Jan Dyer

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.

In a modern twist on clinical data gathering, crowd-sourcing has helped researchers identify “weak genetic signals” of depression. By combining data from the genetic information website 23andMe.com and previous genetic research, researchers identified for the first time 15 regions of the genome that may be associated with depression in people of European ancestry. Their findings should help “make clear that this is a brain disease,” said Roy Perlis, MD, MSc, a lead investigator and associate professor of psychiatry at Harvard Medical School, “which we hope will decrease the stigma still associated with these kinds of illnesses.”

Other studies have, of course, investigated genetic components of depression. But they may have been too small to uncover the subtle effects of the many genes influencing the risk of depression, these researchers say.

In their first analysis, using data from > 300,000 people of European ancestry who had purchased genetic profiles on 23andMe.com (and who consented to share their information with researchers), the researchers identified 2 genomic regions significantly associated with depression risk, including 1 previously associated with epilepsy and intellectual disability.

They then combined that information with data from genomewide association studies of 9,200 people with a history of depression and 9,500 controls, along with another group of 151,800 people with and without depression. That analysis revealed 15 genomic regions, including 17 specific sites, significantly associated with a diagnosis of depression. Several of the sites are located in or near genes known to be involved in brain development.

“The neurotransmitter-based models we are currently using to treat depression are more than 40 years old,” says Dr. Perlis. “We really need new treatment targets. We hope that finding these genes will point us toward novel treatment strategies. “[T]he traditional way of doing genetic studies is not the only way that works. Using existing large datasets or biobanks may be far more efficient.”

In a modern twist on clinical data gathering, crowd-sourcing has helped researchers identify “weak genetic signals” of depression. By combining data from the genetic information website 23andMe.com and previous genetic research, researchers identified for the first time 15 regions of the genome that may be associated with depression in people of European ancestry. Their findings should help “make clear that this is a brain disease,” said Roy Perlis, MD, MSc, a lead investigator and associate professor of psychiatry at Harvard Medical School, “which we hope will decrease the stigma still associated with these kinds of illnesses.”

Other studies have, of course, investigated genetic components of depression. But they may have been too small to uncover the subtle effects of the many genes influencing the risk of depression, these researchers say.

In their first analysis, using data from > 300,000 people of European ancestry who had purchased genetic profiles on 23andMe.com (and who consented to share their information with researchers), the researchers identified 2 genomic regions significantly associated with depression risk, including 1 previously associated with epilepsy and intellectual disability.

They then combined that information with data from genomewide association studies of 9,200 people with a history of depression and 9,500 controls, along with another group of 151,800 people with and without depression. That analysis revealed 15 genomic regions, including 17 specific sites, significantly associated with a diagnosis of depression. Several of the sites are located in or near genes known to be involved in brain development.

“The neurotransmitter-based models we are currently using to treat depression are more than 40 years old,” says Dr. Perlis. “We really need new treatment targets. We hope that finding these genes will point us toward novel treatment strategies. “[T]he traditional way of doing genetic studies is not the only way that works. Using existing large datasets or biobanks may be far more efficient.”

In a modern twist on clinical data gathering, crowd-sourcing has helped researchers identify “weak genetic signals” of depression. By combining data from the genetic information website 23andMe.com and previous genetic research, researchers identified for the first time 15 regions of the genome that may be associated with depression in people of European ancestry. Their findings should help “make clear that this is a brain disease,” said Roy Perlis, MD, MSc, a lead investigator and associate professor of psychiatry at Harvard Medical School, “which we hope will decrease the stigma still associated with these kinds of illnesses.”

Other studies have, of course, investigated genetic components of depression. But they may have been too small to uncover the subtle effects of the many genes influencing the risk of depression, these researchers say.

In their first analysis, using data from > 300,000 people of European ancestry who had purchased genetic profiles on 23andMe.com (and who consented to share their information with researchers), the researchers identified 2 genomic regions significantly associated with depression risk, including 1 previously associated with epilepsy and intellectual disability.

They then combined that information with data from genomewide association studies of 9,200 people with a history of depression and 9,500 controls, along with another group of 151,800 people with and without depression. That analysis revealed 15 genomic regions, including 17 specific sites, significantly associated with a diagnosis of depression. Several of the sites are located in or near genes known to be involved in brain development.

“The neurotransmitter-based models we are currently using to treat depression are more than 40 years old,” says Dr. Perlis. “We really need new treatment targets. We hope that finding these genes will point us toward novel treatment strategies. “[T]he traditional way of doing genetic studies is not the only way that works. Using existing large datasets or biobanks may be far more efficient.”

