The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health (NIH), has launched a multicultural outreach initiative to raise awareness about the availability of NIH and other Federal resources to help people with diseases and conditions of the bones, joints, muscles and skin. NIAMS is a reliable resource for patients, family members, health professionals, and others in search of meaningful, relevant and science-based health information about bones, joints, muscles and skin. The initiative also aims to emphasize research as the foundation for progress, and to support and involve organizations in multicultural outreach. Through the Initiative, NIAMS is working with national partners to develop and disseminate culturally appropriate messages and materials in the areas of bones, joints, muscles and skin for racial, ethnic and underserved populations.

NIAMS has created a series of health planners—titled A Year of Health—that provide health tips and information about staying healthy and managing conditions of the bones, joints, muscles and skin. The four planners, created with community input, are tailored for the following audiences:

• African Americans
• American Indians/Alaska Natives/Native Hawaiians
• Asian Americans/Pacific Islanders
• Hispanics/Latinos (bilingual planner)

Additionally, to support your library’s outreach efforts, NIAMS has created an electronic toolkit to help you and your organization prepare your planner distribution strategies. The materials include:

• Resources for conducting outreach
• Electronic versions of the four health planners
• A sticker template to customize the planners with your organization’s contact information
• An image gallery of multicultural photos to tailor materials for your organization’s community

To order A Year of Health planners, call the NIAMS toll free at 877–226–4267 (TTY: 301–565–2966) or email at NIAMSinfo@mail.nih.gov. Orders are limited to addresses in the United States and its territories.

In December, 2012, NLM’s Division of Specialized Information Services (SIS) released a major update for the Radiation Emergency Medical Management (REMM) tool. REMM provides guidance for health care providers about the clinical diagnosis and treatment of radiation injury during radiological or nuclear emergencies. It is web-based, but also downloadable to your Windows or Mac, and key information is also available on the mobile apps for Android, iPhone/iPod Touch/iPad & BlackBerry. Key changes are noted below. Many more updates and changes appear throughout REMM. You are strongly encouraged to update any versions of REMM you have previously downloaded to your computer, USB drive, or mobile device.

1. Creation of REMM Multimedia Library
   • Display of REMM multimedia items in carousel format
   • Items accessible by content category
   • New videos, illustrations, pictures, tables
2. REMM YouTube channel: 4 new videos uploaded
3. Improved REMM bibliography
   • New table of contents improves access to listings
   • Many new references and topics
4. Updated Prototype for Medical Orders
   • Now includes Pediatric information
   • Updated information in many sections, including use of anti-microbial drugs
5. New sections for “Other Audiences”
   • Senior Leaders
   • Legal advisors
   • Radiation Safety Officers
   • Public Health Officers
6. Updates to key pages
   • Nuclear Detonation: Weapons, INDs
   • Transportation Incidents
   • Triage Guidelines
   • Planners: Preparedness and Response
   • What is exposure?
   • What is contamination?
   • Emergency Contacts
7. Print output from Dose Estimator for Lymphocyte Depletion Kinetics and Time to Onset of Vomiting
8. Improved right navigation panel for accessing key items

New Features on Mobile REMM

1. Interactive tool for radiation unit conversions, e.g. curie to becquerel, rad to gray
2. Updates to Emergency Contacts

The National Library of Medicine has released Discovering the Connection: Your Environment, Your Health, an after school science club curriculum for middle school students. The curriculum combines research on the Tox Town web site with hands-on experiments and communication, including social action activities. The objective is to introduce middle school students to environmental health issues in their everyday life, emphasizing the relevance of science to informed citizenship. The curriculum lessons can also be used to support the existing middle school science curriculum, as well as to reinforce the science/society connection in the social science or language arts classroom.

The curriculum was developed as a collaboration between the NLM, the University of Maryland College of Education, and an inter-disciplinary group of middle school teachers. It is based on National Science Education Standards, and is grounded in a problem-based learning approach that promotes in-depth understanding and critical thinking. The curriculum contains six units; each of which introduces one environmental health topic, and includes three to four 50-60 minute lessons. The units include: 1) Water Quality; 2) Air Quality; 3) Chemicals in Your Home; 4) Food Safety; 5) Runoff, Impervious Surfaces, and Smart Development; and 6) The Great Debate: Bottled Water vs. Tap Water in Our School.

The National Library of Medicine (NLM) Specialized Information Services (SIS) has released Especially for Toxicologists, a guide to NLM resources on environmental health, toxicology, and chemical information for toxicologists. Also announced is a new Enviro-Health Links page, Laboratory Safety, which offers links to information for clinical, academic and school laboratories, including resources for handling chemical, biological and nanotechnology safely. Also included are links to regulations and policy, hazard analysis, MSDS, waste management, and pre-formulated TOXNET and PubMed searches.

Other Enviro-Health Links available include Developing and Using Medicines for Children; Education, Careers, and Outreach in Toxicology and Environmental Health; Lead and Human Health; Mercury and Human Health; and Water Pollution.

The usage of “digital volunteers” during disasters is growing in popularity, allowing volunteers with computer and information skills to participate from outside the affected region in supporting disaster response and recovery. One example of this effort is CrisisCamps, which bring together volunteers in information management, and web design and coding, to work on projects identified by federal and state agencies in response to specific events. In the aftermath of Hurricane Sandy, there are CrisisCamps occurring in various locations, including San Francisco. Find out if your area is hosting a CrisisCamp and how to volunteer! Virtual Operations Support Groups, also known as Virtual Operations Support Teams (VOST), are groups that make use of technology and social media tools to provide support to those at the scene of a disaster. VOSTs are activated to perform specific functions in support of affected organizations and jurisdictions. The web site includes a list of active teams in the US. The Standby Task Force is an international digital volunteer platform that uses an open source model for digital volunteering, with a specific focus on crisis mapping. The Red Cross Disaster Digital Volunteer training program includes the use of Radian6 Engagement Console software, and other necessary online platforms to monitor social media and news sources, in order to assist the Red Cross in its response efforts.

