of 8 diseases: adult leukemia, aplastic anemia and other myelodysplastic syndromes, bladder cancer, kidney cancer, liver cancer, multiple myeloma, non-Hodgkin lymphoma, and Parkinson disease. The presumption of service connection regulations went into effect March 14.

The newly effective rule complements the health care already provided for 15 illnesses or conditions as part of the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012. The Camp Lejeune Act requires the VA to provide health care to veterans who served at Camp Lejeune and to reimburse family members or pay providers for medical expenses for those who lived there for ≥ 30 days between August 1, 1953, and December 31, 1987.

The act and new rule relate to 2 on-base water wells that were contaminated with trichloroethylene, perchloroethylene, benzene, vinyl chloride, and other compounds. The wells were shut down in 1985.

The presumption of service connection applies to active-duty, reserve, and National Guard members. The presumption also includes all of Camp Lejeune, Marine Corps Air Station New River, as well as satellite camps and housing areas.

The VHA offers several preventive care programs to veterans who are at high risk for various chronic illnesses: For instance, 20% of veterans smoke, and > 70% of VHA patients are overweight.

Although those programs are well supported and have strong evidence for effectiveness, they’re underused, say researchers from Durham VAMC and Duke University in North Carolina, VA Ann Arbor Healthcare System in Michigan, and VA Salt Lake City Center for Informatics Decision Enhancement and Surveillance and University of Utah. The VHA’s MOVE! Program produced significant weight loss among participants—the only problem was that < 10% of eligible veterans actually joined.

The researchers conducted the ACTIVATE trial, which involved a web-based health risk assessment (HRA) coupled with a health coaching intervention to link veterans to a local prevention program. In the study, veterans completed an online HRA. The researchers then tested whether 2 telephone-based coaching sessions were more effective in getting the veterans to enroll in prevention programs than did completing the HRA.

The coaching was not designed to change behavior but specifically aimed at helping veterans set a “first step” goal by choosing a program to enroll in that aligned with their values and preferences as well as risk factors highlighted by their HRA surveys.

The results aren’t in, but the researchers expect their findings to help the VHA implement its plan to engage veterans in preventive health care. Their “robustly designed trial,” they say, “will add valuable knowledge at a critical time when VHA and other health systems are working to understand how to effectively incorporate HRA findings into the busy clinic flow of primary care.”

The VHA offers several preventive care programs to veterans who are at high risk for various chronic illnesses: For instance, 20% of veterans smoke, and > 70% of VHA patients are overweight.

Although those programs are well supported and have strong evidence for effectiveness, they’re underused, say researchers from Durham VAMC and Duke University in North Carolina, VA Ann Arbor Healthcare System in Michigan, and VA Salt Lake City Center for Informatics Decision Enhancement and Surveillance and University of Utah. The VHA’s MOVE! Program produced significant weight loss among participants—the only problem was that < 10% of eligible veterans actually joined.

The researchers conducted the ACTIVATE trial, which involved a web-based health risk assessment (HRA) coupled with a health coaching intervention to link veterans to a local prevention program. In the study, veterans completed an online HRA. The researchers then tested whether 2 telephone-based coaching sessions were more effective in getting the veterans to enroll in prevention programs than did completing the HRA.

The coaching was not designed to change behavior but specifically aimed at helping veterans set a “first step” goal by choosing a program to enroll in that aligned with their values and preferences as well as risk factors highlighted by their HRA surveys.

The results aren’t in, but the researchers expect their findings to help the VHA implement its plan to engage veterans in preventive health care. Their “robustly designed trial,” they say, “will add valuable knowledge at a critical time when VHA and other health systems are working to understand how to effectively incorporate HRA findings into the busy clinic flow of primary care.”

The VHA offers several preventive care programs to veterans who are at high risk for various chronic illnesses: For instance, 20% of veterans smoke, and > 70% of VHA patients are overweight.

Although those programs are well supported and have strong evidence for effectiveness, they’re underused, say researchers from Durham VAMC and Duke University in North Carolina, VA Ann Arbor Healthcare System in Michigan, and VA Salt Lake City Center for Informatics Decision Enhancement and Surveillance and University of Utah. The VHA’s MOVE! Program produced significant weight loss among participants—the only problem was that < 10% of eligible veterans actually joined.

The researchers conducted the ACTIVATE trial, which involved a web-based health risk assessment (HRA) coupled with a health coaching intervention to link veterans to a local prevention program. In the study, veterans completed an online HRA. The researchers then tested whether 2 telephone-based coaching sessions were more effective in getting the veterans to enroll in prevention programs than did completing the HRA.