Native American tribes have the right to assume responsibility for providing health care to their members and to operate and manage health care programs or services previously provided by IHS, subject to certain requirements. As part of an annual IHS cooperative agreement to support this, IHS has awarded $767,000 to 7 tribes and tribal organizations for self-governance planning and negotiation activities.

The Planning Cooperative Agreement funding will go to Salt River Pima-Maricopa Indian Community, Arizona; Ak-Chin Indian Community, Arizona; White Earth Band of Chippewa Indians, Minnesota; Northwest Portland Area Indian Health Board, Oregon; Pinoleville Pomo Nation, California; and Lake County Tribal Health Consortium, Inc, California. The money will be used for legal and budgetary research and internal tribal government planning related to the administration of health care programs.

The Negotiation Cooperative Agreement funding goes to the Ponca Tribe of Indians of Oklahoma. That money helps defray costs related to preparing for the self-governance program negotiations. Negotiations provide an opportunity for the tribal and federal negotiation teams to work together in good faith to enhance each self-governance agreement, IHS says.

More than one-third (about $1.8 billion) of the total annual IHS funding for American Indian and Alaska Native health is now transferred directly to tribes to operate and manage health programs or services. Of the 567 federally recognized tribes, 354 participate and have negotiated 90 compacts and 115 funding agreements.

The partnership between IHS and self-governance tribes, says IHS Principal Deputy Director Mary Smith, is a “shining example of cooperation in providing access to quality health care.”

Native American tribes have the right to assume responsibility for providing health care to their members and to operate and manage health care programs or services previously provided by IHS, subject to certain requirements. As part of an annual IHS cooperative agreement to support this, IHS has awarded $767,000 to 7 tribes and tribal organizations for self-governance planning and negotiation activities.

The Planning Cooperative Agreement funding will go to Salt River Pima-Maricopa Indian Community, Arizona; Ak-Chin Indian Community, Arizona; White Earth Band of Chippewa Indians, Minnesota; Northwest Portland Area Indian Health Board, Oregon; Pinoleville Pomo Nation, California; and Lake County Tribal Health Consortium, Inc, California. The money will be used for legal and budgetary research and internal tribal government planning related to the administration of health care programs.

The Negotiation Cooperative Agreement funding goes to the Ponca Tribe of Indians of Oklahoma. That money helps defray costs related to preparing for the self-governance program negotiations. Negotiations provide an opportunity for the tribal and federal negotiation teams to work together in good faith to enhance each self-governance agreement, IHS says.

More than one-third (about $1.8 billion) of the total annual IHS funding for American Indian and Alaska Native health is now transferred directly to tribes to operate and manage health programs or services. Of the 567 federally recognized tribes, 354 participate and have negotiated 90 compacts and 115 funding agreements.

The partnership between IHS and self-governance tribes, says IHS Principal Deputy Director Mary Smith, is a “shining example of cooperation in providing access to quality health care.”

Native American tribes have the right to assume responsibility for providing health care to their members and to operate and manage health care programs or services previously provided by IHS, subject to certain requirements. As part of an annual IHS cooperative agreement to support this, IHS has awarded $767,000 to 7 tribes and tribal organizations for self-governance planning and negotiation activities.

The Planning Cooperative Agreement funding will go to Salt River Pima-Maricopa Indian Community, Arizona; Ak-Chin Indian Community, Arizona; White Earth Band of Chippewa Indians, Minnesota; Northwest Portland Area Indian Health Board, Oregon; Pinoleville Pomo Nation, California; and Lake County Tribal Health Consortium, Inc, California. The money will be used for legal and budgetary research and internal tribal government planning related to the administration of health care programs.

The Negotiation Cooperative Agreement funding goes to the Ponca Tribe of Indians of Oklahoma. That money helps defray costs related to preparing for the self-governance program negotiations. Negotiations provide an opportunity for the tribal and federal negotiation teams to work together in good faith to enhance each self-governance agreement, IHS says.

More than one-third (about $1.8 billion) of the total annual IHS funding for American Indian and Alaska Native health is now transferred directly to tribes to operate and manage health programs or services. Of the 567 federally recognized tribes, 354 participate and have negotiated 90 compacts and 115 funding agreements.

The partnership between IHS and self-governance tribes, says IHS Principal Deputy Director Mary Smith, is a “shining example of cooperation in providing access to quality health care.”

