Jan Dyer

Is it safe to give flu vaccinations to patients with an impaired immune response, such as those with diabetes? The evidence was both sparse and inconclusive, say researchers from Imperial College London. But their 7-year study of 124,503 patients with type 2 diabetes suggests “substantial benefits.”

The study covered 4 periods in each cohort year: preinfluenza, influenza season, postinfluenza, and summer. The outcome measures were hospital admissions for acute myocardial infarction (MI), stroke, pneumonia, influenza, and heart failure as well as all-cause death.

During the study, there were 5,142 admissions for acute MI; 4,515 for stroke; 14,154 for pneumonia or influenza; 12,915 for heart failure; and 21,070 deaths.

Vaccine recipients were older and generally more ill; they had more coexisting conditions and were taking more medications than nonrecipients. However, vaccination was associated with significant reductions in all the outcomes during the flu season. After adjusting for residual confounding, the researchers found 19% lower rates of admissions for acute MI, 30% for stroke, 22% for heart failure, and 15% for pneumonia or influenza. The mortality rate for patients was 24% lower than that of nonrecipients.

That was during flu season, but vaccination also was associated with significantly fewer events during the pre- and postinfluenza seasons for all outcomes except for acute MI and pneumonia/influenza in the preinfluenza period.

Concerns about the benefits of influenza vaccination in older adults and patients with chronic illnesses affect the acceptance and uptake of vaccination, the researchers note. But their findings, they add, “underline the importance of influenza vaccination as part of comprehensive secondary prevention in this high-risk population.”

Source:
Vamos EP, Pape UJ, Curcin V, et al. CMAJ. 2016;188(14):E342-E351.

Is it safe to give flu vaccinations to patients with an impaired immune response, such as those with diabetes? The evidence was both sparse and inconclusive, say researchers from Imperial College London. But their 7-year study of 124,503 patients with type 2 diabetes suggests “substantial benefits.”

The study covered 4 periods in each cohort year: preinfluenza, influenza season, postinfluenza, and summer. The outcome measures were hospital admissions for acute myocardial infarction (MI), stroke, pneumonia, influenza, and heart failure as well as all-cause death.

During the study, there were 5,142 admissions for acute MI; 4,515 for stroke; 14,154 for pneumonia or influenza; 12,915 for heart failure; and 21,070 deaths.

Vaccine recipients were older and generally more ill; they had more coexisting conditions and were taking more medications than nonrecipients. However, vaccination was associated with significant reductions in all the outcomes during the flu season. After adjusting for residual confounding, the researchers found 19% lower rates of admissions for acute MI, 30% for stroke, 22% for heart failure, and 15% for pneumonia or influenza. The mortality rate for patients was 24% lower than that of nonrecipients.

That was during flu season, but vaccination also was associated with significantly fewer events during the pre- and postinfluenza seasons for all outcomes except for acute MI and pneumonia/influenza in the preinfluenza period.

Concerns about the benefits of influenza vaccination in older adults and patients with chronic illnesses affect the acceptance and uptake of vaccination, the researchers note. But their findings, they add, “underline the importance of influenza vaccination as part of comprehensive secondary prevention in this high-risk population.”

Source:
Vamos EP, Pape UJ, Curcin V, et al. CMAJ. 2016;188(14):E342-E351.

Is it safe to give flu vaccinations to patients with an impaired immune response, such as those with diabetes? The evidence was both sparse and inconclusive, say researchers from Imperial College London. But their 7-year study of 124,503 patients with type 2 diabetes suggests “substantial benefits.”

The study covered 4 periods in each cohort year: preinfluenza, influenza season, postinfluenza, and summer. The outcome measures were hospital admissions for acute myocardial infarction (MI), stroke, pneumonia, influenza, and heart failure as well as all-cause death.

During the study, there were 5,142 admissions for acute MI; 4,515 for stroke; 14,154 for pneumonia or influenza; 12,915 for heart failure; and 21,070 deaths.

Vaccine recipients were older and generally more ill; they had more coexisting conditions and were taking more medications than nonrecipients. However, vaccination was associated with significant reductions in all the outcomes during the flu season. After adjusting for residual confounding, the researchers found 19% lower rates of admissions for acute MI, 30% for stroke, 22% for heart failure, and 15% for pneumonia or influenza. The mortality rate for patients was 24% lower than that of nonrecipients.

That was during flu season, but vaccination also was associated with significantly fewer events during the pre- and postinfluenza seasons for all outcomes except for acute MI and pneumonia/influenza in the preinfluenza period.

Concerns about the benefits of influenza vaccination in older adults and patients with chronic illnesses affect the acceptance and uptake of vaccination, the researchers note. But their findings, they add, “underline the importance of influenza vaccination as part of comprehensive secondary prevention in this high-risk population.”

Source:
Vamos EP, Pape UJ, Curcin V, et al. CMAJ. 2016;188(14):E342-E351.

Perhaps a seasonal link exists between “epidemic waves” of respiratory syncytial virus (RSV) infections and influenza,. but forecasting seasonal patterns with accuracy isn’t easy due to the many varieties of flu and environmental factors. However, researchers from the Public Health Center of Valencia and University of Valencia, Spain, say they have a way to predict an influenza epidemic 3  to 4 weeks in advance. And that could allow for more effective vaccination programs and influenza prophylaxis.

They used 2 epidemiologic surveillance systems: The first, the analysis of epidemiologicol surveillance system (AVE) in use in eastern Spain since 2004, collects real-time data from notifiable disease outbreaks and alerts. The second, Microbiologica surveillance network of the Comunitat Valenciana (RedMIVA), collects cases of RSV.

The researchers conducted a study that lasted from week 40 (2010) to week 8 (2014). During that time, 239,321 people reported cases of flu, and 19,676 cases of RSV were recorded, with 5,112 laboratory confirmed. Most (85%) of the RSV cases were children aged < 1 year .

