“Of the 22 major occupational groups, employment in health-care support occupations is expected to grow most rapidly (34.5 percent), followed by personal care and services occupations (26.8 percent), and healthcare practitioners and technical occupations (25.9 percent),” the agency said Friday.

Overall, employment is projected to grow by 14.3 percent over this decade, resulting in 20.5 million new jobs.

Of these, health care and social assistance sector is projected to gain the most jobs (5.6 million).

Professional and business service employment will see smaller gains (3.8 million new jobs) as will construction (1.8 million).

The increase in health and personal care services will generate jobs for an estimated 712,000 registered nurses, 706,000 home health aides, and 607,00 personal care aides.

To learn more:

• Go to the summary (which has links to the full report).

In an interview with LocalHealthGuide, the school’s dean, Dr. Howard Frumkin, said a new strategic plan was needed to enable the school to meet the “very big, cross-cutting challenges facing public health,” ranging from the rise of new technologies, such as genomics, to looming global problems, such as climate change.

The document, University of Washington School of Public Health: Strategic Plan 2012-2020, is the result of a nearly year-long process that involved discussions involving the school’s faculty, staff, students and other stakeholders.

“We began with a focus on big, bold, new ideas that would orient us to next few decades of public health challenges,” Dr. Frumkin said, “But what emerged over time was a concern that by focusing on those big, emerging challenges we would neglect the enormous strengths that we already have.”

A major concern, Dr. Frumkin said, was that at a time when state funding for higher education is being slashed and federal funding is leveling off the school’s core programs could be undermined if ambitious new programs began to draw on diminishing resources.

To address those concerns, Dr. Frumkin said, the plan takes a two-pronged approach that aims to strengthen the school’s “core” teaching, research and service programs while also moving to address the new challenges of the coming decades.

In the end, “we came to a very robust consensus on a balance between our existing assets and the new directions in which we want to move,” Dr. Frumkin said.

Seven goals to strengthen the school’s core programs

• Strengthen Teaching

• Strengthen Research

• Strengthen Collaborations with Community Partners

• Globalize the School

• Improve Diversity

• Enhance School Community

• Promote the School

Although the school’s core teaching program is already very strong, Dr. Frumkin said, more needs to be done to incorporate new science into the curriculum and develop the cross-disciplinary approaches that will be needed to address the “upstream” issues that affect health, Dr. Frumkin said.

“Improving health means you have to have a broad, collaborative, interdisciplinary approach where public health expertise might, for example, be blended with social work expertise, urban design expertise, educational approaches, and so on,” Dr. Frumkin said. All new courses will in include curricula that include a broader, big picture approach, he said.

UWSPH Fast Facts:

• Founded in 1970

• 1,014 students (76% women, 7% international, 30% minority)

• 208 undergraduates, 806 graduate students

• Faculty: 251 full, 147 adjunct, 476 affiliate & clinical – 874 total

• Departments: Biostatistics, Environmental & Occupational Health Sciences, Epidemiology, Global Health, Health Services

• $130.8 million (69% Federal Grants & Contracts, 15% State & Local Funds, 1% Gifts & Endowments, 14% Foundations, Industry, etc.)

• Ranked sixth in the nation in the 2011 US News and World Report survey of graduate schools of public health, and third among publicly funded schools of public health.

Hitting the ground

Students will also receive more training in practical policy implementation, said Dr. Frumkin. “The employers are telling us that our students are very good at analytics and that they are very good at working with data, but they don’t necessarily have the practical skills, ranging from creating and managing budgets to going to the county commission and making the case for a public health program,” Dr. Frumkin said. “When you hit the ground and begin practicing public health, you have to have a whole set of skills that aren’t really captured by a more academic approach.”

As part of an effort to develop such skills, the school will broaden its collaborations with local agencies and community organizations, especially through the school’s student practicum programs, Dr. Frumkin said.

Such programs and other initiatives will increase the school’s involvement in communities around the state and region, he said.

Bio: Dr. Howard Frumkin

Dr. Frumkin has a special interest in environmental health, climate change and healthy community design.