Public Comment Open through November 6, 2012.

Participate in the Healthy People 2020 process! The public comment period is now open. Comments will be accepted through 5:00 PM EST on November 6, 2012.
You will be able to:

• Comment on proposed new objectives to be added to the Educational and Community-Based Programs and Social Determinants of Health Topic Areas; and
• Propose new objectives to be included in 1 of the 42 existing Healthy People 2020 Topic Areas, including Healthcare-Associated Infections.

To participate, visit the online public comment database.

The National Library of Medicine, in collaboration with the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS), has launched the NLM Value Set Authority Center (VSAC). The VSAC provides downloadable access to all official versions of vocabulary value sets contained in the 2014 Clinical Quality Measures. The value sets provide lists of the numerical values and individual names from standard vocabularies used to define the clinical concepts, e.g., diabetes or clinical visit, used in the quality measures. The content of the VSAC will gradually expand to incorporate value sets for other use cases, as well as for new measures and updates to existing measures. Access to the Value Set Authority Center requires a free Unified Medical Language System Metathesaurus License. NLM also provides the Data Element Catalog that identifies data element names (value set names) required for capture in Electronic Health Record (EHR) technology, certified under the 2014 Edition of the ONC Standards and Certification Criteria.

The Guide for Reading Eligible Professional and Eligible Hospital 2014 eCQMs, published by CMS, provides guidance for understanding and using the electronically specified eligible professional (EP) and eligible hospital (EH) clinical quality measures (“eMeasures”). CMS has also provided the following release notes with updated program requirements related to the eCQMs, and global changes incorporated across all measures, as well as specific changes to the measures retained in the 2014 eCQMs; Clinical Quality Measures for CMS’s 2014 EHR Incentive Program for Eligible Professionals and Clinical Quality Measures for CMS’s 2014 EHR Incentive Program for Eligible Hospitals. CMS has also published the 2014 Clinical Quality Measures Tipsheet, which includes an overview of the CQMs, including the number of measures eligible professionals (EPs) and eligible hospitals (EHs) must report, CQM reporting options, and reporting and submission periods. For questions about these resources, contact the NLM Value Set Authority Center Help site.

Increasing evidence suggests that there are benefits to actively involving patients and consumers in their health care. There is also growing interest in engaging patients and consumers more actively in the research process. Comparative effectiveness research (CER), patient-centered outcomes research (PCOR), and quality improvement (QI) all offer opportunities to engage patients in generating information that can be used to inform treatment decisions. A new seven-page resource, based on work conducted by AcademyHealth under the auspices of the Electronic Data Methods (EDM) Forum, and developed in coordination with patients, consumers, and health services researchers, outlines key opportunities for engagement in research, and proposes a set of activities to enable patients and consumers to become more active participants in the process of evidence generation. A Framework for Patient and Consumer Engagement in Evidence Generation is now available for download to an iPad through the iTunes app store. This publication can only be viewed using iBooks 2 or later on an iPad with iOS5 or later.

The Electronic Data Methods (EDM) Forum operates on a three-year grant from the Agency for Healthcare Research and Quality (AHRQ), to facilitate learning and foster collaboration across a set of CER projects, designed to build infrastructure and methods for collecting and analyzing prospective electronic clinical data. To ensure EDM Forum activities address a full spectrum of research needs, the EDM Forum seeks to obtain perspectives from a broad array of stakeholders, by encouraging an open and ongoing dialogue on their web site.

Do you wonder if droughts are related to climate change? If so, please consider visiting Tox Town’s newly released Drought Location page. Information is provided on why drought is a concern, how it relates to climate change, and possible health affects related to drought. The page is also available in Spanish, Sequía.

The best known U.S. drought was the Dust Bowl drought of the 1930s, when 65% percent of the country was affected by severe or extreme drought. In the summer of 2012, 55% of the continental United States experienced moderate to extreme drought, which was the largest such area since 1956.

The National Library of Medicine is developing and testing several new technologies which may help transform the way hospitals keep track of patients during emergencies. The People Locator and the Patient Tracking and Locating System are research projects being conducted as part of the public-private Bethesda Hospitals’ Emergency Preparedness Partnership (BHEPP). The People Locator, which is part of the Lost Person Finder, is an online “lost and found” Web site, that can include a person’s name, gender, age, health condition, and any available photo, to assist family members, emergency officials, and others during a disaster search. The Patient Tracking and Locating System, produced by NLM’s Office of Computer and Communications Systems (OCCS), consists of a commercial digital pen that captures patient information via a tiny camera, and tracking of disaster patients and equipment with radio frequency identification (RFID) tags in a real-time location system (RTLS). This system would allow broadcasting of patient location and condition to care providers at a central location, and a software application devised by the OCCS could be used to transfer patient records electronically between hospitals.

The BHEPP formed in 2004, to develop a coordinated disaster response model for hospitals across the country. BHEPP partners include the NLM and three nearby hospitals; the National Institutes of Health (NIH) Clinical Center, Walter Reed National Military Medical Center, and Suburban Hospital Johns Hopkins Medicine, a non-profit community-based hospital in Bethesda, MD. In addition, NLM’s Disaster Information Management Research Center (DIMRC) also has projects under development, including the Military Affiliate Radio System (MARS), a back-up communications system for hospital emergency operations centers, and the Hospital Incident Command Center, a responder training research project that uses “virtual world” technologies. Further details about these projects are available in the NLM in Focus newsletter.