The prevalence of amyotrophic lateral sclerosis (ALS) seems to have gone up—from 4.7 cases per 100,000 in 2012 to 5.0 cases per 100,000 in 2013. But “seems” is the operative word, according to researchers writing in the August 5, 2016, Morbidity and Mortality Weekly Report. It is more likely that the increase is attributable to better detection methods, remarked Paul Mehta, MD, medical epidemiologist and principal investigator of the National ALS Registry and lead author of the report.

Related: A Combined Treatment Protocol for Patients With Diabetic Peripheral Neuropathy

He also credits greater public awareness of the registry, which is the only available data source that can be used to estimate the prevalence of ALS in the U.S. Because ALS is not a nationally notifiable disease, the registry uses administrative data from Medicare, Medicaid, and the VHA to determine “definite” cases. It also uses a secure web portal (https://wwwn.cdc.gov/als/) to identify cases not included in the national administrative databases.

Related: Amyotrophic Lateral Sclerosis, Nutrition, and Feeding Tube Placement

This fall, the registry will launch the National ALS Biorepository, which will store samples (eg, blood, hair, or saliva) from home visits and postmortem collection (eg, brain, bone, spinal cord). Currently, the few existing ALS biorepositories largely rely on samples from specific clinics or medical practices or clinical trials. The specimens for National ALS Biorepository will be collected from a geographically representative sample of people with ALS. The specimens will be used for research, such as genetic analysis, identification of biomarkers, and exposure to environmental toxic substances.

The full report is available at www.cdc.gov/mmwr/index2016.html.

The prevalence of amyotrophic lateral sclerosis (ALS) seems to have gone up—from 4.7 cases per 100,000 in 2012 to 5.0 cases per 100,000 in 2013. But “seems” is the operative word, according to researchers writing in the August 5, 2016, Morbidity and Mortality Weekly Report. It is more likely that the increase is attributable to better detection methods, remarked Paul Mehta, MD, medical epidemiologist and principal investigator of the National ALS Registry and lead author of the report.

Related: A Combined Treatment Protocol for Patients With Diabetic Peripheral Neuropathy

He also credits greater public awareness of the registry, which is the only available data source that can be used to estimate the prevalence of ALS in the U.S. Because ALS is not a nationally notifiable disease, the registry uses administrative data from Medicare, Medicaid, and the VHA to determine “definite” cases. It also uses a secure web portal (https://wwwn.cdc.gov/als/) to identify cases not included in the national administrative databases.

Related: Amyotrophic Lateral Sclerosis, Nutrition, and Feeding Tube Placement

This fall, the registry will launch the National ALS Biorepository, which will store samples (eg, blood, hair, or saliva) from home visits and postmortem collection (eg, brain, bone, spinal cord). Currently, the few existing ALS biorepositories largely rely on samples from specific clinics or medical practices or clinical trials. The specimens for National ALS Biorepository will be collected from a geographically representative sample of people with ALS. The specimens will be used for research, such as genetic analysis, identification of biomarkers, and exposure to environmental toxic substances.

The full report is available at www.cdc.gov/mmwr/index2016.html.

The prevalence of amyotrophic lateral sclerosis (ALS) seems to have gone up—from 4.7 cases per 100,000 in 2012 to 5.0 cases per 100,000 in 2013. But “seems” is the operative word, according to researchers writing in the August 5, 2016, Morbidity and Mortality Weekly Report. It is more likely that the increase is attributable to better detection methods, remarked Paul Mehta, MD, medical epidemiologist and principal investigator of the National ALS Registry and lead author of the report.

Related: A Combined Treatment Protocol for Patients With Diabetic Peripheral Neuropathy

He also credits greater public awareness of the registry, which is the only available data source that can be used to estimate the prevalence of ALS in the U.S. Because ALS is not a nationally notifiable disease, the registry uses administrative data from Medicare, Medicaid, and the VHA to determine “definite” cases. It also uses a secure web portal (https://wwwn.cdc.gov/als/) to identify cases not included in the national administrative databases.

Related: Amyotrophic Lateral Sclerosis, Nutrition, and Feeding Tube Placement

This fall, the registry will launch the National ALS Biorepository, which will store samples (eg, blood, hair, or saliva) from home visits and postmortem collection (eg, brain, bone, spinal cord). Currently, the few existing ALS biorepositories largely rely on samples from specific clinics or medical practices or clinical trials. The specimens for National ALS Biorepository will be collected from a geographically representative sample of people with ALS. The specimens will be used for research, such as genetic analysis, identification of biomarkers, and exposure to environmental toxic substances.