The coaching was not designed to change behavior but specifically aimed at helping veterans set a “first step” goal by choosing a program to enroll in that aligned with their values and preferences as well as risk factors highlighted by their HRA surveys.

The results aren’t in, but the researchers expect their findings to help the VHA implement its plan to engage veterans in preventive health care. Their “robustly designed trial,” they say, “will add valuable knowledge at a critical time when VHA and other health systems are working to understand how to effectively incorporate HRA findings into the busy clinic flow of primary care.”

Does the course of posttraumatic stress disorder (PTSD) differ depending on whether the person is in the military or has left? Researchers from Naval Health Research Center and the VA wondered whether separation from the military could create a “significant disruption of routine, order, and structure,” which might exacerbate PTSD symptoms, and would the symptoms subside as the veteran adjusted to civilian life?

Using data from the Millennium Cohort Study, researchers examined trajectories of PTSD among 22,080 military personnel across 4 time points, about 3 years apart, from 2001 to 2013. They compared trajectories between people who separated before the second time point or remained in the military across the entire study period. The researchers assessed PTSD screening and symptoms using the PTSD Checklist-Civilian, for which higher scores represent more severe symptoms.

The researchers say 4 distinct classes described symptom trajectories: resilient, delayed onset, improving, and elevated-recovering. Overall, the trajectories were similar for veterans and active-duty personnel. Veterans had a higher likelihood of screening positive for PTSD at baseline before separation and were more likely to newly screen positive for PTSD at waves 2, 3, and 4. Of participants who screened positive for PTSD, veterans had more severe symptoms compared with active-duty personnel at baseline but not at any subsequent assessments.

However, differences between the “elevated-recovering” classes grew over time, showing that veterans did not recover as soon or as “dramatically,” the researchers say. This might be due to symptoms being exacerbated by the change in routine.

The good news is that most veterans and active-duty personnel fell into the resilient class (82% and 87%, respectively). The researchers cite other studies that have found resilience is the most common response to PTSD.

The researchers noted several risk factors for slower recovery, such as lower physical well-being and a history of multiple life stressors. The “delayed onset” group may be a good target for interventions, they suggest. This group reported high use of VA care, but still 26% reported no VA care, indicating that they could benefit from continued efforts to identify and treat them.

Does the course of posttraumatic stress disorder (PTSD) differ depending on whether the person is in the military or has left? Researchers from Naval Health Research Center and the VA wondered whether separation from the military could create a “significant disruption of routine, order, and structure,” which might exacerbate PTSD symptoms, and would the symptoms subside as the veteran adjusted to civilian life?

Using data from the Millennium Cohort Study, researchers examined trajectories of PTSD among 22,080 military personnel across 4 time points, about 3 years apart, from 2001 to 2013. They compared trajectories between people who separated before the second time point or remained in the military across the entire study period. The researchers assessed PTSD screening and symptoms using the PTSD Checklist-Civilian, for which higher scores represent more severe symptoms.

The researchers say 4 distinct classes described symptom trajectories: resilient, delayed onset, improving, and elevated-recovering. Overall, the trajectories were similar for veterans and active-duty personnel. Veterans had a higher likelihood of screening positive for PTSD at baseline before separation and were more likely to newly screen positive for PTSD at waves 2, 3, and 4. Of participants who screened positive for PTSD, veterans had more severe symptoms compared with active-duty personnel at baseline but not at any subsequent assessments.

However, differences between the “elevated-recovering” classes grew over time, showing that veterans did not recover as soon or as “dramatically,” the researchers say. This might be due to symptoms being exacerbated by the change in routine.

The good news is that most veterans and active-duty personnel fell into the resilient class (82% and 87%, respectively). The researchers cite other studies that have found resilience is the most common response to PTSD.

The researchers noted several risk factors for slower recovery, such as lower physical well-being and a history of multiple life stressors. The “delayed onset” group may be a good target for interventions, they suggest. This group reported high use of VA care, but still 26% reported no VA care, indicating that they could benefit from continued efforts to identify and treat them.

Does the course of posttraumatic stress disorder (PTSD) differ depending on whether the person is in the military or has left? Researchers from Naval Health Research Center and the VA wondered whether separation from the military could create a “significant disruption of routine, order, and structure,” which might exacerbate PTSD symptoms, and would the symptoms subside as the veteran adjusted to civilian life?

Using data from the Millennium Cohort Study, researchers examined trajectories of PTSD among 22,080 military personnel across 4 time points, about 3 years apart, from 2001 to 2013. They compared trajectories between people who separated before the second time point or remained in the military across the entire study period. The researchers assessed PTSD screening and symptoms using the PTSD Checklist-Civilian, for which higher scores represent more severe symptoms.

