Carroll A.E.,PPI Inc |
Ganiats T.G.,American Academy of Family Physicians |
Jackson M.A.,AAP Committee on Infectious Disease |
Joffe M.D.,AAP Committee Section on Pediatric Emergency Medicine |
And 3 more authors.
Pediatrics | Year: 2013
This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM. In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations. The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships. The practice guideline underwent comprehensive peer review before formal approval by the AAP. This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem. Copyright © 2013 by the American Academy of Pediatrics.
Barr M.S.,The American College |
Mann M.,Maternal and Child Health Bureau |
Pickler L.,American Academy of Family Physicians |
Strickland B.,Maternal and Child Health Bureau |
Weinberg S.T.,PPI Inc
Pediatrics | Year: 2011
Optimal health care is achieved when each person, at every age, receives medically and developmentally appropriate care. The goal of a planned health care transition is to maximize lifelong functioning and well-being for all youth, including those who have special health care needs and those who do not. This process includes ensuring that high-quality, developmentally appropriate health care services are available in an uninterrupted manner as the person moves from adolescence to adulthood. A well-timed transition from child- to adultoriented health care is specific to each person and ideally occurs between the ages of 18 and 21 years. Coordination of patient, family, and provider responsibilities enables youth to optimize their ability to assume adult roles and activities. This clinical report represents expert opinion and consensus on the practice-based implementation of transition for all youth beginning in early adolescence. It provides a structure for training and continuing education to further understanding of the nature of adolescent transition and how best to support it. Primary care physicians, nurse practitioners, and physician assistants, as well as medical subspecialists, are encouraged to adopt these materials and make this process specific to their settings and populations. Copyright © 2011 by the American Academy of Pediatrics.
News Article | September 13, 2016
Hillary Clinton’s “I believe in science” declaration aside, science has not played a starring role in the 2016 presidential election. Far from it. For the most part, the candidates’ science policies have trickled out in dribs and drabs, and in varying degrees of detail — talking points on a website here, a passing comment in response to a spur-of-the-moment question there. Yet science underpins our understanding of, and response to, the world around us. It answers everything from why our coffee sloshes dangerously to what could happen if the planet warms another degree or two. Science often intersects with public policy, and presidential leadership influences research priorities. With that in mind, Science News examines where Clinton, the Democratic Party nominee, and Republican Party nominee Donald Trump stand on seven scientific issues with the power to impact our future. Our writers looked at what the candidates have said publicly at campaign events and in interviews, what they have written on their websites, relevant planks in their party’s platform, and their responses, released September 13, to 20 questions posed by the nation’s science advocates. (Science News’ parent organization, Society for Science & the Public, is among the groups pushing to make science more prominent in the presidential campaigns, via an initiative called ScienceDebate.org.) Read on to find out what Clinton and Trump have said on topics ranging from genetic engineering to space exploration, and how their positions accord with the current state of the science. — Macon Morehouse As she tells the story, Clinton wanted to be an astronaut when she was 14 years old, but NASA told her that they weren’t accepting girls. That doesn’t seem to have dampened her enthusiasm. “I really, really do support the space program,” she told a crowd in July 2015 at a town hall meeting in Dover, N.H. “There’s lots for us to keep learning … Let’s not back off now.” Clinton has provided few specifics on what the United States should be doing in space, but she told ScienceDebate.org that one of her goals is to “advance our ability to make human exploration of Mars a reality.” Clinton’s position seems to align with that of her party’s platform: “Democrats believe in continuing the spirit of discovery that has animated NASA’s exploration of space over the last half century. We will strengthen support for NASA and work in partnership with the international scientific community to launch new missions to space.” The platform makes no mention of what role, if any, commercial enterprises such as SpaceX and Blue Origin should play in furthering space exploration. Clinton has said that she doesn’t object to partnering with private ventures, but that their role is more aligned with applied science, whereas the government should be funding basic research and discovery. Trump is a big fan of space exploration — “a strong space program will encourage our children to seek STEM [education] and will bring millions of jobs and trillions of dollars of investment to this country,” he told ScienceDebate.org. But he has also repeatedly said that it’s a luxury the country can’t afford. “I love NASA, I love what it represents, I love what it stands for,” he said during a November 11 event in Manchester, N.H. “Right now we have bigger problems.