Government and Regulations

Diabetes is a relatively recent phenomenon among American Indian and Alaska Natives (AI/AN). In 1940, only 21 cases of diabetes were identified among a Pima tribe, say researchers from the CDC’s Native Diabetes Wellness Program.

Although rare before the 1940s, diabetes cases have increased exponentially since. During 2010-2012, AI/AN adults were twice as likely to have diabetes as were non-Hispanic white adults. Unfortunately, AI/AN youth are catching up, with a 68% increase in diagnosed diabetes among those aged 15 to 19 years between 1994 and 2004, and a 100% increase between 1994 and 2007 among those aged 18 to 34 years. Moreover, in 2009, 21% of AI/AN children aged 2 to 4 years were obese and at risk for type 2 diabetes.

 In response, the CDC, among other agencies, is encouraging “tribally driven” solutions to the problem, like the CDC-funded Traditional Foods Project (2008-2014), which aims to “reclaim” original native food systems.

The Traditional Foods Project is having promising results, CDC researchers say. During the 6 years of the project, the “food sovereignty” movement to revive foods specific to the landscape, history, and culture of the native people grew both locally and nationally. Partners aligned their efforts with the 2008 Farm Bill and created opportunities to operationalize the Agricultural Act of 2014, such as serving traditional foods in public facilities. Other offshoots include Qaqamiigux: Traditional Foods and Recipes from the Aleutian and Pribilof Islands, published by Traditional Foods Project partner Aleutian Pribilof Islands Association.

Education is key, and tribal schools are providing hands-on learning activities about growing healthful foods, strengthened by local and national efforts such as the Farm to School initiative.

The momentum continues, the researchers say. Although the cooperative agreement ended in 2014, several programs have secured support through tribal councils, university partnerships, state and county health departments, federal agencies, and nonprofit organizations.

Diabetes is a relatively recent phenomenon among American Indian and Alaska Natives (AI/AN). In 1940, only 21 cases of diabetes were identified among a Pima tribe, say researchers from the CDC’s Native Diabetes Wellness Program.

Although rare before the 1940s, diabetes cases have increased exponentially since. During 2010-2012, AI/AN adults were twice as likely to have diabetes as were non-Hispanic white adults. Unfortunately, AI/AN youth are catching up, with a 68% increase in diagnosed diabetes among those aged 15 to 19 years between 1994 and 2004, and a 100% increase between 1994 and 2007 among those aged 18 to 34 years. Moreover, in 2009, 21% of AI/AN children aged 2 to 4 years were obese and at risk for type 2 diabetes.

 In response, the CDC, among other agencies, is encouraging “tribally driven” solutions to the problem, like the CDC-funded Traditional Foods Project (2008-2014), which aims to “reclaim” original native food systems.

The Traditional Foods Project is having promising results, CDC researchers say. During the 6 years of the project, the “food sovereignty” movement to revive foods specific to the landscape, history, and culture of the native people grew both locally and nationally. Partners aligned their efforts with the 2008 Farm Bill and created opportunities to operationalize the Agricultural Act of 2014, such as serving traditional foods in public facilities. Other offshoots include Qaqamiigux: Traditional Foods and Recipes from the Aleutian and Pribilof Islands, published by Traditional Foods Project partner Aleutian Pribilof Islands Association.

Education is key, and tribal schools are providing hands-on learning activities about growing healthful foods, strengthened by local and national efforts such as the Farm to School initiative.

The momentum continues, the researchers say. Although the cooperative agreement ended in 2014, several programs have secured support through tribal councils, university partnerships, state and county health departments, federal agencies, and nonprofit organizations.

Diabetes is a relatively recent phenomenon among American Indian and Alaska Natives (AI/AN). In 1940, only 21 cases of diabetes were identified among a Pima tribe, say researchers from the CDC’s Native Diabetes Wellness Program.

Although rare before the 1940s, diabetes cases have increased exponentially since. During 2010-2012, AI/AN adults were twice as likely to have diabetes as were non-Hispanic white adults. Unfortunately, AI/AN youth are catching up, with a 68% increase in diagnosed diabetes among those aged 15 to 19 years between 1994 and 2004, and a 100% increase between 1994 and 2007 among those aged 18 to 34 years. Moreover, in 2009, 21% of AI/AN children aged 2 to 4 years were obese and at risk for type 2 diabetes.

 In response, the CDC, among other agencies, is encouraging “tribally driven” solutions to the problem, like the CDC-funded Traditional Foods Project (2008-2014), which aims to “reclaim” original native food systems.

The Traditional Foods Project is having promising results, CDC researchers say. During the 6 years of the project, the “food sovereignty” movement to revive foods specific to the landscape, history, and culture of the native people grew both locally and nationally. Partners aligned their efforts with the 2008 Farm Bill and created opportunities to operationalize the Agricultural Act of 2014, such as serving traditional foods in public facilities. Other offshoots include Qaqamiigux: Traditional Foods and Recipes from the Aleutian and Pribilof Islands, published by Traditional Foods Project partner Aleutian Pribilof Islands Association.

Education is key, and tribal schools are providing hands-on learning activities about growing healthful foods, strengthened by local and national efforts such as the Farm to School initiative.