The researchers say 4 distinct classes described symptom trajectories: resilient, delayed onset, improving, and elevated-recovering. Overall, the trajectories were similar for veterans and active-duty personnel. Veterans had a higher likelihood of screening positive for PTSD at baseline before separation and were more likely to newly screen positive for PTSD at waves 2, 3, and 4. Of participants who screened positive for PTSD, veterans had more severe symptoms compared with active-duty personnel at baseline but not at any subsequent assessments.

However, differences between the “elevated-recovering” classes grew over time, showing that veterans did not recover as soon or as “dramatically,” the researchers say. This might be due to symptoms being exacerbated by the change in routine.

The good news is that most veterans and active-duty personnel fell into the resilient class (82% and 87%, respectively). The researchers cite other studies that have found resilience is the most common response to PTSD.

The researchers noted several risk factors for slower recovery, such as lower physical well-being and a history of multiple life stressors. The “delayed onset” group may be a good target for interventions, they suggest. This group reported high use of VA care, but still 26% reported no VA care, indicating that they could benefit from continued efforts to identify and treat them.

Researchers from The Cancer Genome Atlas (TCGA) Research Network analyzed 178 primary cervical cancers, and found > 70% had genomic alteration in 1 or both of 2 important cell signaling pathways. They also found that a subset of tumors showed no evidence of HPV infection.

“This aspect of the research is one of the most intriguing findings to come out of the TCGA program, which has been looking at more than 30 tumor types over the past decade,” said Jean-Claude Zenklusen, PhD, director of the TCGA program office.

The researchers found several instances of amplification of genes that code for known immune targets, which may predict responsiveness to immunotherapy. They also identified several novel mutated genes. Particularly interesting, the researchers say, was the identification of a unique set of 8 cervical cancers that showed molecular similarities to endometrial cancers; the cancers were mainly HPV negative. That finding “confirms that not all cervical cancers are related to HPV infection and that a small percentage of cervical tumors may be due to strictly genetic or other factors,” said Zenklusen.

Researchers from The Cancer Genome Atlas (TCGA) Research Network analyzed 178 primary cervical cancers, and found > 70% had genomic alteration in 1 or both of 2 important cell signaling pathways. They also found that a subset of tumors showed no evidence of HPV infection.

“This aspect of the research is one of the most intriguing findings to come out of the TCGA program, which has been looking at more than 30 tumor types over the past decade,” said Jean-Claude Zenklusen, PhD, director of the TCGA program office.

The researchers found several instances of amplification of genes that code for known immune targets, which may predict responsiveness to immunotherapy. They also identified several novel mutated genes. Particularly interesting, the researchers say, was the identification of a unique set of 8 cervical cancers that showed molecular similarities to endometrial cancers; the cancers were mainly HPV negative. That finding “confirms that not all cervical cancers are related to HPV infection and that a small percentage of cervical tumors may be due to strictly genetic or other factors,” said Zenklusen.

Researchers from The Cancer Genome Atlas (TCGA) Research Network analyzed 178 primary cervical cancers, and found > 70% had genomic alteration in 1 or both of 2 important cell signaling pathways. They also found that a subset of tumors showed no evidence of HPV infection.

“This aspect of the research is one of the most intriguing findings to come out of the TCGA program, which has been looking at more than 30 tumor types over the past decade,” said Jean-Claude Zenklusen, PhD, director of the TCGA program office.

The researchers found several instances of amplification of genes that code for known immune targets, which may predict responsiveness to immunotherapy. They also identified several novel mutated genes. Particularly interesting, the researchers say, was the identification of a unique set of 8 cervical cancers that showed molecular similarities to endometrial cancers; the cancers were mainly HPV negative. That finding “confirms that not all cervical cancers are related to HPV infection and that a small percentage of cervical tumors may be due to strictly genetic or other factors,” said Zenklusen.

A child who has a cold, flu, or other acute illness may be what parents often call “fussy”: irritable, teary, and clingy. Such changes in behavior and mood, or “sickness behavior (SB),” are usually thought to be linked to fever.  Actually, those symptoms are the immune system’s reactions to invasion by a pathogen, say French researchers—and they may be present whether the child has fever or not. The researchers’ say their multicenter study is the first to show dissociation between SB and the severity of the fever.

