AAFP Compiles Resources for Physicians in Aftermath of Terrorist Attacks

The horrific terrorist attacks on September 11 changed the world forever. In their wake, many family physicians will need to help patients and their families as they cope with the aftereffects of these traumatic events—and the American Academy of Family Physicians (AAFP) has pulled together links to resources that can help. The resources include clinical materials about diagnosing and treating post-traumatic stress disorder, as well as materials that family physicians can use when talking with patients, parents and their own loved ones about these traumatic events. To access the links to these resources, visithttps://www.aafp.org/resources.

Endocrinology Groups Announce New Diabetes Guidelines

The American College of Endocrinology (ACE) and the American Association of Clinical Endocrinology (AACE) recently announced their recommendations for new guidelines in the management and screening of diabetes at the first-ever ACE Diabetes Mellitus Consensus Conference. The consensus recommendations include: (1) lowering the age of diabetes screening from 45 years to 30 years for high-risk patients; (2) lowering the target glycosylated hemoglobin A_1c (HbA_1c) level from 8.0 to 6.5 percent; and (3) lowering target levels of blood sugar to 110 before eating (preprandial) and to 140 after eating (two hours postprandial). The new guidelines are in response to figures from the Centers for Disease Control and Prevention (CDC) that showed a 76 percent increase in the prevalence of diabetes in persons 30 to 39 years of age between 1990 and 1998. For more information on these guidelines, visithttp://www.aace.com. The U.S. Preventive Services Task Force (USPSTF) and the AAFP do not recommend screening asymptomatic persons for diabetes and recommend that target HbA_1c levels be individualized. The USPSTF recommendations can be found on the Web athttp://www.ahrq.gov/clinic/uspstf/uspsdiab.htm, and the AAFP's policy on the benefits and risk of glycemic control in type 2 diabetes is available athttps://www.aafp.org/clinical/diabetes.

Performance-Enhancing Supplement Use Is Increasing Among U.S. Youth

Results of a nationally representative survey by the Blue Cross and Blue Shield Association's (BCBSA) Healthy Competition Foundation indicate that approximately 1 million adolescents between the ages of 12 and 17 years have taken potentially dangerous performance-enhancing supplements and drugs, even though 96 percent of the youth surveyed recognized the potential health damage associated with these supplements. Based on projections from the survey results, 390,000 (2 percent) of 10- to 14-year-olds have taken performance-enhancing substances compared with results from a similar BCBSA survey in 1999 that had no respondents below the age of 14 years indicate that they had taken supplements. The most common substances being used were creatine (57 percent of respondents) and steroids (31 percent of respondents). For more information, visit the Foundation's Web site athttp://www.healthycompetition.org.

HRSA Provides New Tool for Improving Cultural Competency

The Health Resources and Services Administration (HRSA) released a new tool to assist health care professionals in becoming more culturally and linguistically competent when providing health care to individuals and families from diverse backgrounds. The publication, called Cultural Competence Works, profiles various practices that provide culturally competent care and the strategies they use. These strategies for practicing cultural competence (defined as the set of behaviors, attitudes, skills and policies that enable organizations and health care staff to work effectively with people of diverse cultures) can expand and improve access to quality health care. For a complete copy of the report, contact the HRSA Information Center at 888-ASK-HRSA (888–275–4772) or visit the HRSA Web site athttp://www.hrsa.gov.

Two Organizations Will Conduct First Major Trial of Digital Mammography

The National Cancer Institute (NCI) and the American College of Radiology Imaging Network (ACRIN) recently launched the Digital Mammographic Imaging Screening Trial (DMIST), the first large, multicenter study to compare digital mammography to standard film mammography for the screening and detection of breast cancer. The investigators plan to recruit 49,500 women from 19 institutions in the United States and Canada over an 18-month period for the study. Women who volunteer will enter the trial at the time of their regular screening mammogram, and will then be followed for several years after receiving both digital and conventional mammograms. The study will open for enrollment Monday, October 15, 2001. The total cost of the digital mammography trial will be $26.3 million. Investigators believe one possible advantage of digital mammography is that it provides an improved contrast resolution that may make it more effective in detecting cancers in women with dense breast tissue. Also, two smaller studies have indicated that digital mammography may result in fewer women being called back for workup of suspicious breast lesions. A list of participating institutions and contact information is available at the DMIST Web site athttp://www.dmist.org.

NHLBI Campaign Promotes Adequate Sleep in Children

The National Heart, Lung, and Blood Institute (NHLBI) is launching a five-year educational initiative, titled Sleep Well. Do Well. Star Sleeper Campaign, to promote the concept that adequate nighttime sleep (at least nine hours of restful sleep each night) is vital to children's health, safety, success in school activities, sports, extracurricular activities and will help improve relationships with family and friends. The campaign will target small children and their parents, teachers and physicians, and will feature the cartoon character Garfield as its “Star Sleeper” and ” spokescat.“ Major components of the campaign include educational materials and promotional items. Organizations that have agreed to be part of the campaign include the National Association of Elementary School Principals, the American Academy of Pediatrics, the American Academy of Sleep Medicine, and the Capital Children's Museum. An interactive online version and other sleep education materials are available on the Web athttp://starsleep.nhlbi.nih.gov.