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HHS WEEKLY REPORT
13-19 October 2002

THIS ISSUE AVAILABLE ONLINE WITH EXPANDED INFORMATION AND PHOTOS AT:
www.hhs.gov/news/newsletter/weekly

IN THIS ISSUE:
1) HHS leads the effort against influenza
2) HHS establishes first phase of medical training program to provide health care assistance in Afghanistan
3) HHS to provide $250,000 to Maryland for mental health services to help deal with sniper attacks
4) NIH grantees win Nobel Prizes
5) Secretary Thompson to address diabetes awareness and education for Hispanic and Native American youth
6) Brain Shrinkage in ADHD Not Caused by Medications
7) El Departamento de Salud y Servicios Humanos encabeza la batalla contra la influenza

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HHS leads the effort against influenza

HHS Secretary Tommy G. Thompson has announced a new policy allowing nursing homes, hospitals and home health agencies that serve Medicare and Medicaid beneficiaries to remind patients when it is time for an annual flu and pneumonia vaccinations, and to ask if they want to receive a shot. The "standing order" is aimed to promote greater access to flu and pneumonia vaccinations, especially for older Americans and others at high risk for illness.

HHS' new policy comes at the beginning of the 2002-2003 flu season and complements recommendations made earlier in the year by the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP), part of the CDC's National Immunization Program.

The new ACIP recommendations call for prioritizing vaccination efforts in October to target persons at high risk of complications from influenza - health care workers and children under 9 years of age receiving the vaccine for the first time. The committee is also encouraging influenza vaccination for children aged 6-23 months because of increased risk for influenza-related hospitalizations.

Each year, about 114,000 people in the United States are hospitalized, and about 20,000 people die because of the flu. According to the CDC, those at high risk for severe influenza illness are:

Individuals 65 years or older;
Children 6-23 months;
Adults and children with a chronic health condition;
Women more than 3 months pregnant during the flu season; and
Health care workers
Healthy people aged 50-64 years, and younger adults are encouraged to receive vaccination starting in November.

Also, In July 2002, HHS launched the Racial and Ethnic Adult Disparities in Immunization Initiative (READII), a new adult immunization initiative to reduce racial and ethnic disparities in influenza and pneumococcal vaccination coverage for adults 65 years of age and older. Through READII, HHS will conduct two-year demonstration projects in five sites to improve influenza and pneumococcal vaccination rates in African-American and Hispanic communities.

For more information on influenza, visit the CDC National Immunization Program Web site at www.cdc.gov/nip/Flu/default.htm.

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HHS establishes first phase of medical training program to provide health care assistance in Afghanistan

HHS Secretary Tommy G. Thompson traveled to Afghanistan last week to announce the first phase of a volunteer program allowing Afghan-American physicians the opportunity to provide needed health care assistance and medical training in their ancestral homeland. The program, undertaken in partnership with the Afghan-American Physicians Association and the Afghan Medical Association, is part of HHS' broader effort to aid in Afghan reconstruction.

"The medical training program is just one of the building blocks in HHS' response to aid in the recovery and reconstruction of Afghanistan. Much work still needs to be done, and having this program in place will increase the free flow of medical information. We look forward to working with the Afghan community on this important public health endeavor," Secretary Thompson said.

To launch the program, HHS is sending a team of four Afghan-American physicians to Kabul, Afghanistan, to help develop a plan of cooperation between the two countries, and to assess where assistance is most needed.

Members of the Afghan physician assessment team will travel to their homeland to collect information on the locations of clinics and hospitals, needed language and medical skills, anticipated workload, needed skill levels of future medical volunteers, as well as information on housing, transportation and expected training activities.

The team plans to meet with various organizations, including the Ministry of Public Health; Ministry of Women's Affairs; UNICEF; World Health Organization country office; International Medical Corps; Relief International; Shuhada; Kabul University Medical School; Char Asiab Hospital, Maidan Shar Hospital and Pole-Alam Hospital, and other facilities.

Team members will be in Afghanistan through mid-October.

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HHS to provide $250,000 to Maryland for mental health services to help deal with sniper attacks

HHS Secretary Tommy G. Thompson has announced that HHS will provide up to $250,000 in immediate assistance to the State of Maryland to provide mental health services to the victims, families and others affected by the random shooter that has claimed six lives and seriously wounded two others in a shooting spree concentrated in two Maryland counties.

"We know that most children and adults can cope with this trauma with the support of their families and others. But some will need more help, perhaps over a longer period of time. It is critically important that we set in place appropriate mental health services designed to ease the trauma of the past few days for today and tomorrow," Secretary Thompson said.

HHS' Substance Abuse and Mental Health Services Administration (SAMHSA) will make the money available and is offering immediate and long-term assistance to support state and local efforts to work with schools and community organizations to reduce the traumatic effects of these shootings.

"We will do what we can to support Maryland so that those affected by these shootings have access to appropriate mental health services. We are also mobilizing SAMHSA's Safe Schools/Healthy Students Action Center and our National Center for Child Traumatic Stress to provide immediate help to assist children experiencing post traumatic stress disorder," SAMSHA Administrator Charles G. Curie said.