The researchers evaluated 6 parameters over the 2 hours preceding consultations with the parents of 200 children with and 200 without fever. Children with particularly painful illnesses and chronic diseases were excluded from the study. Parents used rating scales to report degrees of change in the time the child spent playing, the distance covered (ie. how far from the parent the child roamed), time the child spent seeking comfort, time spent whining or crying, time spent in a state of irritation or anger, most distorted facial expression (on a chart). The researchers also assessed time spent sleeping and appetite in the 24 hours before the consultation. Sickness behavior can’t be reduced to the observation of those 8 behavioral parameters, the researchers note, but they were easy for parents to use and assess.

The mean values of the 8 parameters differed significantly between the 2 groups but were independent of the height of fever in the febrile children. That independence suggests that SB and fever are expressions of 2 autonomous metabolic pathways that are activated simultaneously in febrile conditions, the researchers say, which is in accordance with current pathophysiologic knowledge.

Their findings are in harmony with current treatment recommendations, the researchers say. Because it’s hard to know when behavior changes are due to SB, pain, fatigue, or something else in a febrile child—especially one who is too young to talk about it—it’s more important to focus on relieving the discomfort than in reducing the fever.

Source:

Corrard F, Copin C, Wollner A, et al. PLoS One. 2017;12(3): e0171670.
doi: 10.1371/journal.pone.0171670.

A child who has a cold, flu, or other acute illness may be what parents often call “fussy”: irritable, teary, and clingy. Such changes in behavior and mood, or “sickness behavior (SB),” are usually thought to be linked to fever.  Actually, those symptoms are the immune system’s reactions to invasion by a pathogen, say French researchers—and they may be present whether the child has fever or not. The researchers’ say their multicenter study is the first to show dissociation between SB and the severity of the fever.

The researchers evaluated 6 parameters over the 2 hours preceding consultations with the parents of 200 children with and 200 without fever. Children with particularly painful illnesses and chronic diseases were excluded from the study. Parents used rating scales to report degrees of change in the time the child spent playing, the distance covered (ie. how far from the parent the child roamed), time the child spent seeking comfort, time spent whining or crying, time spent in a state of irritation or anger, most distorted facial expression (on a chart). The researchers also assessed time spent sleeping and appetite in the 24 hours before the consultation. Sickness behavior can’t be reduced to the observation of those 8 behavioral parameters, the researchers note, but they were easy for parents to use and assess.

The mean values of the 8 parameters differed significantly between the 2 groups but were independent of the height of fever in the febrile children. That independence suggests that SB and fever are expressions of 2 autonomous metabolic pathways that are activated simultaneously in febrile conditions, the researchers say, which is in accordance with current pathophysiologic knowledge.

Their findings are in harmony with current treatment recommendations, the researchers say. Because it’s hard to know when behavior changes are due to SB, pain, fatigue, or something else in a febrile child—especially one who is too young to talk about it—it’s more important to focus on relieving the discomfort than in reducing the fever.

Source:

Corrard F, Copin C, Wollner A, et al. PLoS One. 2017;12(3): e0171670.
doi: 10.1371/journal.pone.0171670.

A child who has a cold, flu, or other acute illness may be what parents often call “fussy”: irritable, teary, and clingy. Such changes in behavior and mood, or “sickness behavior (SB),” are usually thought to be linked to fever.  Actually, those symptoms are the immune system’s reactions to invasion by a pathogen, say French researchers—and they may be present whether the child has fever or not. The researchers’ say their multicenter study is the first to show dissociation between SB and the severity of the fever.

The researchers evaluated 6 parameters over the 2 hours preceding consultations with the parents of 200 children with and 200 without fever. Children with particularly painful illnesses and chronic diseases were excluded from the study. Parents used rating scales to report degrees of change in the time the child spent playing, the distance covered (ie. how far from the parent the child roamed), time the child spent seeking comfort, time spent whining or crying, time spent in a state of irritation or anger, most distorted facial expression (on a chart). The researchers also assessed time spent sleeping and appetite in the 24 hours before the consultation. Sickness behavior can’t be reduced to the observation of those 8 behavioral parameters, the researchers note, but they were easy for parents to use and assess.

The mean values of the 8 parameters differed significantly between the 2 groups but were independent of the height of fever in the febrile children. That independence suggests that SB and fever are expressions of 2 autonomous metabolic pathways that are activated simultaneously in febrile conditions, the researchers say, which is in accordance with current pathophysiologic knowledge.

Their findings are in harmony with current treatment recommendations, the researchers say. Because it’s hard to know when behavior changes are due to SB, pain, fatigue, or something else in a febrile child—especially one who is too young to talk about it—it’s more important to focus on relieving the discomfort than in reducing the fever.

Source:

Corrard F, Copin C, Wollner A, et al. PLoS One. 2017;12(3): e0171670.
doi: 10.1371/journal.pone.0171670.