The momentum continues, the researchers say. Although the cooperative agreement ended in 2014, several programs have secured support through tribal councils, university partnerships, state and county health departments, federal agencies, and nonprofit organizations.

The federal government has launched the second phase of its HIPAA Audit Program and will soon be identifying health providers it plans to target.

For the 2016 Phase 2 HIPAA Audit Program, auditors will review policies and procedures enacted by covered entities and their business associates to meet selected standards of the Privacy, Security, and Breach Notification Rules, according to a March 21 announcement by the Department of Health & Human Services Office for Civil Rights (OCR).

©zimmytws/Thinkstock.com

Physicians and other covered entities can expect an email at some point this year requesting that updated contact information be provided to the OCR. The office will then send health providers a pre-audit questionnaire to gather data about the practice’s size, type, and operations, according to the announcement. The government will use the data as well as other information to create audit subject pools. If an entity does not respond to the OCR’s contact request or the pre-audit questionnaire, the agency will use publicly available information about the practice.

Every covered entity and business associate is eligible for an audit, the OCR noted. For Phase 2, the government plans to identify health providers and business associates that represent a wide range of health care providers, health plans, health care clearinghouses and business associates to access HIPAA compliance across the industry. Sampling criteria for auditee selection will include size of the entity, affiliation with other health care organizations, whether an organization is public or private, geographic factors, and present enforcement activity with OCR. Entities with open complaints or that are currently undergoing investigations will not be chosen.

The first set of audits will be desk audits of covered entities followed by a second round of desk audits of business associates, OCR stated. OCR plans to complete all desk audits by December 2016. A third set of audits will be on site and will examine a broader scope of requirements under the HIPAA rules. Some desk auditees may be subject to a subsequent on-site audit, the government noted.

A list of frequently asked questions about the 2016 Phase 2 HIPAA Audit Program can be found on the OCR’s website.

Round 2 of the HIPAA audits follows a pilot program launched in 2011 and 2012 by OCR that assessed HIPAA controls and processes implemented by 115 covered entities. The second phase will draw on the results and experiences learned from the pilot program, according to OCR.

agallegos@frontlinemedcom.com

On Twitter @legal_med

The federal government has launched the second phase of its HIPAA Audit Program and will soon be identifying health providers it plans to target.

For the 2016 Phase 2 HIPAA Audit Program, auditors will review policies and procedures enacted by covered entities and their business associates to meet selected standards of the Privacy, Security, and Breach Notification Rules, according to a March 21 announcement by the Department of Health & Human Services Office for Civil Rights (OCR).

©zimmytws/Thinkstock.com

Physicians and other covered entities can expect an email at some point this year requesting that updated contact information be provided to the OCR. The office will then send health providers a pre-audit questionnaire to gather data about the practice’s size, type, and operations, according to the announcement. The government will use the data as well as other information to create audit subject pools. If an entity does not respond to the OCR’s contact request or the pre-audit questionnaire, the agency will use publicly available information about the practice.

Every covered entity and business associate is eligible for an audit, the OCR noted. For Phase 2, the government plans to identify health providers and business associates that represent a wide range of health care providers, health plans, health care clearinghouses and business associates to access HIPAA compliance across the industry. Sampling criteria for auditee selection will include size of the entity, affiliation with other health care organizations, whether an organization is public or private, geographic factors, and present enforcement activity with OCR. Entities with open complaints or that are currently undergoing investigations will not be chosen.

The first set of audits will be desk audits of covered entities followed by a second round of desk audits of business associates, OCR stated. OCR plans to complete all desk audits by December 2016. A third set of audits will be on site and will examine a broader scope of requirements under the HIPAA rules. Some desk auditees may be subject to a subsequent on-site audit, the government noted.

A list of frequently asked questions about the 2016 Phase 2 HIPAA Audit Program can be found on the OCR’s website.

Round 2 of the HIPAA audits follows a pilot program launched in 2011 and 2012 by OCR that assessed HIPAA controls and processes implemented by 115 covered entities. The second phase will draw on the results and experiences learned from the pilot program, according to OCR.

agallegos@frontlinemedcom.com

On Twitter @legal_med

The federal government has launched the second phase of its HIPAA Audit Program and will soon be identifying health providers it plans to target.

For the 2016 Phase 2 HIPAA Audit Program, auditors will review policies and procedures enacted by covered entities and their business associates to meet selected standards of the Privacy, Security, and Breach Notification Rules, according to a March 21 announcement by the Department of Health & Human Services Office for Civil Rights (OCR).

©zimmytws/Thinkstock.com

Physicians and other covered entities can expect an email at some point this year requesting that updated contact information be provided to the OCR. The office will then send health providers a pre-audit questionnaire to gather data about the practice’s size, type, and operations, according to the announcement. The government will use the data as well as other information to create audit subject pools. If an entity does not respond to the OCR’s contact request or the pre-audit questionnaire, the agency will use publicly available information about the practice.