Using the data from the surveillance systems, the researchers found that the peak of maximum activity of the influenza virus appears at least 3 weeks after the RSV peak.  Interestingly, they also found evidence suggesting that RSV infection has a short-term protective effect against human influenza type A (H1N1) infection. The seasons with the highest number of recorded cases of RSV coincided with the lowest number of influenza cases. In both seasons, the predominant influenza virus type was H1N1.

Source:
Míguez A, Iftimi A, Montes F. Epidemiol Infect. 2016;144(12):2621-2632.

Perhaps a seasonal link exists between “epidemic waves” of respiratory syncytial virus (RSV) infections and influenza,. but forecasting seasonal patterns with accuracy isn’t easy due to the many varieties of flu and environmental factors. However, researchers from the Public Health Center of Valencia and University of Valencia, Spain, say they have a way to predict an influenza epidemic 3  to 4 weeks in advance. And that could allow for more effective vaccination programs and influenza prophylaxis.

They used 2 epidemiologic surveillance systems: The first, the analysis of epidemiologicol surveillance system (AVE) in use in eastern Spain since 2004, collects real-time data from notifiable disease outbreaks and alerts. The second, Microbiologica surveillance network of the Comunitat Valenciana (RedMIVA), collects cases of RSV.

The researchers conducted a study that lasted from week 40 (2010) to week 8 (2014). During that time, 239,321 people reported cases of flu, and 19,676 cases of RSV were recorded, with 5,112 laboratory confirmed. Most (85%) of the RSV cases were children aged < 1 year .

Using the data from the surveillance systems, the researchers found that the peak of maximum activity of the influenza virus appears at least 3 weeks after the RSV peak.  Interestingly, they also found evidence suggesting that RSV infection has a short-term protective effect against human influenza type A (H1N1) infection. The seasons with the highest number of recorded cases of RSV coincided with the lowest number of influenza cases. In both seasons, the predominant influenza virus type was H1N1.

Source:
Míguez A, Iftimi A, Montes F. Epidemiol Infect. 2016;144(12):2621-2632.

Perhaps a seasonal link exists between “epidemic waves” of respiratory syncytial virus (RSV) infections and influenza,. but forecasting seasonal patterns with accuracy isn’t easy due to the many varieties of flu and environmental factors. However, researchers from the Public Health Center of Valencia and University of Valencia, Spain, say they have a way to predict an influenza epidemic 3  to 4 weeks in advance. And that could allow for more effective vaccination programs and influenza prophylaxis.

They used 2 epidemiologic surveillance systems: The first, the analysis of epidemiologicol surveillance system (AVE) in use in eastern Spain since 2004, collects real-time data from notifiable disease outbreaks and alerts. The second, Microbiologica surveillance network of the Comunitat Valenciana (RedMIVA), collects cases of RSV.

The researchers conducted a study that lasted from week 40 (2010) to week 8 (2014). During that time, 239,321 people reported cases of flu, and 19,676 cases of RSV were recorded, with 5,112 laboratory confirmed. Most (85%) of the RSV cases were children aged < 1 year .

Using the data from the surveillance systems, the researchers found that the peak of maximum activity of the influenza virus appears at least 3 weeks after the RSV peak.  Interestingly, they also found evidence suggesting that RSV infection has a short-term protective effect against human influenza type A (H1N1) infection. The seasons with the highest number of recorded cases of RSV coincided with the lowest number of influenza cases. In both seasons, the predominant influenza virus type was H1N1.

Source:
Míguez A, Iftimi A, Montes F. Epidemiol Infect. 2016;144(12):2621-2632.

The 5-year relative survival rate for non-Hodgkin lymphoma (NHL) climbed to 72.7% and is as high as 82.6% for localized NHL, according to the most recent SEER data. The number of new cases remains high at 19.1 per 100,000 people (all races) per year; however the number of deaths is relatively low at 5.7 deaths per 100,000 people (all races) per year. Death rates have been falling on average 2.4% each year from 2004 to 2013.

While the new cases represent 4.3% of all new cancer diagnoses, NHL deaths represent 3.4% of all cancer deaths. Based on 2011-2013 SEER data, about 2.1% of men and women will receive a NHL diagnosis at some point during their lifetime.

Patient diagnoses by stage:

• 28% are diagnosed at the local stage
• 15% are diagnosed with spread to regional lymph nodes
• 50% are diagnosed after distant cancer has metastasized
• 8% unknown/unstaged

As of 2013, there were an estimated 569,536 people living with NHL in the U.S.

Using statistical models for analysis, rates for new non-Hodgkin lymphoma cases have not changed significantly over the past 10 years.

The 5-year relative survival rate for non-Hodgkin lymphoma (NHL) climbed to 72.7% and is as high as 82.6% for localized NHL, according to the most recent SEER data. The number of new cases remains high at 19.1 per 100,000 people (all races) per year; however the number of deaths is relatively low at 5.7 deaths per 100,000 people (all races) per year. Death rates have been falling on average 2.4% each year from 2004 to 2013.

While the new cases represent 4.3% of all new cancer diagnoses, NHL deaths represent 3.4% of all cancer deaths. Based on 2011-2013 SEER data, about 2.1% of men and women will receive a NHL diagnosis at some point during their lifetime.

Patient diagnoses by stage:

• 28% are diagnosed at the local stage
• 15% are diagnosed with spread to regional lymph nodes
• 50% are diagnosed after distant cancer has metastasized
• 8% unknown/unstaged

As of 2013, there were an estimated 569,536 people living with NHL in the U.S.

Using statistical models for analysis, rates for new non-Hodgkin lymphoma cases have not changed significantly over the past 10 years.