Before he was appointed dean of the UW School of Public Health in 2010, he served at the U.S. Centers for Disease Control and Prevention (CDC) from 2005-2010, where he was the first director of the National Center for Environmental Health and Agency for Toxic Substances and Disease Registry, and later served as Special Assistant to the CDC Director for Climate Change and Health.

From 1990-2005, Dr. Frumkin was Professor and Chair of Environmental and Occupational Health at Emory University’s Rollins School of Public Health and Professor of Medicine at Emory Medical School.

His research interests include: the public health aspects of the built environment, climate change, energy policy, and nature contact; the toxic effects of chemicals; and environmental health policy.

He has co-edited or co-authored a number of books, including:

• Urban Sprawl and Public Health
• Emerging Illness and Society
• Environmental Health: From Global to Local
• Making Healthy Places

Diversity

Although the school already has a significant number of minority and international students, more can be done to make the school more diverse in culture and outlook, Dr. Frumkin said.

As part of the effort to promote diversity, the school plans to expand its outreach to local high schools, community colleges and other institutions by offering courses and other programs designed to encourage minority students to pursue careers in public health.

“Through such conduits or pipelines, I think we can build pathways through which students from under-represented groups can get into public health and serve their communities,” Frumkin said.

Emerging Challenges

• Global Environmental Change and Human Health

• Genomics and Public Health

• Obesity, Food, Physical Activity, and Health

• Health Policy and Health Systems

• Public Health Implementation Science

• Social Determinants of Health

Emerging Challenges:

The health effects of global environmental change are a particular interest of Dr. Frumkin and he believes the school already is well positioned to become a world leader in the field.

The UW’s Department of Global Health, for example, has already launched a “Climate Change and Global Health” initiative, which is focusing on threats to food and water security due to climate changes, he noted.

The school will also be able to harness the existing expertise of such programs as UW’s Colleges and Schools of Environment, Built Environments and Engineering.

Genomics and public health

The school is also well-placed to become a leader in the application of genetics and genomic science to public health, Dr. Frumkin said, with its Institute for Public Health Genetics and  Center for Genomics & Public Health and the opportunity to collaborate with the researchers at other UW programs, such as the Department of Genome Sciences and the School of Medicine’s Northwest Institute of Genetic Medicine and the Northwest Genomics Center.

Socioeconomic determinants of health

Although listed last, an effort to address the socioeconomic determinants of health will be a important part of the school’s plan to tackle “upstream” problems that directly affect health, such as education, living conditions and access to community services,  Dr. Frumkin said.

“If you’re committed to improving health, you can’t avoid people’s circumstances,” he said. ”We know the poverty is the most accurate predictor of bad health.”

The foundation, which focuses on raising money for breast cancer research and prevention, said it was pulling about $700,000 in breast cancer screening and service grants from the Planned Parenthood Federation of America under a new policy that forbid support for organizations under investigation.

Planned Parenthood is the under investigation that was launched last fall by House Energy and Commerce Investigative Subcommittee Chairman Cliff Stearns, R-Fla.

But Planned Parenthood’s supporters argued the investigation is politically motivated and based on allegations proved to be unsubstantiated.

Komen, they charged, was simply knuckling under to pressure from anti-abortion groups and using the new policy as cover.

Reaction was swift and fierce with abortion-rights supporters denouncing Komen from the floor of Congress to Facebook pages.

In a statement, released today the Komen board for directors said:

We want to apologize to the American public for recent decisions that cast doubt upon our commitment to our mission of saving women’s lives. The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen. We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood. They were not.

Our original desire was to fulfill our fiduciary duty to our donors by not funding grant applications made by organizations under investigation. We will amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.

In a statement released in response to the Komen decision Planned Parenthood said:

In recent weeks, the treasured relationship between the Susan G. Komen for the Cure Foundation and Planned Parenthood has been challenged, and we are now heartened that we can continue to work in partnership toward our shared commitment to breast health for the most underserved women. We are enormously grateful that the Komen Foundation has clarified its grantmaking criteria, and we look forward to continuing our partnership with Komen partners, leaders and volunteers.