Every covered entity and business associate is eligible for an audit, the OCR noted. For Phase 2, the government plans to identify health providers and business associates that represent a wide range of health care providers, health plans, health care clearinghouses and business associates to access HIPAA compliance across the industry. Sampling criteria for auditee selection will include size of the entity, affiliation with other health care organizations, whether an organization is public or private, geographic factors, and present enforcement activity with OCR. Entities with open complaints or that are currently undergoing investigations will not be chosen.

The first set of audits will be desk audits of covered entities followed by a second round of desk audits of business associates, OCR stated. OCR plans to complete all desk audits by December 2016. A third set of audits will be on site and will examine a broader scope of requirements under the HIPAA rules. Some desk auditees may be subject to a subsequent on-site audit, the government noted.

A list of frequently asked questions about the 2016 Phase 2 HIPAA Audit Program can be found on the OCR’s website.

Round 2 of the HIPAA audits follows a pilot program launched in 2011 and 2012 by OCR that assessed HIPAA controls and processes implemented by 115 covered entities. The second phase will draw on the results and experiences learned from the pilot program, according to OCR.

agallegos@frontlinemedcom.com

On Twitter @legal_med

Since 2011, CDC Health Disparities and Inequalities reports have highlighted public health programs that are both innovative and effective. A recent supplement details some of the most successful.

The key components to an effective public health program include evidence-based interventions, partnerships, and performance management, says CDC Director Thomas Frieden, MD, MPH, in a foreword to the supplement. Of these components, performance management—real-time monitoring and evaluation to ensure continuous improvement—is particularly important. But results in public health programs may not be apparent for months or even years. “Even the best designed programs might fail without timely, honest evaluation,” notes Friedan.

The 8 programs featured in the supplement are praised for effective performance management, such as sustainable monitoring systems. The supplement also included the Boston Children’s Hospital’s Community Asthma Initiative, which focuses on black and Hispanic low-income children who are hospitalized with complications of asthma more often than white children. The program offers advanced asthma care, including case management and home visits. Evaluations found the program significantly improved asthma outcomes over a 3-year period. The program has been adapted to local cultural variations in other cities and states.

The programs described in the supplement demonstrate that public health disparities can be overcome by “innovative, well-designed, and consistently evaluated programs that build viable and sustainable long-term partnerships and inspire political commitment through effective implementation and communication,” says Frieden.

Since 2011, CDC Health Disparities and Inequalities reports have highlighted public health programs that are both innovative and effective. A recent supplement details some of the most successful.

The key components to an effective public health program include evidence-based interventions, partnerships, and performance management, says CDC Director Thomas Frieden, MD, MPH, in a foreword to the supplement. Of these components, performance management—real-time monitoring and evaluation to ensure continuous improvement—is particularly important. But results in public health programs may not be apparent for months or even years. “Even the best designed programs might fail without timely, honest evaluation,” notes Friedan.

The 8 programs featured in the supplement are praised for effective performance management, such as sustainable monitoring systems. The supplement also included the Boston Children’s Hospital’s Community Asthma Initiative, which focuses on black and Hispanic low-income children who are hospitalized with complications of asthma more often than white children. The program offers advanced asthma care, including case management and home visits. Evaluations found the program significantly improved asthma outcomes over a 3-year period. The program has been adapted to local cultural variations in other cities and states.

The programs described in the supplement demonstrate that public health disparities can be overcome by “innovative, well-designed, and consistently evaluated programs that build viable and sustainable long-term partnerships and inspire political commitment through effective implementation and communication,” says Frieden.

Since 2011, CDC Health Disparities and Inequalities reports have highlighted public health programs that are both innovative and effective. A recent supplement details some of the most successful.

The key components to an effective public health program include evidence-based interventions, partnerships, and performance management, says CDC Director Thomas Frieden, MD, MPH, in a foreword to the supplement. Of these components, performance management—real-time monitoring and evaluation to ensure continuous improvement—is particularly important. But results in public health programs may not be apparent for months or even years. “Even the best designed programs might fail without timely, honest evaluation,” notes Friedan.

The 8 programs featured in the supplement are praised for effective performance management, such as sustainable monitoring systems. The supplement also included the Boston Children’s Hospital’s Community Asthma Initiative, which focuses on black and Hispanic low-income children who are hospitalized with complications of asthma more often than white children. The program offers advanced asthma care, including case management and home visits. Evaluations found the program significantly improved asthma outcomes over a 3-year period. The program has been adapted to local cultural variations in other cities and states.

The programs described in the supplement demonstrate that public health disparities can be overcome by “innovative, well-designed, and consistently evaluated programs that build viable and sustainable long-term partnerships and inspire political commitment through effective implementation and communication,” says Frieden.

Numerous reports have surfaced of veterans “experiencing adverse credit reporting or debt collection” and health care providers refusing to care for veterans because of slow payments and other accounting issues. Other concerns with VCA have ranged from lack of access to urgent and emergent care to the confusing array of separate programs created by VCA. In response, the VA has created a Community Care Call Center, and the U.S. Senate is considering 2 bills to fix issues with the Veterans Choice Act (VCA).

“VA has consistently failed to reimburse the hospitals for services rendered,” explains Senator Richard Burr (R-NC). Burr helped draft the original Veterans Choice Act (VCA) and the Veterans Choice Improvement Act, which aims to correct issues with the VCA. According to Burr, the bill would establish a standard for how long it takes the VA to reimburse claims and ensure that late payments accrue interest.