The 5-year relative survival rate for non-Hodgkin lymphoma (NHL) climbed to 72.7% and is as high as 82.6% for localized NHL, according to the most recent SEER data. The number of new cases remains high at 19.1 per 100,000 people (all races) per year; however the number of deaths is relatively low at 5.7 deaths per 100,000 people (all races) per year. Death rates have been falling on average 2.4% each year from 2004 to 2013.

While the new cases represent 4.3% of all new cancer diagnoses, NHL deaths represent 3.4% of all cancer deaths. Based on 2011-2013 SEER data, about 2.1% of men and women will receive a NHL diagnosis at some point during their lifetime.

Patient diagnoses by stage:

• 28% are diagnosed at the local stage
• 15% are diagnosed with spread to regional lymph nodes
• 50% are diagnosed after distant cancer has metastasized
• 8% unknown/unstaged

As of 2013, there were an estimated 569,536 people living with NHL in the U.S.

Using statistical models for analysis, rates for new non-Hodgkin lymphoma cases have not changed significantly over the past 10 years.

The IHS announced 42 new awards to promote best practice strategies for preventing suicide and substance abuse, incorporating culturally appropriate approaches that are effective for tribal communities.

The awards, totaling more than $7 million for 1 year, are specifically for Methamphetamine and Suicide Prevention Initiative (MSPI) funding. The award recipients focus on boosting positive youth development, fostering resiliency, and promoting family engagement among Native youth, the IHS says. “We know that protective factors provided through caring adults, traditional practices, and Native language and culture help offset negative outcomes and foster the long-term development of resilience,” said IHS Principal Deputy Director Mary Smith, in announcing the awards.

Current funded projects include the Ohkay Owingeh MSPI Project in New Mexico. The evidence- and practice-based prevention program,  conducted by the local Boys and Girls Club, “strongly focuses” on the issues surrounding methamphetamine and other drugs and self-harm in Native communities.

Another funded program, Fresno American Indian Health Project, targets Native youth at risk for substance abuse and suicide in the San Francisco Bay Area. The Stronghold Project II after-school programs help to strengthen cultural systems and family capacity, addressing family violence and suicide due to substance abuse.

From 2009 through 2015, MSPI supported > 12,200 people entering treatment for methamphetamine abuse, plus > 16,560 substance use and mental health disorder encounters via telehealth. The funding also supported training nearly 17,000 professionals and community members in suicide crisis response, with  nearly 700,000 encounters with youth through prevention activities. The recently announced awards build on the more than $13 million awarded in 2015.

The IHS announced 42 new awards to promote best practice strategies for preventing suicide and substance abuse, incorporating culturally appropriate approaches that are effective for tribal communities.

The awards, totaling more than $7 million for 1 year, are specifically for Methamphetamine and Suicide Prevention Initiative (MSPI) funding. The award recipients focus on boosting positive youth development, fostering resiliency, and promoting family engagement among Native youth, the IHS says. “We know that protective factors provided through caring adults, traditional practices, and Native language and culture help offset negative outcomes and foster the long-term development of resilience,” said IHS Principal Deputy Director Mary Smith, in announcing the awards.

Current funded projects include the Ohkay Owingeh MSPI Project in New Mexico. The evidence- and practice-based prevention program,  conducted by the local Boys and Girls Club, “strongly focuses” on the issues surrounding methamphetamine and other drugs and self-harm in Native communities.

Another funded program, Fresno American Indian Health Project, targets Native youth at risk for substance abuse and suicide in the San Francisco Bay Area. The Stronghold Project II after-school programs help to strengthen cultural systems and family capacity, addressing family violence and suicide due to substance abuse.

From 2009 through 2015, MSPI supported > 12,200 people entering treatment for methamphetamine abuse, plus > 16,560 substance use and mental health disorder encounters via telehealth. The funding also supported training nearly 17,000 professionals and community members in suicide crisis response, with  nearly 700,000 encounters with youth through prevention activities. The recently announced awards build on the more than $13 million awarded in 2015.

The IHS announced 42 new awards to promote best practice strategies for preventing suicide and substance abuse, incorporating culturally appropriate approaches that are effective for tribal communities.

The awards, totaling more than $7 million for 1 year, are specifically for Methamphetamine and Suicide Prevention Initiative (MSPI) funding. The award recipients focus on boosting positive youth development, fostering resiliency, and promoting family engagement among Native youth, the IHS says. “We know that protective factors provided through caring adults, traditional practices, and Native language and culture help offset negative outcomes and foster the long-term development of resilience,” said IHS Principal Deputy Director Mary Smith, in announcing the awards.

Current funded projects include the Ohkay Owingeh MSPI Project in New Mexico. The evidence- and practice-based prevention program,  conducted by the local Boys and Girls Club, “strongly focuses” on the issues surrounding methamphetamine and other drugs and self-harm in Native communities.

Another funded program, Fresno American Indian Health Project, targets Native youth at risk for substance abuse and suicide in the San Francisco Bay Area. The Stronghold Project II after-school programs help to strengthen cultural systems and family capacity, addressing family violence and suicide due to substance abuse.

From 2009 through 2015, MSPI supported > 12,200 people entering treatment for methamphetamine abuse, plus > 16,560 substance use and mental health disorder encounters via telehealth. The funding also supported training nearly 17,000 professionals and community members in suicide crisis response, with  nearly 700,000 encounters with youth through prevention activities. The recently announced awards build on the more than $13 million awarded in 2015.

More than half of the new HIV diagnoses among American Indians and Alaska Natives are estimated to be among those aged < 35 years, according to the CDC. To improve HIV prevention and care outcomes, an ongoing collaboration between IHS and the CDC is funding cooperative agreements with First Nations Community HealthSource, Albuquerque, and Inter Tribal Council of Arizona, Phoenix. The groups will receive up to $100,000 a year for up to 5 years for community health care services. “These awards increase access to culturally appropriate, high-quality HIV treatment for our American Indian and Alaska Native communities,” said Mary L. Smith, IHS principal deputy director.