… We’ve got to fix our potholes.” NASA should focus on exploring new frontiers, Trump told Aerospace America in May. Infrastructure, economics and defense come first, however. “Our first priority is to restore a strong economic base to this country,” he said. “If we are growing with all of our people employed and our military readiness back to acceptable levels, then we can take a look at the timeline for sending more people into space.” Both Trump and the Republican Party support working with private companies to expand access to space. “I think there needs to be a growing partnership between the government and the private sector as we continue to explore space,” Trump told Aerospace America. “There seems to be tremendous overlap of interests so it seems logical to go forward together.” Pluto reconnaissance. Ripples in spacetime. Discovery of thousands of worlds around other stars. Space exploration is in a golden age, and astronomers as well as policy experts want continued support for basic research, whether by building new telescopes or sending probes to far-flung worlds. NASA is on track to launch James Webb, the next major space-based telescope, late in 2018 and has started work on that telescope’s successor, WFIRST. The agency launched a probe in September to bring samples of an asteroid back to Earth (SN Online: 9/8/16), and plans are under way for the next Mars rover and a mission to Jupiter’s moon Europa (SN Online: 6/18/15). Current policy regarding the role of humans in space is muddled. “No dream, no vision, no plan, no budget,” said former NASA administrator Mike Griffin at a congressional hearing in February. NASA proclaims it will send humans to Mars in the next 20 years — while others argue for a return to the moon — but there is no clear outline or long-term financial support (SN Online: 5/24/16). Private companies, despite the occasional rocket explosion, are enjoying a run of success. Dramatic rocket landings are making reusable launch components a reality, and SpaceX and Orbital ATK have been making supply runs to the International Space Station. SpaceX also plans to send an uncrewed mission to Mars in 2018. — Christopher Crockett Clinton has not taken a public stance on human genetic engineering or genetic modification of animals or insects. Genetically engineered crops, often called GMOs, are another matter. “I stand in favor of using seeds and products that have a proven track record … scientifically proven,” she said at a meeting of the Biotechnology Industry Organization in 2014. “Genetically modified sounds Frankensteinish, [but] drought resistant sounds really [like] something you want.” At a town hall meeting in Fairfield, Iowa, in December, she elaborated: “There are a lot advocates who fight hunger in Africa who are desperate for GMO seeds because they are drought resistant and they don’t know how else they are going to get enough yield to feed people.” At that same town hall, Clinton said she also favors food labeling. “There’s a right to know,” she said. “There’s also a right to have the best science.… Whatever kind of overall plan we can have that will give us information, we deserve to know and get more science done that is independent science that we can count on that doesn’t get done by some institution, company, whatever, that has a stake in the outcome.” Trump has been silent on matters concerning genetic engineering, whether it’s involving humans, animals or plants. But the Republican Party platform weighs in on GMO food and labeling: “We oppose the mandatory labeling of genetically modified food, which has proven to be safe, healthy and a literal life-saver for millions in the developing world.” Genetic engineering has taken on new vigor with the introduction of technologies such as the powerful gene editor CRISPR/Cas9 (SN: 12/12/15, p. 16; SN: 9/3/16, p. 22). Scientists may soon be able to alter genes in any organism, including humans, at will. That has many people, including scientists, worried about social, health, ethical and environmental consequences. The United States doesn’t have laws to establish what types of genetic engineering are allowed, but does regulate the release of genetically modified organisms into the environment. For instance, the U.S. Food and Drug Administration recently OK’d the first GM mosquito trial in an effort to curb the spread of the Zika virus (SN Online: 8/5/16). And in July, President Obama signed into law a measure that requires labeling of foods that contain genetically modified organisms, or GMOs. One of the most controversial uses of gene editing is making changes to the human germ line — embryos, eggs, sperm and the cells that give that rise to them — that could be carried to future generations. Such edits could cure genetic diseases permanently, but may also lead to “designer babies” and raises fears of a new kind of eugenics (SN: 5/30/15, p. 16). An international group of scientists said last year that research on human gene editing should go ahead, but that no babies should be born as a result (SN: 12/26/15, p. 12). A federal spending bill prohibits the FDA from considering, or even acknowledging, applications for scientists to make heritable changes in human embryos. Some call it an effective ban on engineering the human germ line, including the creation of “three-parent