The Improving Veterans Access to Care in Community Act also tackles other complaints about the original bill—the confusing array of separate programs it established for seeking non-VA care. “The laws and regulations that govern these programs differ in substantial ways, and this is confusing to the veteran, confusing to doctors and hospitals, and oftentimes, confusing to the VA itself,” Senator Burr explained.

Under the new legislation, the VCA programs would be consolidated into a single permanent program, the Veterans Choice Program. Previously, the VCA was established as a temporary program.

Although VA officials professed happiness with making VCA permanent, Sharon Johnson, MSN, RN-BC, president of the Nurses Organization of Veterans Affairs (NOVA) expressed concern in a statement submitted to the committee. “NOVA believes that making Choice permanent at this time would be a mistake and that further review and oversight of the many issues occurring in the field is needed. We also believe that the veteran should be at the forefront as you consider all forms of non-VA/fee-based care.”

Veterans service organizations largely liked what they saw in the legislation. “Both bills address deficiencies in current law, as well as provide a comprehensive framework and foundation for consolidating the purchase of care in the community,” Louis J. Celli, Jr. of the American Legion told the Senate panel.

Carlos Fuentes of the Veterans of Foreign Wars concurred, noting that the legislation would “improve how veterans access community care options and ensure the private sector supplements, not supplants, the excellent health care veterans receive from VA health care professionals.”

The 2 bills offered differing approaches to whether the VA could create tiered networks of non-VA providers. Disabled American Veterans (DAV) and the VA urged the committee to adopt the tiered model, which could produce what the DAV described as “Veterans-Centered Integrated Health Care Networks” of VA and non-VA providers, whereas the American Medical Association strongly opposed the concept.

During the hearing, Secretary McDonald also answered questions related to the hiring and firing of VA employees, which now seems to be under control. The new legislation offers a number of fixes to make it easier for the VA to remove employees, although the rules may not directly impact health care providers. “All the individuals in the medical professionals in the VA should be Title 38,” McDonald explained to the committee. “Title 38 gives us the ability to hire directly, which will speed up the hiring process and make us competitive with the private sector. Title 38 will allow the VA to pay more competitively and recruit more competitively.”

A final signed bill is expected by the end of May 2016.

Numerous reports have surfaced of veterans “experiencing adverse credit reporting or debt collection” and health care providers refusing to care for veterans because of slow payments and other accounting issues. Other concerns with VCA have ranged from lack of access to urgent and emergent care to the confusing array of separate programs created by VCA. In response, the VA has created a Community Care Call Center, and the U.S. Senate is considering 2 bills to fix issues with the Veterans Choice Act (VCA).

“VA has consistently failed to reimburse the hospitals for services rendered,” explains Senator Richard Burr (R-NC). Burr helped draft the original Veterans Choice Act (VCA) and the Veterans Choice Improvement Act, which aims to correct issues with the VCA. According to Burr, the bill would establish a standard for how long it takes the VA to reimburse claims and ensure that late payments accrue interest.

The Improving Veterans Access to Care in Community Act also tackles other complaints about the original bill—the confusing array of separate programs it established for seeking non-VA care. “The laws and regulations that govern these programs differ in substantial ways, and this is confusing to the veteran, confusing to doctors and hospitals, and oftentimes, confusing to the VA itself,” Senator Burr explained.

Under the new legislation, the VCA programs would be consolidated into a single permanent program, the Veterans Choice Program. Previously, the VCA was established as a temporary program.

Although VA officials professed happiness with making VCA permanent, Sharon Johnson, MSN, RN-BC, president of the Nurses Organization of Veterans Affairs (NOVA) expressed concern in a statement submitted to the committee. “NOVA believes that making Choice permanent at this time would be a mistake and that further review and oversight of the many issues occurring in the field is needed. We also believe that the veteran should be at the forefront as you consider all forms of non-VA/fee-based care.”

Veterans service organizations largely liked what they saw in the legislation. “Both bills address deficiencies in current law, as well as provide a comprehensive framework and foundation for consolidating the purchase of care in the community,” Louis J. Celli, Jr. of the American Legion told the Senate panel.

Carlos Fuentes of the Veterans of Foreign Wars concurred, noting that the legislation would “improve how veterans access community care options and ensure the private sector supplements, not supplants, the excellent health care veterans receive from VA health care professionals.”

The 2 bills offered differing approaches to whether the VA could create tiered networks of non-VA providers. Disabled American Veterans (DAV) and the VA urged the committee to adopt the tiered model, which could produce what the DAV described as “Veterans-Centered Integrated Health Care Networks” of VA and non-VA providers, whereas the American Medical Association strongly opposed the concept.

During the hearing, Secretary McDonald also answered questions related to the hiring and firing of VA employees, which now seems to be under control. The new legislation offers a number of fixes to make it easier for the VA to remove employees, although the rules may not directly impact health care providers. “All the individuals in the medical professionals in the VA should be Title 38,” McDonald explained to the committee. “Title 38 gives us the ability to hire directly, which will speed up the hiring process and make us competitive with the private sector. Title 38 will allow the VA to pay more competitively and recruit more competitively.”

