New AMA, CDC Initiative Aims to “Prevent Diabetes STAT”

New AMA, CDC Initiative Aims to “Prevent Diabetes STAT”

With more than 86 million Americans living with prediabetes and nearly 90% of them unaware of it, the American Medical Association (AMA) and the Centers for Disease Control and Prevention (CDC) announced in March that they have joined forces to take urgent action to prevent diabetes and are urging others to join in this critical effort.
Prevent Diabetes STAT: Screen, Test, Act – Today™, is a multi-year initiative that expands on the robust work each organization has already begun to reach more Americans with prediabetes and stop the progression to type 2 diabetes, one of the nation’s most debilitating chronic diseases. Through this initiative, the AMA and CDC are sounding an alarm and shining a light on prediabetes as a critical and serious medical condition.

“It’s time that the nation comes together to take immediate action to help prevent diabetes before it starts,” says AMA President Robert M. Wah, MD. “Type 2 diabetes is one of our nation’s leading causes of suffering and death—with one out of three people at risk of developing the disease in their lifetime. To address and reverse this alarming national trend, America needs frontline physicians and other health care professionals as well as key stakeholders such as employers, insurers, and community organizations to mobilize and create stronger linkages between the care delivery system, our communities, and the patients we serve.”
People with prediabetes have higher-than-normal blood glucose levels but not high enough yet to be considered type 2 diabetes. Research shows that 15% to 30% of overweight people with prediabetes will develop type 2 diabetes within five years unless they lose weight through healthy eating and increased physical activity.
As an immediate result of this partnership, the AMA and CDC have co-developed a toolkit to serve as a guide for physicians and other health care providers on the best methods to screen and refer high-risk patients to diabetes prevention programs in their communities. The toolkit along with additional information on how physicians and other key stakeholders can Prevent Diabetes STAT is available online at www.preventdiabetesstat.org.

Over the past two years, both the CDC and the AMA have been laying the groundwork for this national effort. In 2012, the CDC launched its National Diabetes Prevention Program based on research led by the National Institutes of Health, which showed that high-risk individuals who participated in lifestyle change programs, like those recognized by the CDC, saw a significant reduction in the incidence of type 2 diabetes. Today, there are more than 500 of these programs across the country, including online options.
The AMA launched its Improving Health Outcomes initiative in 2013 aimed at preventing both type 2 diabetes and heart disease. That work includes a partnership with the YMCA of the USA to increase the number of physicians who screen patients for prediabetes and refer them to diabetes prevention programs offered by local YMCAs that are part of the CDC’s recognition program. This joint effort included 11 physician practice pilot sites in four states, where care teams helped to inform the development of the AMA and CDC’s toolkit. In the coming months, the AMA will be identifying states in which to strengthen the linkages between the clinical care setting and communities to reduce the incidence of diabetes.

“Long-term, we are confident that this important and necessary work will improve health outcomes and reduce the staggering burden associated with the public health epidemic of type 2 diabetes,” says Wah.

Coffee Intake May Lower Endometrial Cancer Risk

Coffee Intake May Lower Endometrial Cancer Risk

Women who drank about four cups of coffee per day appeared to have decreased endometrial cancer risk compared with those who drank less than a cup each day, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
“We used a ‘nutrient-wide association study,’ a new approach to systematically evaluate the association of dietary factors with endometrial cancer risk,” says Melissa A. Merritt, PhD, a research fellow in cancer epidemiology at Imperial College London in the United Kingdom. “This approach was inspired by genome-wide association studies that look at genetic risk factors for cancer, but in our case we investigated 84 foods and nutrients in place of genes as risk factors for endometrial cancer.
“We confirmed observations from previous studies that having a high versus low intake of coffee was associated with a reduced risk for endometrial cancer, and for most other dietary factors there was no association with endometrial cancer risk,” Merritt adds.

“Coffee intake is worth investigating further to see if coffee can be used for the prevention of endometrial cancer. However, before clinical recommendations can be made, further studies are needed to evaluate this question in other studies and to try to isolate the components of coffee that may be responsible for any influence on endometrial cancer,” Merritt says.