babies” in which the nucleus from a mother’s egg is transplanted into an empty donor egg to help a mother avoid passing mitochondrial diseases on her children. A panel of scientists have deemed that procedure ethical under certain circumstances (SN Online: 2/3/16). — Tina Hesman Saey “I believe in science. I believe that climate change is real and that we can save our planet while creating millions of good-paying clean energy jobs,” Clinton said during her acceptance speech at the Democratic National Convention in Philadelphia in July. She has called last December’s 195-nation Paris climate agreement a “historic step forward” and says she’ll deliver on the U.S. pledge to curb warming without “relying on the climate deniers in Congress to pass new legislation.” Her goal: reduce greenhouse gas emissions in 2025 by 30 percent relative to 2005 levels and ultimately by 80 percent by 2050. To reach those ambitious targets, Clinton would invest in renewable energy, including creating a $60 billion Clean Energy Challenge to promote cutting carbon pollution and expanding clean energy. Within 10 years of taking office, she hopes to have enough renewable energy capacity in the United States to power every home and cut oil consumption by a third. “I'm proud that we shaped a global climate agreement,” she said at the convention. “Now we have to hold every country accountable to their commitments, including ourselves.” Trump has repeatedly called human-caused climate change a hoax; any efforts to combat it are needlessly burdensome on the economy, he says. “President Obama entered the United States into the Paris climate accords. Unilaterally and without the permission of Congress, this agreement gives foreign bureaucrats control over... what we do on our land in our country,” Trump said May 26 at a campaign event at the Williston Basin Petroleum Conference in Bismarck, N.D. “We’re going to cancel the Paris climate agreement and stop all payments of the United States tax dollars to U.N. global warming programs.” Trump has said that he would undo many climate initiatives put in place by the Obama administration, such as the U.S. Environmental Protection Agency’s plan to cut emissions from power plants. Trump would also end the Interior Department’s moratorium on coal mining permits and “encourage, not discourage, the use of natural gas and other American energy resources.” According to the Trump campaign, lifting these and other restrictions would increase the country’s economic output by $700 billion annually over the next 30 years, increase wages by $30 billion annually and create millions of new jobs. Satellite and on-the-ground measurements have recorded a sharp rise in global temperatures over the past several decades that is unprecedented in the last millennium. That warming is in large part caused by emissions from human activities such as fossil fuel burning, computer simulations and direct observations have shown (SN: 4/4/15, p. 14). Greenhouse gases from these emissions, such as carbon dioxide, trap heat that would otherwise escape into space. As a result, the global average temperature has risen around 1 degree Celsius since the start of the Industrial Revolution, and the rate of warming has nearly doubled over the past half century. If continued unabated, this climate change will raise sea levels, shift rainfall patterns and cause health and economic problems around the world (SN: 4/6/16, p. 22), many scientists warn. The Paris climate agreement is the most ambitious plan yet to limit and reverse this trend (SN: 1/9/16, p. 6). The pact, reached in December, aims to limit warming to “well below” 2 degrees Celsius above preindustrial levels, with a possibility of adopting an even more ambitious 1.5-degree target down the road. U.S. participation is crucial to the success of the agreement: The United States is the second largest greenhouse gas emitter worldwide and the seventh largest per capita. — Thomas Sumner “I’m committed to ramping up our funding for biomedical research and development, including $2 billion per year for Alzheimer’s research, which is the amount leading researchers say will be necessary to effectively treat the disease and make a cure possible by 2025,” Clinton writes on her campaign website. She has endorsed the Obama administration’s cancer moonshot initiative (SN Online: 9/8/16): “By combining new funding with creative approaches, we will not only catalyze progress against cancer: We will strengthen the nation’s entire scientific enterprise.… As president, I will take up the charge.” Clinton also has also pushed for additional funding to fight the Zika virus. In an Aug. 8 Quora post, she wrote: “If we’re serious about keeping families safe, there’s no time to waste. We need to step up mosquito control and abatement, provide families with critical health services, including access to contraception, develop a vaccine and treatment, and ensure people know how to protect themselves and their kids.” She told ScienceDebate.org that she would create a Public Health Rapid Response Fund with stable funding and the agility “to quickly and aggressively respond to major public health crises and pandemics.” Trump has said little on issues regarding biomedical research, but noted on a radio show in 2015, “I hear so much about the NIH [National Institutes of Health] and it’s terrible.” “We cannot simply throw money at these institutions and assume that the nation will be well