A final signed bill is expected by the end of May 2016.

Numerous reports have surfaced of veterans “experiencing adverse credit reporting or debt collection” and health care providers refusing to care for veterans because of slow payments and other accounting issues. Other concerns with VCA have ranged from lack of access to urgent and emergent care to the confusing array of separate programs created by VCA. In response, the VA has created a Community Care Call Center, and the U.S. Senate is considering 2 bills to fix issues with the Veterans Choice Act (VCA).

“VA has consistently failed to reimburse the hospitals for services rendered,” explains Senator Richard Burr (R-NC). Burr helped draft the original Veterans Choice Act (VCA) and the Veterans Choice Improvement Act, which aims to correct issues with the VCA. According to Burr, the bill would establish a standard for how long it takes the VA to reimburse claims and ensure that late payments accrue interest.

The Improving Veterans Access to Care in Community Act also tackles other complaints about the original bill—the confusing array of separate programs it established for seeking non-VA care. “The laws and regulations that govern these programs differ in substantial ways, and this is confusing to the veteran, confusing to doctors and hospitals, and oftentimes, confusing to the VA itself,” Senator Burr explained.

Under the new legislation, the VCA programs would be consolidated into a single permanent program, the Veterans Choice Program. Previously, the VCA was established as a temporary program.

Although VA officials professed happiness with making VCA permanent, Sharon Johnson, MSN, RN-BC, president of the Nurses Organization of Veterans Affairs (NOVA) expressed concern in a statement submitted to the committee. “NOVA believes that making Choice permanent at this time would be a mistake and that further review and oversight of the many issues occurring in the field is needed. We also believe that the veteran should be at the forefront as you consider all forms of non-VA/fee-based care.”

Veterans service organizations largely liked what they saw in the legislation. “Both bills address deficiencies in current law, as well as provide a comprehensive framework and foundation for consolidating the purchase of care in the community,” Louis J. Celli, Jr. of the American Legion told the Senate panel.

Carlos Fuentes of the Veterans of Foreign Wars concurred, noting that the legislation would “improve how veterans access community care options and ensure the private sector supplements, not supplants, the excellent health care veterans receive from VA health care professionals.”

The 2 bills offered differing approaches to whether the VA could create tiered networks of non-VA providers. Disabled American Veterans (DAV) and the VA urged the committee to adopt the tiered model, which could produce what the DAV described as “Veterans-Centered Integrated Health Care Networks” of VA and non-VA providers, whereas the American Medical Association strongly opposed the concept.

During the hearing, Secretary McDonald also answered questions related to the hiring and firing of VA employees, which now seems to be under control. The new legislation offers a number of fixes to make it easier for the VA to remove employees, although the rules may not directly impact health care providers. “All the individuals in the medical professionals in the VA should be Title 38,” McDonald explained to the committee. “Title 38 gives us the ability to hire directly, which will speed up the hiring process and make us competitive with the private sector. Title 38 will allow the VA to pay more competitively and recruit more competitively.”

A final signed bill is expected by the end of May 2016.

After 6 of about 9,000 blood samples produced “unusual results,” scientists at the Mayo Clinic thought they might be looking at a new cause of Lyme disease. DNA sequencing showed that a new bacterium was the cause.

Provisionally named Borrelia mayonii (B mayonii), the bacterium is closely related to Borrelia burgdorferi (B burgdorferi), which until now was the only bacterium believed to cause Lyme disease in North America. Borrelia mayonii causes fever, headache, rash, and neck pain in the early stages and arthritis in later stages. Unlike B burgdorferi, B mayonii is also associated with nausea, vomiting, and a higher concentration of bacteria in blood. Instead of the famous “bull’s-eye rash,” B mayonii produces diffuse rashes.

The researchers believe, like B burgdorferi, B mayonii is transmitted by the bite of an infected deer tick. It has been identified in ticks collected in at least 2 counties in northwestern Minnesota. The patients were most likely infected in north central Minnesota and western Wisconsin; the CDC cautions that the infected ticks are found throughout both states. So far the new species is found only in the upper Midwest. Blood samples from residents of 43 other states with suspected tick-borne disease did not carry the bacterium.

Patients were treated successfully with the antibiotics used to treat Lyme disease caused by B burgdorferi. The CDC recommends that health care providers for patients infected by B mayonii follow the antibiotic regimen described by the Infectious Diseases Society of America.

After 6 of about 9,000 blood samples produced “unusual results,” scientists at the Mayo Clinic thought they might be looking at a new cause of Lyme disease. DNA sequencing showed that a new bacterium was the cause.

Provisionally named Borrelia mayonii (B mayonii), the bacterium is closely related to Borrelia burgdorferi (B burgdorferi), which until now was the only bacterium believed to cause Lyme disease in North America. Borrelia mayonii causes fever, headache, rash, and neck pain in the early stages and arthritis in later stages. Unlike B burgdorferi, B mayonii is also associated with nausea, vomiting, and a higher concentration of bacteria in blood. Instead of the famous “bull’s-eye rash,” B mayonii produces diffuse rashes.