First Nations, New Mexico’s urban Indian health center and a Federally Qualified Health Center, operates 2 clinic sites and 3 school-based health centers. The Inter Tribal Council of Arizona, representing 21 tribal governments, operates more than 30 projects and provides technical assistance and training to tribal governments in program planning and development, research and data collection, resource development, management and evaluation.

The awards support activities in 5 main areas:

• Increasing access to comprehensive pre-exposure prophylaxis;
• Identifying local-level priorities for HIV care needs and creating tools and resources;
• Making it easier for people living with HIV and AIDS to stay in treatment;
• Teaching people who inject drugs about reducing risks and extending access to services for medication-assisted therapies for people with opioid use disorder in accordance with federal, state, tribal, and local laws; and
• Increasing age-appropriate prevention education at the local levels.

 “This multiyear collaboration supports a sustained, in-depth HIV prevention program that will benefit not only tribes, but also American Indians and Alaska Natives in urban locations,” said Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention. “We are bringing services right to the local level, reaching American Indian and Alaska Native communities.”

More than half of the new HIV diagnoses among American Indians and Alaska Natives are estimated to be among those aged < 35 years, according to the CDC. To improve HIV prevention and care outcomes, an ongoing collaboration between IHS and the CDC is funding cooperative agreements with First Nations Community HealthSource, Albuquerque, and Inter Tribal Council of Arizona, Phoenix. The groups will receive up to $100,000 a year for up to 5 years for community health care services. “These awards increase access to culturally appropriate, high-quality HIV treatment for our American Indian and Alaska Native communities,” said Mary L. Smith, IHS principal deputy director.

First Nations, New Mexico’s urban Indian health center and a Federally Qualified Health Center, operates 2 clinic sites and 3 school-based health centers. The Inter Tribal Council of Arizona, representing 21 tribal governments, operates more than 30 projects and provides technical assistance and training to tribal governments in program planning and development, research and data collection, resource development, management and evaluation.

The awards support activities in 5 main areas:

• Increasing access to comprehensive pre-exposure prophylaxis;
• Identifying local-level priorities for HIV care needs and creating tools and resources;
• Making it easier for people living with HIV and AIDS to stay in treatment;
• Teaching people who inject drugs about reducing risks and extending access to services for medication-assisted therapies for people with opioid use disorder in accordance with federal, state, tribal, and local laws; and
• Increasing age-appropriate prevention education at the local levels.

 “This multiyear collaboration supports a sustained, in-depth HIV prevention program that will benefit not only tribes, but also American Indians and Alaska Natives in urban locations,” said Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention. “We are bringing services right to the local level, reaching American Indian and Alaska Native communities.”

More than half of the new HIV diagnoses among American Indians and Alaska Natives are estimated to be among those aged < 35 years, according to the CDC. To improve HIV prevention and care outcomes, an ongoing collaboration between IHS and the CDC is funding cooperative agreements with First Nations Community HealthSource, Albuquerque, and Inter Tribal Council of Arizona, Phoenix. The groups will receive up to $100,000 a year for up to 5 years for community health care services. “These awards increase access to culturally appropriate, high-quality HIV treatment for our American Indian and Alaska Native communities,” said Mary L. Smith, IHS principal deputy director.

First Nations, New Mexico’s urban Indian health center and a Federally Qualified Health Center, operates 2 clinic sites and 3 school-based health centers. The Inter Tribal Council of Arizona, representing 21 tribal governments, operates more than 30 projects and provides technical assistance and training to tribal governments in program planning and development, research and data collection, resource development, management and evaluation.

The awards support activities in 5 main areas:

• Increasing access to comprehensive pre-exposure prophylaxis;
• Identifying local-level priorities for HIV care needs and creating tools and resources;
• Making it easier for people living with HIV and AIDS to stay in treatment;
• Teaching people who inject drugs about reducing risks and extending access to services for medication-assisted therapies for people with opioid use disorder in accordance with federal, state, tribal, and local laws; and
• Increasing age-appropriate prevention education at the local levels.

 “This multiyear collaboration supports a sustained, in-depth HIV prevention program that will benefit not only tribes, but also American Indians and Alaska Natives in urban locations,” said Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention. “We are bringing services right to the local level, reaching American Indian and Alaska Native communities.”

Identifying people who might be at risk for posttraumatic stress disorder (PTSD) before the trauma—and teaching them preventive coping skills—could reduce or prevent long-term effects, according to University of Oxford in Oxford, United Kingdom, and King’s College London, United Kingdom, researchers.

They assessed 453 newly recruited paramedics every 4 months for 2 years. Of those, 386 paramedics participated in follow-up interviews.

Related: Let’s Dance: A Holistic Approach to Treating Veterans With Posttraumatic Stress Disorder

Over the 2 years, 32 participants (8.3%) had an episode of PTSD, and 41 participants had (10.6%) an episode of major depression (MD). Most of the episodes were moderate and short lived. In most cases, the participant had recovered by the next 4-month assessment. However, at 2 years, those who had experienced episodes of PTSD or MD during the follow-up period reported more days off work, poorer sleep, poorer quality of life, and greater burn out as well as weight gain (mean gain, 6.9 kg) for those with PTSD.

Ten participants who developed PTSD received treatment during follow-up, as did 12 participants who developed MD. Five of 9 participants who had recurrent PTSD or MD received treatment during the follow-up period but did not recover.

Related: Telehealth for Native Americans With PTSD

The researchers tested a number of possible pretrauma predictors of PTSD and MD. They correlated several: cognitive style (eg, suppression, rumination, intentional numbing), coping style (eg, avoidant styles, such as wishful thinking), and psychological traits (eg, neuroticism). However, they found rumination about memories of stressful events uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD.