served,” he told ScienceDebate.org. “Our efforts to support research and public health initiatives will have to be balanced with other demands for scarce resources.” When asked a question about Alzheimer’s disease at a New Hampshire town hall, he responded: “It’s a total top priority for me. I have so many friends whose families are devastated by Alzheimer’s. There are some answers. They’ve made less progress than we’ve hoped, as you know.” (Trump’s father had Alzheimer’s.) On Zika, he told a Miami television station in August: “Well, first of all you have a great governor, who’s doing a fantastic job, Rick Scott, on the Zika. And it’s a problem, it’s a big problem. But I watch and I see, and I see what they’re doing with the spraying and everything else. And I think he’s doing a fantastic job. And he’s letting everyone know exactly what the problem is and how to get rid of it. He’s going to have it under control. He probably already does.” The National Institutes of Health funded $32.3 billion of biomedical research during the 2015–2016 fiscal year. Parceling out those dollars and setting research priorities can be controversial, with advocacy groups for specific diseases jostling for more money for their own cause. But with people generally living longer than they did 50 years ago, funding for aging-related diseases like Alzheimer’s is on the rise. Research into cancer, neuroscience and genetics, among other broad topics, is also funded by the NIH. But some scientists caution against devoting too much energy to curing specific diseases at the expense of basic research — studies that don’t have an immediate application, but that can yield results leading to advances disciplines. On the public health front, emerging diseases are a growing threat. Warming temperatures are letting infectious tropical diseases thrive in places they couldn’t previously, the World Health Organization warns. Zika virus is a case in point, having blazed a path through the Americas (and beyond) in less than a year (SN Editor’s Picks). Most experts agree that Zika is currently a serious problem in the United States requiring a national response. The virus had infected more than 18,000 people in the states and territories as of early September, and with mosquitoes in Florida now carrying and spreading the disease, the numbers are expected to climb. — Laurel Hamers In February, Clinton sent out a tweet heard round the world: “The science is clear: The earth is round, the sky is blue, and #vaccineswork. Let’s protect all our kids. #GrandmothersKnowBest.” She reiterated her pro-vaccine stance in response to a ScienceDebate.org question, vowing to “speak out and educate parents about vaccines, focusing on their extraordinary track record in saving lives and pointing out the dangers of not vaccinating our children.” But Clinton hasn’t always been this definitive. In 2008, in response to a questionnaire from a web newspaper called Age of Autism, Clinton appeared to question one heavily researched area of vaccine safety. “I am committed to make investments to find the causes of autism, including possible environmental causes like vaccines,” she wrote. “We don't know what, if any, kind of link there is between vaccines and autism — but we should find out.” Clinton has since stepped away from this view. Though her campaign website highlights the need to support people with autism, it makes no mention of vaccines. Instead, Clinton pledges to ramp up funding for research “to better understand child brain development and the genetic linkages for autism” and calls for a nationwide study of the prevalence of autism in adults. Donald Trump occupies a nebulous, quantum-flux sort of position on vaccines that places him in both the pro- and the anti- camps. For years, he has championed the idea that vaccines cause autism. In 2014, he tweeted: “Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn't feel good and changes — AUTISM. Many such cases!” But Trump objects to being lumped in with anti-vaxxers. In 2014, Trump tweeted: “To all haters and losers: I am NOT anti-vaccine, but I am against shooting massive doses into tiny children. Spread shots out over time.” Trump’s campaign website does not mention vaccines or autism, but he has admitted to slowing the vaccine schedule for his youngest son, Barron. But he has also said that as president, he would support vaccinations. “We should educate the public on the values of a comprehensive vaccination program,” Trump told ScienceDebate.org. “This seems to be of enough importance that we should put resources against this task.” Vaccines have all but wiped out dozens of infectious diseases. In the United States, a case of smallpox hasn’t been reported for more than 60 years, polio has been eliminated, and measles deaths have plummeted. Diseases suffered by one generation can be nearly vanquished in the next. Children today, for example, can receive vaccines against the viruses that cause chicken pox and cervical cancer. Today’s children also receive more vaccines than they did 20 years ago — 14 by age 2 compared with nine in 1996. But today’s vaccines contain far fewer of the viral or bacterial particles that rev up the immune system. Yet many parents worry about the current vaccine schedule. In 2013, 87 percent of pediatricians reported that parents refused at least some vaccines for their children. That’s up from 74.5 percent in 2006. A 2013 report from the Institute of