The full report is available at www.cdc.gov/mmwr/index2016.html.

In 2012, a survey found that 1 in 4 American adults had > 1 chronic health condition. In 2014, the National Health Interview Survey of 36,697 adults found the same thing. The stable prevalence of multiple chronic conditions (MCC) indicates a continuing public health issue, according to an article in the July 29, 2016 Morbidity and Mortality Weekly Report.

The prevalence varied across the country, from 19% in Colorado to 38% in Kentucky. Prevalence was higher than the national average percentage in Alabama, West Virginia, Mississippi, Montana, New Mexico, Maine, Michigan, Ohio, and Pennsylvania.

Several states with higher prevalence of MCC overlapped the so-called stroke belt, which includes much of the southern U.S. Similarly, MCC prevalence also overlapped the diabetes belt—again taking in much of the South and parts of the Midwest and West.

The survey covered 10 conditions: arthritis, asthma, cancer, chronic obstructive pulmonary disease, coronary artery disease, diabetes, hepatitis, hypertension, stroke, and weak or failing kidneys. But those are only 10 of the 20 conditions HHS has identified for inclusion in studies of MCC. Moreover, no data on mental health conditions, undiagnosed conditions, or adults in long-term care or congregant facilities were included, so the findings are limited in generalizability. Nonetheless, the MMWR report authors say the findings further HHS research and surveillance objectives. Geographic disparities in MCC prevalence can inform state-level surveillance programs and groups targeting service delivery or allocating resources.

In 2012, a survey found that 1 in 4 American adults had > 1 chronic health condition. In 2014, the National Health Interview Survey of 36,697 adults found the same thing. The stable prevalence of multiple chronic conditions (MCC) indicates a continuing public health issue, according to an article in the July 29, 2016 Morbidity and Mortality Weekly Report.

The prevalence varied across the country, from 19% in Colorado to 38% in Kentucky. Prevalence was higher than the national average percentage in Alabama, West Virginia, Mississippi, Montana, New Mexico, Maine, Michigan, Ohio, and Pennsylvania.

Several states with higher prevalence of MCC overlapped the so-called stroke belt, which includes much of the southern U.S. Similarly, MCC prevalence also overlapped the diabetes belt—again taking in much of the South and parts of the Midwest and West.

The survey covered 10 conditions: arthritis, asthma, cancer, chronic obstructive pulmonary disease, coronary artery disease, diabetes, hepatitis, hypertension, stroke, and weak or failing kidneys. But those are only 10 of the 20 conditions HHS has identified for inclusion in studies of MCC. Moreover, no data on mental health conditions, undiagnosed conditions, or adults in long-term care or congregant facilities were included, so the findings are limited in generalizability. Nonetheless, the MMWR report authors say the findings further HHS research and surveillance objectives. Geographic disparities in MCC prevalence can inform state-level surveillance programs and groups targeting service delivery or allocating resources.

In 2012, a survey found that 1 in 4 American adults had > 1 chronic health condition. In 2014, the National Health Interview Survey of 36,697 adults found the same thing. The stable prevalence of multiple chronic conditions (MCC) indicates a continuing public health issue, according to an article in the July 29, 2016 Morbidity and Mortality Weekly Report.

The prevalence varied across the country, from 19% in Colorado to 38% in Kentucky. Prevalence was higher than the national average percentage in Alabama, West Virginia, Mississippi, Montana, New Mexico, Maine, Michigan, Ohio, and Pennsylvania.

Several states with higher prevalence of MCC overlapped the so-called stroke belt, which includes much of the southern U.S. Similarly, MCC prevalence also overlapped the diabetes belt—again taking in much of the South and parts of the Midwest and West.

The survey covered 10 conditions: arthritis, asthma, cancer, chronic obstructive pulmonary disease, coronary artery disease, diabetes, hepatitis, hypertension, stroke, and weak or failing kidneys. But those are only 10 of the 20 conditions HHS has identified for inclusion in studies of MCC. Moreover, no data on mental health conditions, undiagnosed conditions, or adults in long-term care or congregant facilities were included, so the findings are limited in generalizability. Nonetheless, the MMWR report authors say the findings further HHS research and surveillance objectives. Geographic disparities in MCC prevalence can inform state-level surveillance programs and groups targeting service delivery or allocating resources.