E-News

Please send items of interest for the E-News -- and any other feedback -- to E-News editor Dave Cundiff, MD, MPH. Thanks!

The 2005-06-18 minutes to be approved are in the December 2005 AAPHP Bulletin , now available online as a 1-MB PDF file at http://www.aaphp.org/Bulletins/bulletin05dec.pdf . An interim Treasurer's Report (as of mid-November 2005) is also in this issue of the AAPHP Bulletin . The Bulletin also has reports on AAPHP's House of Delegates, Health Care Disparities, and CPT activities.

*** AGENDA ITEM #4 (ACTION REQUIRED) ***

Board members on the 2005-11-14 Board conference call generally favored a $10/year increase in Active and Retired dues from 2005 to 2006. All Board members favored continuation of the free memberships for medical students and residents for 2006 and 2007. We are still in conversations about 2006 member benefits. The recommendations of the Officers and Board will be shared at the 2005-12-11 meeting, where members will have the final say about 2006 dues levels.

*** AGENDA ITEM #6 (ACTION REQUESTED) ***

A new Associate Membership Category has been proposed by the Chair of our Bylaws Committee, Dr. KEVIN SHERIN, following discussion and e mail exchanges among officers of the AAPHP:

If approved at the December 11, 2005 Membership meeting in Philadelphia, the following edited language will be added to: Article III-A, Eligibility for Dues Paid Membership, by Category.

A new item #7 will replace the current item #7, (which will then become #8)

" 7. Associate: A person without a license to practice medicine and surgery in the United States, a non physician, or a non medical student who does not meet criterion for other dues paying membership categories. Associate members receive AAPHP publications and may attend AAPHP General Membership meetings and CME meetings. Associate members will pay annual membership dues approved in accordance with Article X, B, will have no vote and may not hold any Officer or a Board of Trustees position. At the President's discretion, an Associate member may be appointed as a non-voting member of an AAPHP Committee."

This proposal, if approved, would create a non-voting membership for those who would like to support AAPHP and benefit from its work. Some of our friends who may be interested include physicians who have let their licenses lapse because they no longer expect to do work that legally requires a license; international physicians; physician assistants; public health administrators; and others.

Please send comments about this proposal, or any other agenda items, to the Secretary at cundiff@reachone.com before the meeting.

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2) Core Disaster Life Support Course (CDLS) Update:

About 75 people have registered for the AMA's Core Disaster Life Support course (CDLS), to be held Sunday 2005-12-11 from 2:30 pm to 6:30 pm at the Marriott Philadelphia Downtown Hotel, International Ballroom, Salon I.

Thanks to those who pre-registered. This has reserved you a place and materials, if you arrive at the room promptly by 2:30 pm on Sunday. Your pre-registration also helped AAPHP and our partners to estimate the total attendance and to order materials for everyone.

Pre-registration will continue through this week. Please contact the AAPHP Secretary at cundiff@reachone.com for registration information and forms. "Walk-in" participants will be accommodated if space and materials permit.

CDLS training has been made possible not just by the in-kind support of the three sponsoring organizations (AAPHP, APHA, and AMA), but also by support from the Joint Center for Political and Economic Studies in Washington DC. AAPHP joins our partners in thanking the Joint Center for this generous support.

From the Joint Center's Web site: "The Joint Center for Political and Economic Studies is a national, nonprofit research and public policy institution. Founded in 1970 by black intellectuals and professionals to provide training and technical assistance to newly elected black officials, the Joint Center is recognized today as one of the nation's premier think tanks on a broad range of public policy issues of concern to African Americans and other communities of color." More information on the Joint Center for Political and Economic Studies is available at http://www.jointcenter.org .

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3) Influenza Update:

A letter from Olsen et al, in the November 2005 issue of Emerging Infectious Diseases , discusses family clusters of highly pathogenic avian influenza H5N1 (HPAI H5N1) in Southeast Asia.

These clusters account for more than one-third of reported human HPAI H5N1 cases. The proportion of clusters to single cases has not changed significantly. This is one indication that the HPAI H5N1 virus has not mutated to become more transmissible. Epidemiologists are monitoring factors such as clustering and case-fatality rates wherever human HPAI H5N1 is reported. They believe that these epidemiologic findings may be our earliest signal of dangerous mutations.

This letter from Olsen and colleagues is on the Web at http://www.cdc.gov/ncidod/EID/vol11no11/05-0646.htm .

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Scott F. Dowell, MD, MPH, director of CDC's Global Disease Detection unit and one of the co-authors of Dr. Olsen's letter, spoke on "Avian Influenza" at CDC's Clinician Outreach and Communication Activity (COCA) 90-minute conference call today. PowerPoint slides for the call are now available at http://www.bt.cdc.gov/coca/callsummary.asp .

Mathematical models of possible, more virulent strains suggest that an early epidemic can be controlled. Sensitivity analysis using these models has been done. The most important variables appear to be the speed with which an early mutation is found, and the speed with which local disease control measures are instituted.