The researchers believe, like B burgdorferi, B mayonii is transmitted by the bite of an infected deer tick. It has been identified in ticks collected in at least 2 counties in northwestern Minnesota. The patients were most likely infected in north central Minnesota and western Wisconsin; the CDC cautions that the infected ticks are found throughout both states. So far the new species is found only in the upper Midwest. Blood samples from residents of 43 other states with suspected tick-borne disease did not carry the bacterium.

Patients were treated successfully with the antibiotics used to treat Lyme disease caused by B burgdorferi. The CDC recommends that health care providers for patients infected by B mayonii follow the antibiotic regimen described by the Infectious Diseases Society of America.

After 6 of about 9,000 blood samples produced “unusual results,” scientists at the Mayo Clinic thought they might be looking at a new cause of Lyme disease. DNA sequencing showed that a new bacterium was the cause.

Provisionally named Borrelia mayonii (B mayonii), the bacterium is closely related to Borrelia burgdorferi (B burgdorferi), which until now was the only bacterium believed to cause Lyme disease in North America. Borrelia mayonii causes fever, headache, rash, and neck pain in the early stages and arthritis in later stages. Unlike B burgdorferi, B mayonii is also associated with nausea, vomiting, and a higher concentration of bacteria in blood. Instead of the famous “bull’s-eye rash,” B mayonii produces diffuse rashes.

The researchers believe, like B burgdorferi, B mayonii is transmitted by the bite of an infected deer tick. It has been identified in ticks collected in at least 2 counties in northwestern Minnesota. The patients were most likely infected in north central Minnesota and western Wisconsin; the CDC cautions that the infected ticks are found throughout both states. So far the new species is found only in the upper Midwest. Blood samples from residents of 43 other states with suspected tick-borne disease did not carry the bacterium.

Patients were treated successfully with the antibiotics used to treat Lyme disease caused by B burgdorferi. The CDC recommends that health care providers for patients infected by B mayonii follow the antibiotic regimen described by the Infectious Diseases Society of America.

Swimming with sharks, tightrope walking across a chasm, or leaping from a cliff are some of the striking visual warnings on posters for the Mind Your Risks public health campaign, launched by the National Institute of Neurological Disorders and Stroke (NINDS).

To raise awareness of how uncontrolled high blood pressure is linked to stroke, cognitive decline, and dementia, the NINDS is partnering with other groups, such as the CDC’s Million Hearts and the What Is Brain Health campaign, sponsored by the HHS Administration for Community Living.

The website, https://mindyourrisks.nih.gov, links to a variety of tools and resources available at the partner sites to help educate about high blood pressure. The website also hosts summaries of scientific studies on high blood pressure and dementia or cognitive impairment, including findings from Atherosclerosis Risk in Communities, an epidemiologic study whose data have been published in more than 800 articles in peer-reviewed journals.

The CDC provides fact sheets on stroke and heart disease, podcasts on heart healthy diets, PDFs on high blood pressure in English and Spanish, and other resources. The Million Hearts Team Up. Pressure Down program provides animated videos on treatment, handouts, a medication tracker wallet card, and more. The National Heart, Lung, and Blood Institute resources include a Google hangout video on “Myth-busting blood pressure.”

Swimming with sharks, tightrope walking across a chasm, or leaping from a cliff are some of the striking visual warnings on posters for the Mind Your Risks public health campaign, launched by the National Institute of Neurological Disorders and Stroke (NINDS).

To raise awareness of how uncontrolled high blood pressure is linked to stroke, cognitive decline, and dementia, the NINDS is partnering with other groups, such as the CDC’s Million Hearts and the What Is Brain Health campaign, sponsored by the HHS Administration for Community Living.

The website, https://mindyourrisks.nih.gov, links to a variety of tools and resources available at the partner sites to help educate about high blood pressure. The website also hosts summaries of scientific studies on high blood pressure and dementia or cognitive impairment, including findings from Atherosclerosis Risk in Communities, an epidemiologic study whose data have been published in more than 800 articles in peer-reviewed journals.

The CDC provides fact sheets on stroke and heart disease, podcasts on heart healthy diets, PDFs on high blood pressure in English and Spanish, and other resources. The Million Hearts Team Up. Pressure Down program provides animated videos on treatment, handouts, a medication tracker wallet card, and more. The National Heart, Lung, and Blood Institute resources include a Google hangout video on “Myth-busting blood pressure.”

Swimming with sharks, tightrope walking across a chasm, or leaping from a cliff are some of the striking visual warnings on posters for the Mind Your Risks public health campaign, launched by the National Institute of Neurological Disorders and Stroke (NINDS).

To raise awareness of how uncontrolled high blood pressure is linked to stroke, cognitive decline, and dementia, the NINDS is partnering with other groups, such as the CDC’s Million Hearts and the What Is Brain Health campaign, sponsored by the HHS Administration for Community Living.

The website, https://mindyourrisks.nih.gov, links to a variety of tools and resources available at the partner sites to help educate about high blood pressure. The website also hosts summaries of scientific studies on high blood pressure and dementia or cognitive impairment, including findings from Atherosclerosis Risk in Communities, an epidemiologic study whose data have been published in more than 800 articles in peer-reviewed journals.