Interestingly, about 42% of the study participants had a psychiatric history before training—more than the general population. That might be a factor that draws them to emergency work, the researchers suggest.

Related: Yoga-Based Classes for Veterans With Severe Mental Illness: Development, Dissemination, and Assessment

Some predictors, such as psychiatric history, are fixed, the researchers note. But others, such as cognitive styles, can be modified or taught. Studies have shown that rumination can be redirected through training in concrete thinking, for instance, and psychoeducation and cognitive behavioral techniques (eg, modifying interpretations of stressful events) have been used to strengthen resilience. The predictors they identified in their study could serve as targets, the researchers suggest, for modifying future resilience programs.

Source:
Wild J, Smith KV, Thompson E, Béar F, Lommen MJ, Ehlers A. Psychol Med. 2016;46(12):2571-2582. doi: 10.1017/S0033291716000532.

Identifying people who might be at risk for posttraumatic stress disorder (PTSD) before the trauma—and teaching them preventive coping skills—could reduce or prevent long-term effects, according to University of Oxford in Oxford, United Kingdom, and King’s College London, United Kingdom, researchers.

They assessed 453 newly recruited paramedics every 4 months for 2 years. Of those, 386 paramedics participated in follow-up interviews.

Related: Let’s Dance: A Holistic Approach to Treating Veterans With Posttraumatic Stress Disorder

Over the 2 years, 32 participants (8.3%) had an episode of PTSD, and 41 participants had (10.6%) an episode of major depression (MD). Most of the episodes were moderate and short lived. In most cases, the participant had recovered by the next 4-month assessment. However, at 2 years, those who had experienced episodes of PTSD or MD during the follow-up period reported more days off work, poorer sleep, poorer quality of life, and greater burn out as well as weight gain (mean gain, 6.9 kg) for those with PTSD.

Ten participants who developed PTSD received treatment during follow-up, as did 12 participants who developed MD. Five of 9 participants who had recurrent PTSD or MD received treatment during the follow-up period but did not recover.

Related: Telehealth for Native Americans With PTSD

The researchers tested a number of possible pretrauma predictors of PTSD and MD. They correlated several: cognitive style (eg, suppression, rumination, intentional numbing), coping style (eg, avoidant styles, such as wishful thinking), and psychological traits (eg, neuroticism). However, they found rumination about memories of stressful events uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD.

Interestingly, about 42% of the study participants had a psychiatric history before training—more than the general population. That might be a factor that draws them to emergency work, the researchers suggest.

Related: Yoga-Based Classes for Veterans With Severe Mental Illness: Development, Dissemination, and Assessment

Some predictors, such as psychiatric history, are fixed, the researchers note. But others, such as cognitive styles, can be modified or taught. Studies have shown that rumination can be redirected through training in concrete thinking, for instance, and psychoeducation and cognitive behavioral techniques (eg, modifying interpretations of stressful events) have been used to strengthen resilience. The predictors they identified in their study could serve as targets, the researchers suggest, for modifying future resilience programs.

Source:
Wild J, Smith KV, Thompson E, Béar F, Lommen MJ, Ehlers A. Psychol Med. 2016;46(12):2571-2582. doi: 10.1017/S0033291716000532.

Identifying people who might be at risk for posttraumatic stress disorder (PTSD) before the trauma—and teaching them preventive coping skills—could reduce or prevent long-term effects, according to University of Oxford in Oxford, United Kingdom, and King’s College London, United Kingdom, researchers.

They assessed 453 newly recruited paramedics every 4 months for 2 years. Of those, 386 paramedics participated in follow-up interviews.

Related: Let’s Dance: A Holistic Approach to Treating Veterans With Posttraumatic Stress Disorder

Over the 2 years, 32 participants (8.3%) had an episode of PTSD, and 41 participants had (10.6%) an episode of major depression (MD). Most of the episodes were moderate and short lived. In most cases, the participant had recovered by the next 4-month assessment. However, at 2 years, those who had experienced episodes of PTSD or MD during the follow-up period reported more days off work, poorer sleep, poorer quality of life, and greater burn out as well as weight gain (mean gain, 6.9 kg) for those with PTSD.

Ten participants who developed PTSD received treatment during follow-up, as did 12 participants who developed MD. Five of 9 participants who had recurrent PTSD or MD received treatment during the follow-up period but did not recover.

Related: Telehealth for Native Americans With PTSD

The researchers tested a number of possible pretrauma predictors of PTSD and MD. They correlated several: cognitive style (eg, suppression, rumination, intentional numbing), coping style (eg, avoidant styles, such as wishful thinking), and psychological traits (eg, neuroticism). However, they found rumination about memories of stressful events uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD.

Interestingly, about 42% of the study participants had a psychiatric history before training—more than the general population. That might be a factor that draws them to emergency work, the researchers suggest.

Related: Yoga-Based Classes for Veterans With Severe Mental Illness: Development, Dissemination, and Assessment

Some predictors, such as psychiatric history, are fixed, the researchers note. But others, such as cognitive styles, can be modified or taught. Studies have shown that rumination can be redirected through training in concrete thinking, for instance, and psychoeducation and cognitive behavioral techniques (eg, modifying interpretations of stressful events) have been used to strengthen resilience. The predictors they identified in their study could serve as targets, the researchers suggest, for modifying future resilience programs.

Source:
Wild J, Smith KV, Thompson E, Béar F, Lommen MJ, Ehlers A. Psychol Med. 2016;46(12):2571-2582. doi: 10.1017/S0033291716000532.

As many as 5 million older Americans are at risk because they aren’t taking their blood pressure medicine properly, according to a Vital Signs report.