This call was recorded. The recording will be available by toll-free number at (800) 819-5743 until 2005-12-13.

***

On 2005-11-07 the CDC released "FluSurge 2.0", an Excel spreadsheet designed to project the impact of an influenza epidemic on hospitals. This version allows users to alter several of the modeling assumptions, in order to examine a variety of epidemic scenarios.

In a succinct commentary in the 2005-12-01 CBN Weekly Bulletin , public health physician Eric Toner, MD, from the University of Pittsburgh Clinicians' Biosecurity Network (CBN), notes that in several resource categories, the need for epidemic-related hospital resources could substantially exceed the resources of the entire U.S. health care system. Spreadsheets won't close that gap. We need to prepare to think in new ways about health care.

CDC's FluSurge 2.0 spreadsheet and user's manual are available at http://www.cdc.gov/flu/flusurge.htm . The CBN Weekly Bulletin is available at http://www.upmc-cbn.org/dmz/index.html?whereto=%2F . The current issue of CBN Weekly Bulletin is displayed publicly; archived CBN publications require free registration.

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The new Federal plan for pandemic influenza surveillance and response are at http://www.pandemicflu.gov . State and local health departments say that the new plan is an improvement over prior pandemic plans, but that the plan seems to have unrealistically low levels of Federal support for state and local government.

The Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO) released similar responses to the Federal plan on 2005-11-02. The ASTHO statement is at http://www.astho.org/templates/display_pub.php?u=JnB1Yl9pZD0xNzQ1 and the NACCHO statement is at http://www.naccho.org/documents/NACCHOPandemicFluPlanResponseNov2005.pdf .

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Indonesia, with a lot of backyard poultry farming, is attempting to develop an animal health surveillance system to track and control avian flu. The Indonesian government faces many financial and logistical challenges in this work. Africa may see even greater difficulty in coping with the agricultural and nutritional crisis of avian influenza.

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4) Pakistan Earthquake Still a Public Health Crisis:

Hundreds of thousands of earthquake victims remain in remote villages since the earthquake two months ago. The nearby cities are stressed. The lethal combination of malnutrition and measles has begun to appear.

World Health Organization staff are conducting emergency vaccination campaigns. World Food Program authorities have called for funds to maintain airlifts through the winter.

This morning's NPR report, and an interview with Doctors Without Borders mission head Nick Lawson, are available at http://www.npr.org/templates/story/story.php?storyId=5040464 . The World Health Organization earthquake response site at http://www.who.int/hac/crises/international/pakistan_earthquake/en/index.html is updated periodically. The World Food Program site at http://www.wfp.org/english/ includes an appeal for funds; click on "Winter Food Aid for Quake Victims" for more details.

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5) MCH Potpourri - Recess, Methamphetamine, Periodontal Care:

"Schools Cut Recess To Cram For Tests", according to an article in The Oregonian (Portland, Oregon's daily newspaper) on 2005-12-02. Another example of America's neglect of physical activity? Maybe not. Teachers are finding time-efficient ways to keep children's bodies moving with "power walks" and "brain breaks".

The full story is in the newspaper's ad-supported 14-day archive at http://www.oregonlive.com/search/index/ssf?/base/front_page/1133495724263660.xml?oregonian?fpfp&coll=7&thispage=1. If that link doesn't work for you, try the home page at http://www.oregonlive.com with the search phrase "Schools Cut Recess".

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A recent report said that methamphetamine-using parents are now involved in more than half the Child Protective Service (CPS) placements in Oregon. (Radio reports on KWSO, Warm Springs OR, 2005-12-01 and 2005-12-02)

I couldn't find that statistic on-line, but I found other interesting and useful methamphetamine-related sites.

The federal Administration for Children and Families has information about "Impact of Methamphetamines on the Child Welfare System" at http://nccanch.acf.hhs.gov/topics/issues/meth.cfm .

In October 2004, The Oregonian published a special report on methamphetamine, "The Unnecessary Epidemic". Reporters noted dramatic decreases in addiction, crime, and treatment demand when methamphetamine precursors are regulated. The decrease in methamphetamine is seen in all parts of the methamphetamine industry, but especially in the big labs that make the bulk of America's methamphetamine. Regulation of source compounds has been mostly ineffective, largely due to drug industry lobbying. An isomer of pseudoephedrine seems to be a better decongestant than the one we use now. When turned into isomeric methamphetamine, it doesn't produce a "high". However, with few prospects for competitive advantage, the patent holder hasn't pursued approval of the safer isomer. The full series is still on-line at http://www.oregonlive.com/special/oregonian/meth/ .

[Editor's Note: With news reports like this and with public health and law enforcement advocacy, we're seeing tighter regulation of methamphetamine precursors in 2005 in Oregon and in Washington State.]

In some parts of rural Minnesota, judges estimate up to 80% of their child protection caseload is methamphetamine-related. One recent story on this is at http://news.yahoo.com/s/ap/20051206/ap_on_he_me/methamphetamine_children .

