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Volume 6, No. 6, June 2008
From Your Colleagues
Scott Giberson, HQE
National HIV Testing Mobilization Campaign
Our colleagues at the Office of HIV/AIDS Policy (OHAP) have launched the National HIV Testing Mobilization Campaign Web site. IHS has worked in concert with OHAP (on the Minority AIDS Initiative) and now supports the Mobilization Campaign as one of their HHS partners.
Sponsored by the U.S. Department of Health and Human Services’ Office of HIV/AIDS Policy, the Campaign encourages all Americans, ages 13-64, to get tested for HIV.
Today, more than 250,000 Americans are believed to be living with HIV but do not know they are infected. Research shows that once people know that they are HIV-positive, they are more likely to seek care for themselves and take steps to protect others from becoming infected.
The Web site offers information about the importance of HIV testing, resource materials, and links to the CDC’s national HIV testing location database. Please take a minute and check out the Web site today! Visit www.aids.gov/takecontrol.
“Testing is one of the most important weapons we have in the war
against HIV/AIDS.”
Mike
Leavitt
Secretary
U.S.
Department of Health and Human Services
Upcoming CDC Rapid HIV Testing Training through SAMHSA and IHS
SAMHSA and IHS work together on multiple HIV initiatives. One of which is rapid testing training. With some of SAMHSA's Minority AIDS Initiative dollars, they have been able to coordinate HIV rapid testing training (and one training of trainers session) from the CDC for I/T/U personnel. Please consider the below HIV rapid testing trainings for you or staff that would benefit. The announcement includes the following contact information:
If you work for a Tribal or Urban facility and are interested, please contact Deepa or Ivy (dchhatwal@iqsolutions.com or ivedamuthu@iqsolutions.com) listed below in the SAMHSA announcement… Please initially send them your complete contact information including email, phone numbers and facility you work.
If you are an IHS employee and provider of HIV services and are interested in ANY of the trainings below or know someone on your staff that should attend , please contact me as soon as possible and we will discuss this in detail. This IHS/SAMHSA collaboration will thus provide training for all three personnel, I/T/U. For tribal and urban sites, SAMHSA has provided additional details below.
(In order to participate in the "training of trainers session" you will need to have already been certified in HIV Rapid Testing).
CDC Rapid HIV Testing Training
July
22-24 in Denver, CO
CDC Rapid HIV Testing Train the Trainer
August
5-7 in Denver, CO
These trainings are designed to increase the capacity of HIV screening in Native communities by certified and train providers.
Funding opportunity for HIV/AIDS outreach to AI/AN from NIH/National Library of Medicine (NLM)—Deadline for proposals is Monday, June 16, 2008.
The purpose of the AIDS Community Information Outreach Project is to enable organizations to design local programs for improving HIV/AIDS health information access for patients and the affected community as well as their caregivers and the general public. Emphasis is on providing information or access to health and medical information in a way that is meaningful to the target community, and increasing the awareness and utilization of National Library of Medicine (NLM) online health and medical resources in the HIV/AIDS Community.
A major effort to enhance the understanding of information needs, resources, and services began in June 1993 when NLM and the NIH Office of AIDS Research (OAR) cosponsored a conference that brought together users of NIH information resources including health care providers, scientists, information specialists, journalists, and members of the community affected by HIV/AIDS. The purpose of the conference was to review the various HIV/AIDS information services, assess current efforts with respect to needs, and identify additional needs. As a result of the recommendations made during the conference, the National Library of Medicine issued a Request for Quotations (RFQ) for AIDS Community Information Outreach Projects in May of 1994. That program is continuing with the issue of the current solicitation.
Here is the posting from FedBizOpps
Elaine Locke, ACOG
ACOG/IHS Denver Course Now in Salt Lake City, Utah!
Obstetric, Neonatal and Gynecologic Care, September 14-18, 2008; Salt Lake City, Utah
This annual women’s health update for Nurses, Advanced Practice Clinicians, and physicians provides a four-day schedule of lectures, workshops, hands-on sessions, and team building. The large interdisciplinary faculty collaborates to teach clinical and practical topics as they apply in Indian health settings. Many faculty members are your colleagues in IHS and Tribal facilities; private sector faculty also bring a wide range of experience providing Indian health care.
Learn the latest evidence-based approaches to maternal and child health services, and share problems and solutions with your colleagues from across Indian country. The course can also serve as a good foundation for professionals who are new to women’s health care or new to the Indian health system.
In addition to the basic course, you may sign up for the Neonatal Resuscitation Program, and come away with your certificate from this convenient pre-course program. The opportunity to fulfill continuing education requirements in a concentrated format is significant: With the optional NRP, we can document your participation in seven half-days of education.
Sign up early! You’ll have first chance for support from your facility and coverage for your time in Salt Lake City. Getting these benefits lined up takes time, so don’t delay and miss out! In addition, early registration holds your place, and puts you in line for possible availability of scholarship funds.
Watch your mail for the course brochure and registration form, or download it from here:
http://www.ihs.gov/MedicalPrograms/MCH/F/CN01.cfm?module=08&option=9#top
Contact Yvonne Malloyymalloy@acog.org for additional information.