The CDC provides fact sheets on stroke and heart disease, podcasts on heart healthy diets, PDFs on high blood pressure in English and Spanish, and other resources. The Million Hearts Team Up. Pressure Down program provides animated videos on treatment, handouts, a medication tracker wallet card, and more. The National Heart, Lung, and Blood Institute resources include a Google hangout video on “Myth-busting blood pressure.”

Ronald Nosek, MS, FASHP, received the 2016 Distinguished Federal Pharmacy award at the Federal Pharmacy Forum held in Baltimore, Maryland on March 4th. The award recognizes a long distinguished career. Mr. Nosek currently serves as the associate chief consultant of pharmacy benefits management services at the VA and also is the national director for the CHAMPVA Meds by Mail Program. Prior to joining the VA, Mr. Nosek spent 20 years in the U.S. Navy and retired as the director of pharmacy at the National Naval Medical Center in Bethesda, Maryland.

Related: Mail Order Pharmacy Wins Popular Vote

Mr. Nosek also delivered an address at the meeting that updated VA pharmacy activities to about 200 federal pharmacists and pharmacy technicians. “The VA has worked very hard over the years to advance the practice of clinical pharmacists,” Nosek told the audience. “Today we have almost 3,200 pharmacists who practice with a scope of practice, which accounts for about 47% of our pharmacist workforce in the VA. We continue to advance from disease specific-based scopes of practice to practice area scopes of practice.” A July 2015 policy guidance has helped standardize clinical pharmacy practice at the VA.

Related: New Developments in Adult Vaccination: Challenges and Opportunities to Protect Vulnerable Veterans From Pneumococcal Disease

RADM Pamela Schweitzer, PharmD, BCACP, assistant surgeon general and chief professional officer for pharmacy at the PHS, discussed Office of the Sugeon General initiatives, including adult immunization, a forthcoming opioid addiction campaign, and tobacco cessation. According to RADM Schweitzer, only 39% of adults have all the universally recommended vaccinations. “This is potentially a crisis if we have an epidemic,” RADM Schweitzer warned. The low rates also extend to health care providers, with just 62% of health care providers having all the recommended vaccinations.

Related: Defense Health Agency Stands Up

Dr. George E. Jones, Jr. chief, Pharmacy Operations Division at the Defense Health Agency (DHA) discussed the agency’s efforts to become more patient centric and integrate army, navy and air force systems for greater efficiency Dr. Jones discussed the creation of a medication therapy management (MTM pilot that is now being developed to improve medication use.

Ronald Nosek, MS, FASHP, received the 2016 Distinguished Federal Pharmacy award at the Federal Pharmacy Forum held in Baltimore, Maryland on March 4th. The award recognizes a long distinguished career. Mr. Nosek currently serves as the associate chief consultant of pharmacy benefits management services at the VA and also is the national director for the CHAMPVA Meds by Mail Program. Prior to joining the VA, Mr. Nosek spent 20 years in the U.S. Navy and retired as the director of pharmacy at the National Naval Medical Center in Bethesda, Maryland.

Related: Mail Order Pharmacy Wins Popular Vote

Mr. Nosek also delivered an address at the meeting that updated VA pharmacy activities to about 200 federal pharmacists and pharmacy technicians. “The VA has worked very hard over the years to advance the practice of clinical pharmacists,” Nosek told the audience. “Today we have almost 3,200 pharmacists who practice with a scope of practice, which accounts for about 47% of our pharmacist workforce in the VA. We continue to advance from disease specific-based scopes of practice to practice area scopes of practice.” A July 2015 policy guidance has helped standardize clinical pharmacy practice at the VA.

Related: New Developments in Adult Vaccination: Challenges and Opportunities to Protect Vulnerable Veterans From Pneumococcal Disease

RADM Pamela Schweitzer, PharmD, BCACP, assistant surgeon general and chief professional officer for pharmacy at the PHS, discussed Office of the Sugeon General initiatives, including adult immunization, a forthcoming opioid addiction campaign, and tobacco cessation. According to RADM Schweitzer, only 39% of adults have all the universally recommended vaccinations. “This is potentially a crisis if we have an epidemic,” RADM Schweitzer warned. The low rates also extend to health care providers, with just 62% of health care providers having all the recommended vaccinations.

Related: Defense Health Agency Stands Up

Dr. George E. Jones, Jr. chief, Pharmacy Operations Division at the Defense Health Agency (DHA) discussed the agency’s efforts to become more patient centric and integrate army, navy and air force systems for greater efficiency Dr. Jones discussed the creation of a medication therapy management (MTM pilot that is now being developed to improve medication use.

Ronald Nosek, MS, FASHP, received the 2016 Distinguished Federal Pharmacy award at the Federal Pharmacy Forum held in Baltimore, Maryland on March 4th. The award recognizes a long distinguished career. Mr. Nosek currently serves as the associate chief consultant of pharmacy benefits management services at the VA and also is the national director for the CHAMPVA Meds by Mail Program. Prior to joining the VA, Mr. Nosek spent 20 years in the U.S. Navy and retired as the director of pharmacy at the National Naval Medical Center in Bethesda, Maryland.