CDC researchers analyzed data from more than 18.5 million people enrolled in Medicare Advantage or Original Medicare with Part D prescription drug coverage during 2014. Among their findings:

• Seven out of 10 adults aged 65 and older have high blood pressure, but nearly half don’t have it under control.
• American Indians/Alaska Natives, blacks, and Hispanics are more likely to not take their blood pressure medicine as directed.
• Southern U.S. states, Puerto Rico, and the U.S. Virgin Islands had the highest overall rates of not taking medicine as directed.North Dakota, Wisconsin, and Minnesota had the highest rates of adherence.

The CDC gave examples of how health care systems and providers can help:

• Simplify blood pressure treatments by offering 90-day refills and combination medicines, coordinating pill refills for the same date, and prescribing generic medicines.
• Involve the whole health care team at several points of care to ensure patients are taking medicine as directed, answer questions, and provide counseling.
• Encourage the use of home blood pressure monitors and easy-to-use tools, such as mobile apps to track and share readings.

As many as 5 million older Americans are at risk because they aren’t taking their blood pressure medicine properly, according to a Vital Signs report.

CDC researchers analyzed data from more than 18.5 million people enrolled in Medicare Advantage or Original Medicare with Part D prescription drug coverage during 2014. Among their findings:

• Seven out of 10 adults aged 65 and older have high blood pressure, but nearly half don’t have it under control.
• American Indians/Alaska Natives, blacks, and Hispanics are more likely to not take their blood pressure medicine as directed.
• Southern U.S. states, Puerto Rico, and the U.S. Virgin Islands had the highest overall rates of not taking medicine as directed.North Dakota, Wisconsin, and Minnesota had the highest rates of adherence.

The CDC gave examples of how health care systems and providers can help:

• Simplify blood pressure treatments by offering 90-day refills and combination medicines, coordinating pill refills for the same date, and prescribing generic medicines.
• Involve the whole health care team at several points of care to ensure patients are taking medicine as directed, answer questions, and provide counseling.
• Encourage the use of home blood pressure monitors and easy-to-use tools, such as mobile apps to track and share readings.

As many as 5 million older Americans are at risk because they aren’t taking their blood pressure medicine properly, according to a Vital Signs report.

CDC researchers analyzed data from more than 18.5 million people enrolled in Medicare Advantage or Original Medicare with Part D prescription drug coverage during 2014. Among their findings:

• Seven out of 10 adults aged 65 and older have high blood pressure, but nearly half don’t have it under control.
• American Indians/Alaska Natives, blacks, and Hispanics are more likely to not take their blood pressure medicine as directed.
• Southern U.S. states, Puerto Rico, and the U.S. Virgin Islands had the highest overall rates of not taking medicine as directed.North Dakota, Wisconsin, and Minnesota had the highest rates of adherence.

The CDC gave examples of how health care systems and providers can help:

• Simplify blood pressure treatments by offering 90-day refills and combination medicines, coordinating pill refills for the same date, and prescribing generic medicines.
• Involve the whole health care team at several points of care to ensure patients are taking medicine as directed, answer questions, and provide counseling.
• Encourage the use of home blood pressure monitors and easy-to-use tools, such as mobile apps to track and share readings.

The U.S. has more motor vehicle crash deaths than do other high-income countries. Iin fact, the rate in the U.S. is roughly double the nearest countries in line: 10 deaths per 100,000 people, vs 5 to 6 in New Zealand, Canada, and France.

About one-third of deaths are due to drunk driving, and speeding contributes to another third. More than 9,500 of the deaths were due to passengers not using seat belts, car seats, or booster seats. Seat belts saved 12,500 plus lives in 2013, the CDC says, but about half of drivers or passengers who died in crashes weren’t buckled up. By contrast, 99% of drivers and passengers use front seat belts in France, and the average of the 19 countries studied is 94%—vs 87% in the U.S.

Although U.S. crash deaths fell 31% between 2000 and 2013, losing 90 people a day to crashes is still far too high, says the CDC. According to a Vital Signs report, more than 18,000 of the 32,000 lives lost each year could be saved if the U.S. took some safety tips from the other countries, the report says. Enforcing seat belt laws that cover everyone in every seat would be a good step, for instance. As would redefining blood alcohol concentration (BAC) limits—all the comparison countries use BAC levels at 0.02% to 0.05%, vs 0.08% in the U.S., Canada, and the United Kingdom. The report also urges using advanced engineering and technology, such as ignition interlocks for people convicted of drunk driving.

In the meantime, the CDC says, health care providers can help by reminding patients about using a seat belt on every trip, no matter how short; counseling parents on age- and size-appropriate seats for children; talking to patients about the dangers of impaired driving and “distracted” driving (eg, using cell phones or texting); and giving parents and caregivers of teens resources on safe teen driving.

The U.S. has more motor vehicle crash deaths than do other high-income countries. Iin fact, the rate in the U.S. is roughly double the nearest countries in line: 10 deaths per 100,000 people, vs 5 to 6 in New Zealand, Canada, and France.

About one-third of deaths are due to drunk driving, and speeding contributes to another third. More than 9,500 of the deaths were due to passengers not using seat belts, car seats, or booster seats. Seat belts saved 12,500 plus lives in 2013, the CDC says, but about half of drivers or passengers who died in crashes weren’t buckled up. By contrast, 99% of drivers and passengers use front seat belts in France, and the average of the 19 countries studied is 94%—vs 87% in the U.S.

Although U.S. crash deaths fell 31% between 2000 and 2013, losing 90 people a day to crashes is still far too high, says the CDC. According to a Vital Signs report, more than 18,000 of the 32,000 lives lost each year could be saved if the U.S. took some safety tips from the other countries, the report says. Enforcing seat belt laws that cover everyone in every seat would be a good step, for instance. As would redefining blood alcohol concentration (BAC) limits—all the comparison countries use BAC levels at 0.02% to 0.05%, vs 0.08% in the U.S., Canada, and the United Kingdom. The report also urges using advanced engineering and technology, such as ignition interlocks for people convicted of drunk driving.