Medicine, however, found no evidence that the vaccine schedule was unsafe. (In fact, the report concluded that a study to spread out vaccines would “needlessly endanger children’s lives.”) And skipping vaccines weakens herd immunity, putting people who can’t get vaccinated — some infants, people with compromised immune systems — at risk (SN Online: 2/11/15). Scientists have also found no evidence that vaccines cause autism, another concern parents cite (SN Online: 4/1/16). Still, the number of children diagnosed with autism spectrum disorder has risen, from 1 in 150 children in 2002 to 1 in 68 in 2012. Scientists don’t fully understand why, or what triggers the disorder. But researchers around the world have spent years and more than a billion dollars investigating the purported link between vaccines and autism. Their conclusion: It’s just not there. — Meghan Rosen Clinton has staked out a position as the candidate favoring gun control. But her stance on gun research isn’t so clear. At a campaign event in South Carolina in February, she alluded to the difficulties facing lawmakers and gun violence researchers: “I know we are a smart enough nation to figure out how you protect responsible gun owners’ rights and get guns out of the hands of people who shouldn’t have them.” Clinton’s campaign website lists a few major gun policy changes she’d make as president, including expanding background checks and making it harder for mentally ill people and violent criminals to buy and own guns. Her website doesn’t, however, address the question of research funding. Like Clinton, Trump has not made his position on funding gun research clear. But he has planted himself firmly on the pro-gun side. Trump proposes a “national right to carry,” which would let people with concealed weapon permits carry guns in all 50 states. His website questions the efficacy of background checks and calls gun bans “a total failure.” That’s a reversal from a statement he made in his 2000 book, The America We Deserve: “I generally oppose gun control, but I support the ban on assault weapons and I support a slightly longer waiting period to purchase a gun.” In June, the American Medical Association announced a new effort to revive gun violence research. For the United States, gun violence is a public health crisis “unrivaled in any other developed country,” the doctors’ group declared. Research, the association argued, could help scientists figure out how to reduce the number of gun-related deaths — more than 33,000 per year. But America doesn’t make researching gun violence easy (SN: 5/14/16). Federal laws limit funding and keep some gun data hidden from the public. There’s no “ban” on gun research — technically — though some scientists argue that one law does essentially just that. Called the Dickey amendment, it prevents the U.S. Centers for Disease Control and Prevention and the National Institutes of Health from using funds to “advocate or promote gun control.” A second law, called the Tiahrt amendment, limits sharing of gun-crime data. Only law enforcement, not the public, can access the detailed data about gun crimes collected by the Bureau of Alcohol, Tobacco, Firearms and Explosives. Researchers do have some data to work with — it’s just not all that complete. The National Violent Death Reporting System, for example, tracks deaths by guns, but in only 32 states. In December, the Senate passed the Mental Health Awareness and Improvement Act, which encouraged inclusion of more states. Participation would be voluntary. “Without research and being brave enough to ask the questions, we’re going to have ill-informed, emotional arguments,” American Academy of Family Physicians president Wanda Filer told The Hill newspaper in June. “What we’re saying is, we need research.” — Meghan Rosen While Clinton has positioned herself as a proponent of K–12 education, when it comes to STEM — science, technology, engineering and math — she’s been most vocal about needing to boost computer science literacy. Citing more than a half million open jobs in the tech industry, Clinton’s campaign platform pledges to “provide every student in America an opportunity to learn computer science.” (The pledge is based on President Obama’s current “Computer Science for All” initiative.) Clinton also supports creating schools — public and charter — that, in part, provide more opportunities for minority students to study science and technology, she told ScienceDebate.org. To boost interest in STEM fields, she wants to promote partnerships between university research programs and K–12 schools, “makerspaces” (spaces where anyone can create and learn), robotics competitions and online education programs like those offering “nanodegrees” — certifications in specific skills such as machine learning and data analysis. Trump has said little on science education, telling ScienceDebate.org that “there are a host of STEM programs already in existence” and that the federal government should “make sure that educational opportunities are available for everyone.” But the bigger issue, he says, is keeping K–12 education close to home. In January, Trump noted that, if elected president, he planned to reduce funding for the Department of Education, saying that “education should be local and locally managed.” In his campaign platform video on education, Trump called Common Core — a nationally enforced set of standards for reading and math — “a total disaster.” “We