Related: Mail Order Pharmacy Wins Popular Vote

Mr. Nosek also delivered an address at the meeting that updated VA pharmacy activities to about 200 federal pharmacists and pharmacy technicians. “The VA has worked very hard over the years to advance the practice of clinical pharmacists,” Nosek told the audience. “Today we have almost 3,200 pharmacists who practice with a scope of practice, which accounts for about 47% of our pharmacist workforce in the VA. We continue to advance from disease specific-based scopes of practice to practice area scopes of practice.” A July 2015 policy guidance has helped standardize clinical pharmacy practice at the VA.

Related: New Developments in Adult Vaccination: Challenges and Opportunities to Protect Vulnerable Veterans From Pneumococcal Disease

RADM Pamela Schweitzer, PharmD, BCACP, assistant surgeon general and chief professional officer for pharmacy at the PHS, discussed Office of the Sugeon General initiatives, including adult immunization, a forthcoming opioid addiction campaign, and tobacco cessation. According to RADM Schweitzer, only 39% of adults have all the universally recommended vaccinations. “This is potentially a crisis if we have an epidemic,” RADM Schweitzer warned. The low rates also extend to health care providers, with just 62% of health care providers having all the recommended vaccinations.

Related: Defense Health Agency Stands Up

Dr. George E. Jones, Jr. chief, Pharmacy Operations Division at the Defense Health Agency (DHA) discussed the agency’s efforts to become more patient centric and integrate army, navy and air force systems for greater efficiency Dr. Jones discussed the creation of a medication therapy management (MTM pilot that is now being developed to improve medication use.

A landmark study cofunded by the National Institute of Mental Health (NIMH), the Broad Institute, and other NIH components has shown that the risk of schizophrenia is increased in people who inherit a “suspect gene” that may affect the maturing adolescent brain.

Versions of the gene C4 may trigger “runaway pruning” of synapses, eliminating connections between neurons. People with schizophrenia show fewer neuron connections. “Normally, pruning gets rid of excess connections we no longer need, streamlining our brain for optimal performance,” says Thomas Lehner, PhD, director of the Office of Genomics Research Coordination at the NIMH. But overpruning can impair mental function, he says. The time of streamlining, during late teens and early adulthood, corresponds to the usual age-of-onset of schizophrenic symptoms.

In this study, researchers analyzed the genomes of 65,000 people and 700 postmortem brains. They found that the gene C4 switched on more in people with the suspect versions; those people faced a higher risk of schizophrenia.

Although it affects only about 1% of the population, schizophrenia is as much as 90% heritable. But just how the genes work to confer risk has been a mystery, say the researchers. Lead investigator Steve McCarroll, PhD, says, “Understanding these genetic effects on risk is a way of prying open that black box, peering inside and starting to see actual biological mechanisms.”

A landmark study cofunded by the National Institute of Mental Health (NIMH), the Broad Institute, and other NIH components has shown that the risk of schizophrenia is increased in people who inherit a “suspect gene” that may affect the maturing adolescent brain.

Versions of the gene C4 may trigger “runaway pruning” of synapses, eliminating connections between neurons. People with schizophrenia show fewer neuron connections. “Normally, pruning gets rid of excess connections we no longer need, streamlining our brain for optimal performance,” says Thomas Lehner, PhD, director of the Office of Genomics Research Coordination at the NIMH. But overpruning can impair mental function, he says. The time of streamlining, during late teens and early adulthood, corresponds to the usual age-of-onset of schizophrenic symptoms.

In this study, researchers analyzed the genomes of 65,000 people and 700 postmortem brains. They found that the gene C4 switched on more in people with the suspect versions; those people faced a higher risk of schizophrenia.

Although it affects only about 1% of the population, schizophrenia is as much as 90% heritable. But just how the genes work to confer risk has been a mystery, say the researchers. Lead investigator Steve McCarroll, PhD, says, “Understanding these genetic effects on risk is a way of prying open that black box, peering inside and starting to see actual biological mechanisms.”

A landmark study cofunded by the National Institute of Mental Health (NIMH), the Broad Institute, and other NIH components has shown that the risk of schizophrenia is increased in people who inherit a “suspect gene” that may affect the maturing adolescent brain.

Versions of the gene C4 may trigger “runaway pruning” of synapses, eliminating connections between neurons. People with schizophrenia show fewer neuron connections. “Normally, pruning gets rid of excess connections we no longer need, streamlining our brain for optimal performance,” says Thomas Lehner, PhD, director of the Office of Genomics Research Coordination at the NIMH. But overpruning can impair mental function, he says. The time of streamlining, during late teens and early adulthood, corresponds to the usual age-of-onset of schizophrenic symptoms.

In this study, researchers analyzed the genomes of 65,000 people and 700 postmortem brains. They found that the gene C4 switched on more in people with the suspect versions; those people faced a higher risk of schizophrenia.

Although it affects only about 1% of the population, schizophrenia is as much as 90% heritable. But just how the genes work to confer risk has been a mystery, say the researchers. Lead investigator Steve McCarroll, PhD, says, “Understanding these genetic effects on risk is a way of prying open that black box, peering inside and starting to see actual biological mechanisms.”