Merritt and colleagues evaluated the association of 84 foods and nutrients based on dietary questionnaires from a prospective cohort study, the European Prospective Investigation Into Cancer and Nutrition (EPIC) Study. They then validated nine foods and nutrients identified from the EPIC study as having associations with endometrial cancer risk in two prospective cohort studies, the Nurses’ Health Study (NHS) and NHSII, two cohorts based at Brigham and Women’s Hospital, Boston, and Harvard School of Public Health, Boston, respectively.
Among the EPIC study participants, those who drank about three cups of coffee per day (750 g/day) had a 19% lower risk for endometrial cancer compared with those who drank less than one cup of coffee per day. Among the NHS/NHSII participants, those who drank about four cups of coffee per day (1,000 g/day) had an 18% lower risk for endometrial cancer compared with those who never drank coffee.

This study focused on 1,303 endometrial cancer cases in the EPIC study, and 1,531 endometrial cancer cases from the NHS/NHSII studies.
The nine foods/nutrients that were found to have associations with endometrial cancer in the EPIC cohort were total fat, monounsaturated fat, carbohydrates, phosphorus, butter, yogurt, cheese, potatoes, and coffee.

Total fat, monounsaturated fat, and phosphorus were associated with decreased risk for endometrial cancer, and carbohydrates and butter intake were associated with increased risk for endometrial cancer in the EPIC cohort, but these findings could not be validated in the NHS/NHSII cohorts.

Boston Nurse Wins National Award for Outstanding Filipino American Women

For Gretheline R. Bolandrina, BSN, RN, CRRN, being recognized for outstanding service to the nursing profession and the community is nothing new. The Boston nurse, who works for SunBridge Care and Rehabilitation for Milford in Milford, Mass., has been honored over the years with numerous awards from organizations such as the Girl Scouts of the USA, the Philippine Nurses Association of New England and the National Federation of Filipino American Associations.

This past fall, Bolandrina, who is also a clinical instructor at the Massachusetts Bay Community College, added another, even more prestigious honor to her resume. She received the 2005 National Prism Award for Women of Style and Achievements, given by the Gintong Pamana (Golden Heritage) Awards Foundation in cooperation with the publications PhilippineTIME-U.S.A. and The Fil-Am Weekly MegaScene.

The National Prism Award celebrates the achievements of outstanding Filipino American women who have “an inherent power to make things happen [and who have] consistently made a difference in other people’s lives.” Bolandrina, a 1987 graduate of the University of Santo Tomas College of Nursing in Manila, certainly fits that description. Since coming to Boston in 1989, she has volunteered with many community service organizations, including the Girl Scouts, Locks of Love, HOPE Foundation International, Iskwelahang Pilipino, the Lowell Folk Festival, Bagong Kulturang Pinoy and more. She also writes a column for the newsmagazine Planet Philippines.

Stronger Collaboration between RNs, Employers Encouraged to Reduce Risks from Nurse Fatigue

Stronger Collaboration between RNs, Employers Encouraged to Reduce Risks from Nurse Fatigue

The American Nurses Association (ANA) calls for stronger collaboration between registered nurses (RNs) and their employers to reduce the risks of nurse fatigue for patients and nurses associated with shift work and long hours, and emphasizes strengthening a culture of safety in the work environment in a new position statement. 

ANA contends that evidence-based strategies must be implemented to proactively address nurse fatigue and sleepiness. Such strategies are needed to promote the health, safety, and wellness of RNs and ensure optimal patient outcomes.

“Research shows that prolonged work hours can hinder a nurse’s performance and have negative impacts on patients’ safety and outcomes,” says ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “We’re concerned not only with greater likelihood for errors, diminished problem solving, slower reaction time, and other performance deficits related to fatigue, but also with dangers posed to nurses’ own health.”

Research links shift work and long working hours to sleep disturbances, injuries, musculoskeletal disorders, gastrointestinal problems, mood disorders, obesity, diabetes mellitus, metabolic syndrome, cardiovascular disease, cancer, and adverse reproductive outcomes.

ANA offers numerous evidence-based recommendations for RNs and employers to enhance performance, safety, and patient outcomes, such as the following suggestions:

•Involve nurses in the design of work schedules and use a regular and predictable schedule so nurses can plan for work and personal responsibilities.