Charles Q. North, Headquarters
Effect of lower targets for blood pressure and LDL cholesterol on atherosclerosis in diabetes: the SANDS randomized trial
CONTEXT: Individuals with diabetes are at increased risk for cardiovascular disease (CVD), but more aggressive targets for risk factor control have not been tested.
OBJECTIVE: To compare progression of subclinical atherosclerosis in adults with type 2 diabetes treated to reach aggressive targets of low-density lipoprotein cholesterol (LDL-C) of 70 mg/dL or lower and systolic blood pressure (SBP) of 115 mm Hg or lower vs standard targets of LDL-C of 100 mg/dL or lower and SBP of 130 mm Hg or lower.
DESIGN, SETTING, AND PARTICIPANTS: A randomized, open-label, blinded-to-end point, 3-year trial from April 2003-July 2007 at 4 clinical centers in Oklahoma, Arizona, and South Dakota. Participants were 499 American Indian men and women aged 40 years or older with type 2 diabetes and no prior CVD events.
INTERVENTIONS: Participants were randomized to aggressive (n=252) vs standard (n=247) treatment groups with stepped treatment algorithms defined for both.
MAIN OUTCOME MEASURES: Primary end point was progression of atherosclerosis measured by common carotid artery intimal medial thickness (IMT). Secondary end points were other carotid and cardiac ultrasonographic measures and clinical events.
RESULTS: Mean target LDL-C and SBP levels for both groups were reached and maintained. Mean (95% confidence interval) levels for LDL-C in the last 12 months were 72 (69-75) and 104 (101-106) mg/dL and SBP levels were 117 (115-118) and 129 (128-130) mm Hg in the aggressive vs standard groups, respectively. Compared with baseline, IMT regressed in the aggressive group and progressed in the standard group (-0.012 mm vs 0.038 mm; P < .001); carotid arterial cross-sectional area also regressed (-0.02 mm(2) vs 1.05 mm(2); P < .001); and there was greater decrease in left ventricular mass index (-2.4 g/m(2.7) vs -1.2 g/m(2.7); P = .03) in the aggressive group. Rates of adverse events (38.5% and 26.7%; P = .005) and serious adverse events (n = 4 vs 1; P = .18) related to blood pressure medications were higher in the aggressive group. Clinical CVD events (1.6/100 and 1.5/100 person-years; P = .87) did not differ significantly between groups.
CONCLUSIONS: Reducing LDL-C and SBP to lower targets resulted in regression of carotid IMT and greater decrease in left ventricular mass in individuals with type 2 diabetes. Clinical events were lower than expected and did not differ significantly between groups. Further follow-up is needed to determine whether these improvements will result in lower long-term CVD event rates and costs and favorable risk-benefit outcomes.
Howard BV, et al., Effect of lower targets for blood pressure and LDL cholesterol on atherosclerosis in diabetes: the SANDS randomized trial. JAMA. 2008 Apr 9;299(14):1678-89.
http://www.ncbi.nlm.nih.gov/pubmed/18398080
Comment in:
Peterson ED, Wang TY., The great debate of 2008--how low to go in preventive cardiology? JAMA. 2008 Apr 9;299(14):1718-20.
http://www.ncbi.nlm.nih.gov/pubmed/18398086
Comments from Dr. North:
This important study is worth reading and considering when setting goals. Congratulations to the patients, communities, and authors for making this contribution to improve care.
Ty Reidhead, Chronic Care Initiative, White River, AZ
Chronic Care Initiative Readiness Curriculum Web-based Call Series
The Readiness Curriculum is a monthly web-based call series that includes training on improvement and care models, project management, and leadership for improvement. This call series is a resource for all health care organizations across the Indian health system.
Three hundred persons representing the Indian health system attended the IHI National Forum in December 2007. This experience created an increased demand and expectation for further improvement opportunities. Sites asked to be involved in improvement discussions and they requested further learning about improvement methodologies and topics. Rather than risking “wasted will”, the Chronic Care Initiative planning group developed a “Readiness Curriculum”. This curriculum includes learning activities designed to reach all Tribal, Federal, and Urban sites that are willing and eager to learn more about the improvement methods used to test and implement change ideas from the Care Model as well as improvement methodologies in general.
The goals of the Readiness Curriculum Web-based Call Series include;
- To address stimulating topics of interest that relate to improving planned care for all,
- To generate useful tools and references for attendees to learn more about improvement methodologies and how to use them to transform their organizations, and
- To support the Innovations in Planned Care work that is currently underway.
For your reference, the Chronic Care Initiative’s Readiness Curriculum web-based call series description, topics and connection information is attached to this email and posted to the IHS Director’s Initiatives webpage. http://www.ihs.gov/NonMedicalPrograms/DirInitiatives/index.cfm
Please mark your calendars for the next session on May 28 th at 12N EDT on the use of The Green Book on assessing your facilities’ practice. It will be a great session! If you are unable to participate, the web site also has information about accessing archived sessions.
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OB/GYN
Dr. Neil Murphy is the Obstetrics and Gynecology Chief Clinical Consultant (OB/GYN C.C.C.). Dr. Murphy is very interested in establishing a dialogue and/or networking with anyone involved in women's health or maternal child health, especially as it applies to Native or indigenous peoples around the world. Please don't hesitate to contact him by e-mail or phone at 907-729-3154.