are rated 28 in the world,” he said. “The United States, think of it, 28 in the world, and frankly we spend far more per pupil than any other country in the world. By far it’s not even a close second.” In March, Trump indicated that he wanted to have former Republican rival Ben Carson be “very involved with education, something that’s an expertise of his.” Carson, a retired neurosurgeon, has stated that he believes that evolution has “become what is scientifically politically correct” and has mentioned writing a book to refute evolution. He has also dismissed the Big Bang as “ridiculous.” The United States is stuck firmly in the middle of the STEM education pack — 35th in math and 27th in science out of 64 countries, according to the 2012 Program for International Student Assessment. Despite spending 6percent of gross domestic product on education, the numbers of women and minorities also still lag in many STEM fields. Roughly equal numbers of boys and girls completed Advanced Placement tests in calculus and statistics in 2012, and 59 percent of AP biology test-takers were girls. But fields such as computer science (18 percent female) and physics (23 to 35 percent female) showed significant gender gaps. Racial disparities were also apparent. Of AP calculus AB test-takers, 6.1 percent were black and 12.6 percent were Hispanic. In computer science, those percentages dropped to 4.5 and 8.4. Equality in STEM education isn’t just a feel-good issue. Women in science, technology, engineering and math careers earn 33 percent more than those outside of STEM fields — a significant step toward closing the wage gap. And a June 2013 fact sheet on women and girls in STEM from the White House Office of Science and Technology policy notes that STEM skills are increasingly in demand. The economic potential “is enormous,” it notes. “However, the administration can’t be satisfied when more than half the world’s population is not participating in this progress.” — Bethany Brookshire
LeBaron C.,Centers for Disease Control and Prevention |
Atwood L.,American Academy of Family Physicians |
Craigo S.,The American College
Pediatrics | Year: 2012
Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy's 1999 recommendations in this area. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure's benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement. Copyright © 2012 by the American Academy of Pediatrics.
News Article | December 13, 2016
GRAND RAPIDS, Mich.--(BUSINESS WIRE)--Priority Health, one of Michigan’s largest health plans, announced today that James D. Forshee, M.D. has been named the new senior vice president of medical affairs and chief medical officer. Forshee will oversee medical policy and programming, as well as clinical strategies for the organization. “We are delighted to welcome Dr. Forshee,” said Joan Budden, president and chief executive officer of Priority Health. “He is a respected and revered industry veteran, who brings over 25 years of health care experience—both as a physician and executive. He will play a pivotal role in executing our long-term growth strategy and implement innovative tactics to improve patient care.” For the past 11 years, Forshee served as the vice president of medical affairs and chief medical officer for Molina Healthcare of Michigan. Forshee provided clinical leadership for all medical policies, clinical strategies, and medical management health care initiatives including pharmacy, quality improvement and key support for provider networks partnerships. Prior to this, he held executive level positions with United Healthcare, SelectCare, Centene, and Blue Care Network of Michigan. He recently in 2016 was also awarded the Ellis J. Bonner Outstanding Achievement Award by the Michigan Association of Health Plans for his exemplary service, leadership and contributions to the managed care industry and community. Forshee is a member of the State of Michigan Drug Utilization Review, American College of Physician Executives, American Medical Association, Michigan State Medical Society and American Academy of Family Physicians. He earned his medical degree from Michigan State University College of Human Medicine, completed his residency at St. Joseph Hospital in family practice and is board certified in Family Medicine. Forshee also earned a master’s of business administration degree from the University of Michigan, Physician Assistant degree from Trevecca Nazarene University, and his bachelor’s degree from Olivet Nazarene University. Priority Health is an award-winning, Michigan-based non-profit health plan nationally recognized for improving the health and lives of the people it serves. It continues to lead the industry in engaging members in their health, delivering effective health and disease management programs and working with physicians to improve health care outcomes and performance. Priority Health is one of only four health plan nationwide offering wellness programs accredited by the National Committee for Quality Assurance. The State of Michigan named the Priority Health HMO the benchmark plan for all individual and group HMO plans to model. Priority Health offers a broad portfolio of health benefit options for employer groups and individuals, including Medicare and Medicaid plans. Its network of health care providers features 95 percent of practicing physicians available in Michigan and more than 900,000 health care providers nationwide.