•Limit work weeks to 40 hours within seven days and work shifts to 12 hours.

•Eliminate the use of mandatory overtime as a “staffing solution.”

•Promote frequent, uninterrupted rest breaks during work shifts.

•Enact official policy that confers RNs the right to accept or reject a work assignment based on preventing risks from fatigue. The policy should include conditions that a rejected assignment does not constitute patient abandonment, and that RNs should not suffer adverse consequences in retaliation for such a decision.

•Encourage nurses to manage their health and rest, including sleeping seven to nine hours per day; developing effective stress management, nutrition, and exercise habits; and using naps in accordance with policy.

The position statement was developed by a Professional Issues Panel, established by the ANA Board of Directors. The panel was comprised of 15 ANA member nurses with expertise on the issue, with additional input from an advisory committee of about 350 members who expressed interest in participating. The statement was distributed broadly for public comment to nursing organizations, federal agencies, employers, individual RNs, safety and risk assessment experts, and others, whose suggestions were evaluated by the panel for incorporation in the statement. The new position statement replaces two 2006 position statements—one for employers and one for nurses. The statement clearly articulates that health care employers and nurses are jointly responsible for addressing the risks of nurse fatigue.

Source: American Nurses Association

 

Millions of US Women Are Not Getting Screened for Cervical Cancer

Millions of US Women Are Not Getting Screened for Cervical Cancer

Despite evidence that cervical cancer screening saves lives, about 8 million women ages 21 to 65 years have not been screened for cervical cancer in the past five years, according to a new Vital Signs report from the Centers for Disease Control and Prevention (CDC). More than half of new cervical cancer cases occur among women who have never or rarely been screened.

“Every visit to a provider can be an opportunity to prevent cervical cancer by making sure women are referred for screening appropriately,” says CDC Principal Deputy Director Ileana Arias, PhD. “We must increase our efforts to make sure that all women understand the importance of getting screened for cervical cancer. No woman should die from cervical cancer.”

Researchers reviewed data from the 2012 Behavioral Risk Factor Surveillance System to determine women who had not been screened for cervical cancer in the past five years. They analyzed the number of cervical cancer cases that occurred during 2007 to 2011 from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. Cervical cancer deaths were based on death certificates submitted to the National Vital Statistics System.

Key findings include:

• In 2012, 11.4% of women reported they had not been screened for cervical cancer in the past five years; the percentage was larger for women without health insurance (23.1%) and for those without a regular health care provider (25.5%).

• The percentage of women not screened as recommended was higher among older women (12.6%), Asians/Pacific Islanders (19.7%), and American Indians/Alaska Natives (16.5%).

•From 2007 to 2011, the cervical cancer incidence rate decreased by 1.9% per year while the death rate remained stable.

•The Southern region had the highest rate of cervical cancer (8.5 per 100,000), the highest death rate (2.7 per 100,000), and the largest percentage of women who had not been screened in the past five years (12.3%).

Using the human papillomavirus (HPV) vaccine as a primary prevention measure could also help reduce cervical cancer and deaths from cervical cancer. Another recent CDC study showed that the vaccine is underused; only 1 in 3 girls and 1 in 7 boys had received the 3-dose series in 2013. The HPV vaccine is recommended as a routine vaccine for children 11–12 years old. Modeling studies have shown that HPV vaccination and cervical cancer screening combined can prevent as many as 93% of new cervical cancer cases.

Even with improvements in prevention and early detection methods, most cervical cancers occur in women who are not up-to-date with screening. Addressing financial and non-financial barriers can help increase screening rates and, in turn, reduce new cases of and deaths from this disease.

Efforts to Prevent Cervical Cancer

CDC’s National Breast and Cervical Cancer Early Detection Program provides low-income, uninsured, and underinsured women access to breast and cervical cancer screening and diagnostic services in all 50 states, the District of Columbia, five US territories, and 11 American Indian/Alaska Native tribes or tribal organizations.

To learn more about recommended ages and tests for cervical cancer screening, visit www.cdc.gov/cancer/cervical.

 

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