SAMHSA has a $30 million network of grants and contracts to provide services nationally to providers who assist children experiencing post traumatic stress disorder, such as those at Benjamin Tasker Middle School in Bowie, Md., where a 13-year-old boy was shot on Monday. SAMHSA also funds a $2.5 million Safe Schools/Healthy Students Action Center that can provide students, teachers and school administrators with written materials, web-based information and connections to local resources.

According to SAMHSA, parents can help their children understand; teachers can help their students do the same. Some children may have reactions very soon after the event. Others may seem to be doing fine for weeks or months, and then begin to show worrisome behavior. For information about local mental health services or to obtain informational materials to help understand and talk about emotional effects of trauma, call 1-800-789-2647 (TDD: 301-443-9006).


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NIH grantees win Nobel Prizes

Two grantees of the National Institutes of Health - H. Robert Horvitz, Ph.D. and John B. Fenn, Ph.D. - have won Nobel Prizes this year. Dr. Horvitz won the Nobel Prize in Physiology or Medicine, and Dr. Fenn won the Nobel Prize in Chemistry.

H. Robert Horvitz, Ph.D., is cited for characterizing key genes controlling cell death, which is essential for embryonic development and, when improperly controlled, is a hallmark of numerous diseases. NIH has provided more than $7 million to support Dr. Horvitz's research over the past 25 years. He is recognized for "discoveries concerning genetic regulation of organ development and programmed cell death."

Like a sculptor shaving off bits of marble to shape a statue, organisms use cell death to shape developing organs, including the brain. Dr. Horvitz identified the first two "cell death" genes by studying a simple model system - the roundworm Caenorhabditis elegans. He also proved that humans have cell death genes similar to those he identified in the worm.

John B. Fenn, Ph.D., who received support for his research from NIH's National Institute of General Medical Sciences, is a winner of this year's Nobel Prize in Chemistry. He is cited for refining an analytical technique called mass spectrometry, making it possible to analyze large molecules in biological samples. According to the Nobel Foundation, mass spectrometry has revolutionized the development of new pharmaceuticals and promises to advance disease diagnosis.

NIGMS provided more than $1.5 million to support Dr. Fenn's research from 1984 to 1994. His prize-winning research was published during this period.

Mass spectrometry is a highly selective and sensitive analytic technique used to identify substances in a mixture based on how much they weigh. The technique relies on measuring the trajectories of charged molecules in a vacuum when exposed to various combinations of electric and magnetic fields. It is used in almost every chemistry laboratory in the world.

Since 1954, NIH has supported the work of 30 Nobel laureates in chemistry. Of the 80 American Nobel laureates in physiology or medicine since 1945, 61 either worked at or were funded by NIH before winning the prize.

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Secretary Thompson to address diabetes awareness and education for Hispanic and Native American youth

HHS Secretary Tommy G. Thompson reaffirmed HHS' commitment to fighting diabetes in Hispanic and Native American youth in a speech on Monday, Oct. 14 to a conference of the VHA Health Foundation. The conference marks the start of a new VHA Health Foundation educational program designed to target parents and children. "Diabetes Awareness and Education for Hispanic and Native American Youth" will launch in November (Diabetes Awareness Month) in 25 communities nationwide.

Today, about 17 million Americans have diabetes - about one out of every twenty. For Hispanics, the proportion is double that - about one out of every ten. Children are hit especially hard. Type 2 Diabetes was once a disease of adults 40 and older. Now it's found in children as young as eight.

And the risk factors for diabetes have increased, too. The number of overweight children has tripled in the past two decades. And over 10 percent of pre-school-aged children between ages 2 and 5 are overweight, up from 7 percent in 1994. Children of minorities like Hispanics and Native American suffer disproportionately.

"All of these facts are too troubling to ignore and too grim to accept. And I'm here to today to tell you, this Administration is not accepting them - we're acting to change them, and acting boldly and with energy and focus," Secretary Thompson said.

HHS is working to educate the public through targeted efforts, including the National Diabetes Education Program, the bilingual "Take Time to Care About Diabetes" campaign, and "Cuide Su Corazon," a campaign designed to help Hispanic Americans understand what they can do to help prevent diabetes and heart disease. The Secretary's Prevention campaign, which educates Americans about the benefits of preventive efforts such as a healthy diet, exercise, and doctor's visits, is also a key component of this effort.

The VHA Health Foundation is a public foundation headquartered in Irving, Texas. With more than 2,200 members, VHA (formerly known as the "Volunteer Hospitals of America") is the nation's largest alliance of community-owned health care organizations and physicians. The VHA Corporation created the VHA Health Foundation in 1998, with the stated mission of encouraging community health leadership and innovation.

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Brain Shrinkage in ADHD Not Caused by Medications

A 10-year study by National Institute of Mental Health (NIMH) scientists has found that brains of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) are 3-4 percent smaller than those of children who don't have the disorder - and that medication treatment is not the cause. Indeed, in this first major study to scan previously never-medicated patients, they found "strikingly smaller" white matter volumes in children who had not taken stimulant drugs. Still, the course of brain development in the ADHD patients paralleled that of normal subjects, suggesting that whatever caused the disorder happened earlier.