The U.S. Department of Justice has supported the "National Alliance for Drug Endangered Children" in developing a Web site that focuses on the needs of children removed from methamphetamine-abusing caregivers. This site is at http://www.nationaldec.org/ .

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A randomized controlled study from Chile, recently published in the Journal of Periodontology , adds to the evidence that dental treatment makes a difference in pregnancy outcome. Pregnant women with gingivitis were randomized to receive periodontal treatment (plaque control, scaling, and daily rinsing with 0.12% chlorhexidine) before or after delivery. The incidence of preterm or low-birth-weight delivery (PT/LBW) was 2.1% in the treatment group and 6.7% in the control group. After adjusting for differences in other PT/LBW risk factors, the odds ratio for PT/LBW was still 2.76 (p=0.008, 95% confidence intervals 1.29 to 5.88). The abstract of this study is freely available on the Web at

http://www.joponline.org/doi/abs/10.1902/jop.2005.76.11-S.2144 . Subscription is required to see the full article.

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6) Land Use, Community Planning, and Physical Activity:

The fifth annual conference on "New Partners for Smart Growth: Building Safe, Healthy, and Livable Communities" is scheduled for January 26-28, 2006, in Denver, Colorado.

The conference is co-sponsored by Pennsylvania State University and by the Local Government Commission (LGC). The LGC is based in Sacramento, California, and relates primarily to that state. The LGC advocates and provides resources for local officials trying to achieve community goals -- such as resource conservation and the promotion of physical activity -- through land use planning and other local efforts.

More information on the "Smart Growth" conference is at http://www.outreach.psu.edu/programs/smartgrowth . The LGC web site is at http://www.lgc.org .

***

The American Public Health Association (APHA) sponsors an annual "National Public Health Week" (NPHW) in early April. The 2006 NPHW will focus on "Designing Healthy Communities: Raising Healthy Kids". APHA will use this week to educate professionals and the public about "the relationship between the built environment and the health and safety of children", and will "promote solutions to improve children's health."

The Web site for NPHW 2006 will be available in December. (As of 2005-12-06, the site is still advertising NPHW 2005.) Comments and questions can be sent to nphw@apha.org anytime.

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7) Call for Resources - Public Health Distance Learning:

For a future article about Public Health Distance Learning, please E-mail the editor ( cundiff@reachone.com ) with information about distance learning that you offer, or that you have found useful, for dispersed public health practitioners. This may include Public Health Grand Rounds series, distance-learning degree programs, and other continuing education.

AAPHP members are particularly interested in affordable sources of high-quality Category 1 continuing medical education (CME).

Thanks!

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8) Member Update:

Thanks to Nila Desai, MD, MPH; Karen Furst, MD, MPH; Madison W. Gay, MD; Steven Hale, MD; Eric Henley, MD, MPH; Heidar Heshmati, MD, MPH, PhD; Raam G. Hirlekar, MD; Randall M. Johnson, MD, MPH; Laura H. Kahn, MD, MPH, MPP; Aladin M. Mariano, MD; Lourdes Monsod, MD; Van M. Nguyen, MD; Thomas R. Prince, MD; Richard Solero, MD; and Tung M. Tran, MD, for joining or renewing AAPHP membership since the last E-News update.

AAPHP's 2006 membership form is available at http://www.aaphp.org/Membership/2006MembershipForm.pdf . Medical students and residents (in any specialty) may join AAPHP without charge for 2006 and 2007. Other physicians may join or renew at the 2005 dues level until 2005-12-15.

A previous membership form showed AAPHP's address without a suite number, and with an incorrect Zip code. We were recently notified that some mail with the incomplete address may not have been delivered. If you have sent AAPHP a membership application and have not been acknowledged in Member Update, please send inquiry to the Secretary ( cundiff@reachone.com ) and/or to the Membership Director. We apologize for any inconvenience.

9) Acknowledgements:

In addition to sources cited above, AAPHP thanks the ProMED-Mail service of the International Society for Infectious Diseases ( http://www.promedmail.org ) for much of this week's material on avian influenza. Thanks to the Association of State and Territorial Health Officers ( http://www.astho.org ) for circulating news about periodontal treatment in pregnancy (Primary Care and Prevention Network News) and on the "Smart Growth" conference (Environmental Health newsletter). We got information on the 2006 National Public Health Week from the American Public Health Association ( http://www.apha.org ).

This AAPHP E-News issue will be sent by E-mail to 355 subscribing physicians and medical students. Those of you who forwarded the E-News to colleagues have made this increase in circulation possible. Thank you.

Dave Cundiff, MD, MPH ( cundiff@reachone.com )

AAPHP Secretary and E-News Editor

************ About AAPHP E-News ************

This message is an electronic update from the American Association of Public Health Physicians (AAPHP) to public health physicians.
More information about AAPHP is at http://www.aaphp.org.

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