News Article | December 15, 2016
WASHINGTON - In response to alarming evidence of high rates of depression and suicide among U.S. health care workers, the National Academy of Medicine is launching a wide-ranging "action collaborative" of multiple organizations to promote clinician well-being and resilience. To date, more than 20 professional and educational organizations have committed to the NAM-led initiative, which will identify priorities and collective efforts to advance evidence-based solutions and promote multidisciplinary approaches that will reverse the trends in clinician stress and ultimately improve patient care and outcomes. "It's disturbing that so many clinicians are stressed out and overwhelmed, but even more so when we consider the impact on patients and society," said National Academy of Medicine President Victor J. Dzau, chair of the initiative. "Addressing this problem will require individual, organizational, and systems-level reform. The NAM is committed to leading this collaborative effort in finding workable solutions that will ultimately benefit us all." Clinician burnout has been linked to increased medical errors and patient dissatisfaction, and recent research has shown that declines in the well-being of health care professionals cut across all ages, stages, and career paths - from trainees to experienced practitioners. As many as 400 physicians commit suicide each year, double the suicide rate of the general U.S. population, according to one study. A survey of more than 6,000 physicians conducted over a three-year period found that they have twice the risk of burnout compared with other professions. And the problem is not unique to physicians - nurses and other clinicians also report high rates of dissatisfaction and stress. For example, a 2007 study found that 24 percent of intensive care nurses and 14 percent of general nurses tested positive for symptoms of post-traumatic stress disorder. "Some organizations have begun work to address clinician burnout on their own, but we know that this is a complex problem that no single solution is going to fix," said co-chair of the initiative Darrell G. Kirch, president of the Association of American Medical Colleges. "The NAM's platform will unite stakeholders from across the country and bring a much-needed multifaceted approach to clinician well-being." "We need to better understand the causes of clinician burnout and depression and advance evidence-based solutions that reverse these troubling trends," added co-chair Thomas J. Nasca, chief executive officer of the Accreditation Council for Graduate Medical Education (ACGME) and of ACGME International. "The ACGME has been fully engaged in this issue and we look forward to collaborating with the NAM to find effective solutions." "The very people who have devoted their lives to keeping others healthy are at great risk of suffering from work-induced burnout," said James L. Madara, executive vice president and chief executive officer of the American Medical Association, a sponsor of the initiative. "Physician well-being must be a top priority in national discussions on patient care." The collaborative will begin work in January 2017; public workshops and meetings will be scheduled throughout the year. For more information or to register to receive updates, visit https:/ . Sponsors currently include the Accreditation Council for Continuing Medical Education, Accreditation Council for Graduate Medical Education, American Academy of Family Physicians, American Academy of Neurology, American Academy of Pediatrics, American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Critical-Care Nurses, American Board of Internal Medicine and the ABIM Foundation, American Board of Medical Specialties, American College of Emergency Physicians, American College of Physicians, American College of Surgeons, American Congress of Obstetricians and Gynecologists, American Hospital Association, American Medical Association, American Nurses Association, American Society of Anesthesiologists, Association of American Medical Colleges, Council of Medical Specialty Societies, CRICO, Federation of State Medical Boards, Society for Academic Emergency Medicine and Association of Academic Chairs of Emergency Medicine, Society of Neurological Surgeons, and UAB Medicine. Established originally as the Institute of Medicine in 1970 by the National Academy of Sciences, the National Academy of Medicine addresses critical issues in health, science, medicine, and related policy and inspires positive actions across sectors. The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. The Academies operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln. For more information, visit http://national-academies. .