In the meantime, the CDC says, health care providers can help by reminding patients about using a seat belt on every trip, no matter how short; counseling parents on age- and size-appropriate seats for children; talking to patients about the dangers of impaired driving and “distracted” driving (eg, using cell phones or texting); and giving parents and caregivers of teens resources on safe teen driving.

The U.S. has more motor vehicle crash deaths than do other high-income countries. Iin fact, the rate in the U.S. is roughly double the nearest countries in line: 10 deaths per 100,000 people, vs 5 to 6 in New Zealand, Canada, and France.

About one-third of deaths are due to drunk driving, and speeding contributes to another third. More than 9,500 of the deaths were due to passengers not using seat belts, car seats, or booster seats. Seat belts saved 12,500 plus lives in 2013, the CDC says, but about half of drivers or passengers who died in crashes weren’t buckled up. By contrast, 99% of drivers and passengers use front seat belts in France, and the average of the 19 countries studied is 94%—vs 87% in the U.S.

Although U.S. crash deaths fell 31% between 2000 and 2013, losing 90 people a day to crashes is still far too high, says the CDC. According to a Vital Signs report, more than 18,000 of the 32,000 lives lost each year could be saved if the U.S. took some safety tips from the other countries, the report says. Enforcing seat belt laws that cover everyone in every seat would be a good step, for instance. As would redefining blood alcohol concentration (BAC) limits—all the comparison countries use BAC levels at 0.02% to 0.05%, vs 0.08% in the U.S., Canada, and the United Kingdom. The report also urges using advanced engineering and technology, such as ignition interlocks for people convicted of drunk driving.

In the meantime, the CDC says, health care providers can help by reminding patients about using a seat belt on every trip, no matter how short; counseling parents on age- and size-appropriate seats for children; talking to patients about the dangers of impaired driving and “distracted” driving (eg, using cell phones or texting); and giving parents and caregivers of teens resources on safe teen driving.

More than half of all Americans have a cataract or have had cataract surgery by age 80. Almost 4 million cataract surgeries are performed each year.

The mainstay of treatment has been monofocal lenses that improve distance vision. However, the FDA has just approved the first intraocular lens (IOL) to provide extended depth-of-focus, which improves sharpness of vision at near, intermediate, and far distances.

The Tecnis Symfony Extended Range of Vision IOL has been available in Europe since 2014. At the 2014 American Academy of Ophthalmology meeting, US cataract surgeon Mark Packer, MD, called the new lens “an exciting development.”

The lens is designed to correct both chromatic aberration (inability to focus due to competing wavelengths of light passing through the lens at different angles) and spherical aberration (lack of focus due to the shape of the lens). Clinical studies have demonstrated a low incidence of dysphotopsias such as halo and glare, which can impede night vision and driving. However, the FDA cautions that some patients experience visual halos, glare, or starbursts; some may experience worsening of or blurred vision, bleeding, or infection; and the device may cause reduced contrast sensitivity that worsens under poor visibility conditions.

More than 50 countries have approved the IOL has been approved, and has been widely studied with data from clinical studies involving more than 2,000 eyes, according to the manufacturer, Abbott Laboratories. FDA approval was based on a review of results from a study comparing 148 cataract patients implanted with the Tecnis Symfony Extended Range of Vision IOL and 151 patients implanted with a monofocal IOL.

Both groups of patients had comparable results for good distance vision. Of the patients in the Tecnis Symfony group, 77% had good vision (20/25) without glasses at intermediate distance, compared with 34% of those in the monofocal group. At near distances, patients with the Tecnis Symfony IOL could read 2 additional, progressively smaller lines on a standard eye chart, compared with those in the monofocal group.

In clinical trials for Tecnis IOLs, adverse events occurred at rates between 1.6% and 3.3%, including macular edema, endophthalmitis, and anterior lens tissue ongrowth. However, the events were not related to the lenses, the manufacturer says.

The FDA approval includes a version of the lens for people with astigmatism. The new lens is available in 4 toric models.

More than half of all Americans have a cataract or have had cataract surgery by age 80. Almost 4 million cataract surgeries are performed each year.

The mainstay of treatment has been monofocal lenses that improve distance vision. However, the FDA has just approved the first intraocular lens (IOL) to provide extended depth-of-focus, which improves sharpness of vision at near, intermediate, and far distances.

The Tecnis Symfony Extended Range of Vision IOL has been available in Europe since 2014. At the 2014 American Academy of Ophthalmology meeting, US cataract surgeon Mark Packer, MD, called the new lens “an exciting development.”

The lens is designed to correct both chromatic aberration (inability to focus due to competing wavelengths of light passing through the lens at different angles) and spherical aberration (lack of focus due to the shape of the lens). Clinical studies have demonstrated a low incidence of dysphotopsias such as halo and glare, which can impede night vision and driving. However, the FDA cautions that some patients experience visual halos, glare, or starbursts; some may experience worsening of or blurred vision, bleeding, or infection; and the device may cause reduced contrast sensitivity that worsens under poor visibility conditions.

More than 50 countries have approved the IOL has been approved, and has been widely studied with data from clinical studies involving more than 2,000 eyes, according to the manufacturer, Abbott Laboratories. FDA approval was based on a review of results from a study comparing 148 cataract patients implanted with the Tecnis Symfony Extended Range of Vision IOL and 151 patients implanted with a monofocal IOL.