Drs. Xavier Castellanos, Judith Rapoport, NIMH Child Psychiatry Branch, and colleagues, report on their magnetic resonance imaging (MRI) study of 152 boys and girls with ADHD in the October 9, 2002 Journal of the American Medical Association.

Affecting 3-5 percent of school-age children, ADHD is characterized by over-activity, distractibility and impulsiveness. The disorder affects two to three times as many boys as girls, with as many as 20 percent of boys taking stimulant medication in some school systems. The new study strengthens the validity of the diagnosis by helping to put to rest criticism that structural brain abnormalities seen in ADHD might be drug-induced.

"There is no evidence that medication harms the brain," said Castellanos, who conducted the study at NIMH before joining New York University. "It's possible that medication may promote brain maturation."

While the NIMH group had earlier thought that only certain brain structures were smaller in ADHD, this largest and most sophisticated study found that the whole brain is affected. It's possible that a recently discovered gene that determines brain size could play a role in the disorder, Castellanos suggested. He also suspects that what is now called ADHD may ultimately prove to be a group of disorders with different causes. To identify these subtypes, he suggests that the field begin studying "endophenotypes," factors that may predict the risk of ADHD in the same way that cholesterol predicts the risk of heart disease.

Also participating in the research were: Drs. Patti Lee, Deanna Greenstein, Liv Clasen, Regina James, Jay Giedd, and Wendy Sharp, Christen Ebens, Jonathan Blumenthal, James Walter, NIMH Child Psychiatry Branch; Dr. Neal Jeffries, National Institute of Neurological Disorders and Stroke (NINDS); Drs. Alex Zijdenbos, Alan Evans, MNI, McGill University.

NIMH and NINDS are part of the NIH, the Federal Government's primary agency for biomedical and behavioral research. NIH is part of the U.S. Department of Health and Human Services. For more information, please go to www.nih.gov/news/pr/oct2002/nimh-08.htm.

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El Departamento de Salud y Servicios Humanos encabeza la batalla contra la influenza


El Secretario de Salud y Servicios Humanos de los Estados Unidos, Tommy G. Thompson, anunció una nueva política que permite a los hogares de personas de edad avanzada, los hospitales y las agencias de servicios de salud a domicilio que atienden a los beneficiarios de Medicare y Medicaid recordar a los pacientes cuando les toca recibir sus vacunas anuales contra la gripe y la pulmonía, y preguntarles si desean recibir una inyección. El reglamento vigente o standing order tiene como finalidad promover un mayor acceso a las vacunas contra la gripe y la pulmonía, sobre todo entre los norteamericanos de edad avanzada y otros que se encuentran en situación de alto riesgo para las enfermedades.

La nueva política del Departamento de Salud y Servicios Humanos de los Estados Unidos (HHS) se revela durante la etapa inicial de la temporada de gripe 2002-2003 y complementa las recomendaciones hechas a principios del año por el Advisory Committee on Immunization Practices (ACIP) de los Centros para el Control y la Prevención de Enfermedades (CDC), un componente del Programa Nacional de Inmunización de CDC.

Las nuevas recomendaciones de ACIP instan a que los esfuerzos de vacunación durante el mes de octubre sean dirigidos hacia las personas con alto riesgo de complicaciones por causa de la influenza - los trabajadores de salud y los niños menores de 9 años de edad que se vacunan por primera vez. El comité también está promoviendo la vacunación contra la influenza para los niños de 6 a 23 meses de edad debido al mayor riesgo que tienen de requerir la hospitalización a consecuencia de la influenza.

Cada año, aproximadamente 114,000 personas en los Estados Unidos son hospitalizadas y alrededor de 20,000 personas fallecen por causa de la gripe. Según los CDC, quienes corren mayor riesgo de enfermedad severa de influenza son:

Los personas de 65 años o mayores;
Los niños de 6 a 23 meses;
Los adultos y los niños con una condición crónica de salud;
Las mujeres con más de 3 meses de embarazo durante la temporada de gripe; y
Los trabajadores de salud.
Se les alienta a las personas con buen estado de salud entre las edades de 50 a 64 años, y a los adultos más jóvenes a vacunarse a partir de noviembre.

También, en julio del 2002, HHS lanzó la Racial and Ethnic Adult Disparities in Immunization Initiative (READII), una nueva iniciativa de inmunización para los adultos dirigida a reducir las disparidades raciales y étnicas en la cobertura de vacunación contra la influenza y los neumococos para los adultos de 65 años de edad o mayores. Mediante READII, HHS efectuará proyectos pilotos de dos años en cinco sitios para mejorar las tasas de vacunación contra la gripe y los neumococos en las comunidades afro americanas e hispanas.

Para obtener mayor información sobre la gripen, visite el sitio web del National Immunization Program en www.cdc.gov/nip/Flu/default.htm.

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Last updated 15 October 2002
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