Heim L.,American Academy of Family Physicians
Annals of Family Medicine | Year: 2010
The new Consumer Alliance agreement between the American Academy of Family Physicians (AAFP) and The Coca-Cola Company provides a valuable opportunity to illustrate AAFP's adherence to its ethical foundation, demonstrate the AAFP's commitment to serving physicians and the public, and maintain the trust Americans put in their family physicians and the organization that represents them. Throughout the development of this program, as well as in all business interactions, the AAFP consistently addresses possible conf ict of interest openly and directly, sharing with our members and the public exactly what measures we take to ensure that, in fact, no unethical conduct or breach of trust would-or will in the future-occur. In this case, the AAFP saw a public health and education need that was both unmet and undermined by the barrage of marketing messages and confusing information, and acted to f ll that need. In so doing, the AAFP hewed to its high ethical standards, its core values, and its mission in the decisions made and the actions that followed.
Biggs W.S.,American Academy of Family Physicians |
Demuth R.H.,Michigan State University
American Family Physician | Year: 2011
Premenstrual syndrome is defined as recurrent moderate psychological and physical symptoms that occur during the luteal phase of menses and resolve with menstruation. It affects 20 to 32 percent of premenopausal women. Women with premenstrual dysphoric disorder experience affective or somatic symptoms that cause severe dysfunction in social or occupational realms. The disorder affects 3 to 8 percent of premenopausal women. Proposed etiologies include increased sensitivity to normal cycling levels of estrogen and progesterone, increased aldosterone and plasma renin activity, and neurotransmitter abnormalities, particularly serotonin. The Daily Record of Severity of Problems is one tool with which women may self-report the presence and severity of premenstrual symptoms that correlate with the criteria for premenstrual dysphoric disorder in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision. Symptom relief is the goal for treatment of premenstrual syndrome and premenstrual dysphoric disorder. There is limited evidence to support the use of calcium, vitamin D, and vitamin B 6 supplementation, and insufficient evidence to support cognitive behavior therapy. Serotonergic antidepressants (citalopram, escitalopram, fluoxetine, sertraline, venlafaxine) are first-line pharmacologic therapy. © 2011 American Academy of Family Physicians.
Bird G.C.,American Academy of Family Physicians
Journal of Continuing Education in the Health Professions | Year: 2013
Introduction: Primary care in the United States faces unprecedented challenges from an aging population and the accompanying prevalence of chronic disease. In response, continuing medical education (CME) initiatives have begun to adopt the principles of performance improvement (PI) into their design, although currently there is a dearth of evidence from national initiatives supporting the effectiveness of this methodology. The specific aim of this study was to demonstrate the value of a national PI-CME activity to improve the performance of physicians treating patients with diabetes. Methods: We analyzed data from the American Academy of Family Physicians' METRIC® PI-CME activity in a cohort of family physician learners. The study utilized the 3-stage design standard approved for PI-CME. Baseline and follow-up performance data across a range of clinical and systems-based measures were compared in aggregate. Results: Data were assessed for 509 learners who completed the activity. Statistically significant changes occurred both for self-assessment of a range of practice aspects and for diabetes care measures. Learners recognized that the organization of their practices had improved, and mechanisms were in place for better staff feedback, as well as aspects of patient self-management. Based on the clinical data obtained from 11 538 patient charts, 6 out of 8 diabetes measures were significantly improved. Discussion: The activity appears to have had a positive, measurable impact on the medical practice of learners and suggests that, when appropriately designed and executed, PI-CME on a national scale can be a useful vehicle to influence performance change in physicians and to inform future CME activities. © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.
American Academy Of Family Physicians | Date: 2017-01-20
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