Both groups of patients had comparable results for good distance vision. Of the patients in the Tecnis Symfony group, 77% had good vision (20/25) without glasses at intermediate distance, compared with 34% of those in the monofocal group. At near distances, patients with the Tecnis Symfony IOL could read 2 additional, progressively smaller lines on a standard eye chart, compared with those in the monofocal group.

In clinical trials for Tecnis IOLs, adverse events occurred at rates between 1.6% and 3.3%, including macular edema, endophthalmitis, and anterior lens tissue ongrowth. However, the events were not related to the lenses, the manufacturer says.

The FDA approval includes a version of the lens for people with astigmatism. The new lens is available in 4 toric models.

More than half of all Americans have a cataract or have had cataract surgery by age 80. Almost 4 million cataract surgeries are performed each year.

The mainstay of treatment has been monofocal lenses that improve distance vision. However, the FDA has just approved the first intraocular lens (IOL) to provide extended depth-of-focus, which improves sharpness of vision at near, intermediate, and far distances.

The Tecnis Symfony Extended Range of Vision IOL has been available in Europe since 2014. At the 2014 American Academy of Ophthalmology meeting, US cataract surgeon Mark Packer, MD, called the new lens “an exciting development.”

The lens is designed to correct both chromatic aberration (inability to focus due to competing wavelengths of light passing through the lens at different angles) and spherical aberration (lack of focus due to the shape of the lens). Clinical studies have demonstrated a low incidence of dysphotopsias such as halo and glare, which can impede night vision and driving. However, the FDA cautions that some patients experience visual halos, glare, or starbursts; some may experience worsening of or blurred vision, bleeding, or infection; and the device may cause reduced contrast sensitivity that worsens under poor visibility conditions.

More than 50 countries have approved the IOL has been approved, and has been widely studied with data from clinical studies involving more than 2,000 eyes, according to the manufacturer, Abbott Laboratories. FDA approval was based on a review of results from a study comparing 148 cataract patients implanted with the Tecnis Symfony Extended Range of Vision IOL and 151 patients implanted with a monofocal IOL.

Both groups of patients had comparable results for good distance vision. Of the patients in the Tecnis Symfony group, 77% had good vision (20/25) without glasses at intermediate distance, compared with 34% of those in the monofocal group. At near distances, patients with the Tecnis Symfony IOL could read 2 additional, progressively smaller lines on a standard eye chart, compared with those in the monofocal group.

In clinical trials for Tecnis IOLs, adverse events occurred at rates between 1.6% and 3.3%, including macular edema, endophthalmitis, and anterior lens tissue ongrowth. However, the events were not related to the lenses, the manufacturer says.

The FDA approval includes a version of the lens for people with astigmatism. The new lens is available in 4 toric models.

Caring for a woman who is addicted to opioids—and who is a mother or about to be—can be challenging. But child welfare systems are reporting heavier caseloads, primarily among infants and young children. Moreover, hospitals are reporting increasing numbers of infants born with neonatal abstinence syndrome.

As part of HHS’s overall initiative to address the many public health problems posed by the opioid disorder crisis, SAMHSA, with the Administration on Children, Youth, and Families, is releasing A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders.

The guide is aimed at promoting a coordinated multisystemic approach among agencies and providers, including child welfare, medical, and substance abuse treatment, grounded in early identification and interventions to support families.

The publication covers the extent of opioid use by pregnant women and its effects on their fetus. It offers evidence-based recommendations for treatment approaches, along with recommendations for collaborative planning and tools to conduct a needs-and-gap analysis to develop a collaborative action plan.

SAMHSA also publishes Advancing the Care of Pregnant and Parenting Women with Opioid Use Disorder and their Infants: A Foundation for Clinical Guidance. This report summarizes the evidence review and rating processes SAMHSA used to establish appropriate interventions.

Caring for a woman who is addicted to opioids—and who is a mother or about to be—can be challenging. But child welfare systems are reporting heavier caseloads, primarily among infants and young children. Moreover, hospitals are reporting increasing numbers of infants born with neonatal abstinence syndrome.

As part of HHS’s overall initiative to address the many public health problems posed by the opioid disorder crisis, SAMHSA, with the Administration on Children, Youth, and Families, is releasing A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders.

The guide is aimed at promoting a coordinated multisystemic approach among agencies and providers, including child welfare, medical, and substance abuse treatment, grounded in early identification and interventions to support families.

The publication covers the extent of opioid use by pregnant women and its effects on their fetus. It offers evidence-based recommendations for treatment approaches, along with recommendations for collaborative planning and tools to conduct a needs-and-gap analysis to develop a collaborative action plan.

SAMHSA also publishes Advancing the Care of Pregnant and Parenting Women with Opioid Use Disorder and their Infants: A Foundation for Clinical Guidance. This report summarizes the evidence review and rating processes SAMHSA used to establish appropriate interventions.

Caring for a woman who is addicted to opioids—and who is a mother or about to be—can be challenging. But child welfare systems are reporting heavier caseloads, primarily among infants and young children. Moreover, hospitals are reporting increasing numbers of infants born with neonatal abstinence syndrome.

As part of HHS’s overall initiative to address the many public health problems posed by the opioid disorder crisis, SAMHSA, with the Administration on Children, Youth, and Families, is releasing A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders.

The guide is aimed at promoting a coordinated multisystemic approach among agencies and providers, including child welfare, medical, and substance abuse treatment, grounded in early identification and interventions to support families.

The publication covers the extent of opioid use by pregnant women and its effects on their fetus. It offers evidence-based recommendations for treatment approaches, along with recommendations for collaborative planning and tools to conduct a needs-and-gap analysis to develop a collaborative action plan.

SAMHSA also publishes Advancing the Care of Pregnant and Parenting Women with Opioid Use Disorder and their Infants: A Foundation for Clinical Guidance. This report summarizes the evidence review and rating processes SAMHSA used to establish appropriate interventions.