Full text of both statements are below:

Full text of today’s statement from Komen:

We want to apologize to the American public for recent decisions that cast doubt upon our commitment to our mission of saving women’s lives. The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen. We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood. They were not.

Our original desire was to fulfill our fiduciary duty to our donors by not funding grant applications made by organizations under investigation. We will amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.

Our only goal for our granting process is to support women and families in the fight against breast cancer. Amending our criteria will ensure that politics has no place in our grant process. We will continue to fund existing grants, including those of Planned Parenthood, and preserve their eligibility to apply for future grants, while maintaining the ability of our affiliates to make funding decisions that meet the needs of their communities.

It is our hope and we believe it is time for everyone involved to pause, slow down and reflect on how grants can most effectively and directly be administered without controversies that hurt the cause of women. We urge everyone who has participated in this conversation across the country over the last few days to help us move past this issue. We do not want our mission marred or affected by politics – anyone’s politics.

Starting this afternoon, we will have calls with our network and key supporters to refocus our attention on our mission and get back to doing our work. We ask for the public’s understanding and patience as we gather our Komen affiliates from around the country to determine how to move forward in the best interests of the women and people we serve.

We extend our deepest thanks for the outpouring of support we have received from so many in the past few days and we sincerely hope that these changes will be welcomed by those who have expressed their concern.

Statement released by Planned Parenthood:

“The outpouring of support for women in need of lifesaving breast cancer screening this week has been astonishing and is a testament to our nation’s compassion and sincerity.

“During the last week, millions spontaneously joined a national conversation about lifesaving breast cancer prevention care and reinforced shared values about access to health care for all. This compassionate outcry in support of those most in need rose above political, ideological, and cultural divides, and will surely be recognized as one of our nation’s better moments during a contentious political time. Planned Parenthood thanks each and every person who has contributed to elevating the importance of breast cancer prevention for so many women in need.

“In recent weeks, the treasured relationship between the Susan G. Komen for the Cure Foundation and Planned Parenthood has been challenged, and we are now heartened that we can continue to work in partnership toward our shared commitment to breast health for the most underserved women. We are enormously grateful that the Komen Foundation has clarified its grantmaking criteria, and we look forward to continuing our partnership with Komen partners, leaders and volunteers. What these past few days have demonstrated is the deep resolve all Americans share in the fight against cancer, and we honor those who are at the helm of this battle.

“Planned Parenthood has been a trusted partner with the Komen Foundation in early cancer detection and prevention services. In particular, Planned Parenthood helps the Komen Foundation reach vulnerable populations — low-income women, African-American women, and Latinas — especially in rural areas and underserved communities where Planned Parenthood health centers are their only source of health care. With Komen Foundation grants, over the past five years, Planned Parenthood health centers provided nearly 170,000 clinical breast exams and more than 6,400 mammogram referrals. With the outpouring of support over the past week, even more women in need will receive lifesaving breast cancer care.”

“Bugs,” the two year old boy said as he pointed to an irritated patch of skin on his face. Mary Leitao looked closer, and although she found no visible insects, she was startled to find colored fibers sprouting from her son’s skin. It was a summer evening in 2001 that would change the lives of the Leitao family for years to come.

A medical researcher turned stay-at home mom, Leitao had never seen anything like it and neither had her husband, Edward, an internist at South Allegheny Internal Medicine.  Mary Leitao took her son to be examined by numerous doctors, but none provided a satisfactory explanation. Many suggested that it was a form of psychosis called “delusional infestation” or the conviction of being infected with parasites.

Images from the CDC study in PLoS One

Believing instead that she had discovered a new disease, Leitao named the condition Morgellons and in 2004 established a non-profit organization called the Morgellons Research Foundation (MRF).

Through the efforts of the MRF, the CDC (Centers for Disease Control and Prevention) conducted a three-year government study to research Morgellons.

The results, released last week, indicated that there was no diseased organisms or parasites present in the 115 case-patients.

The protruding fibers were found to be mostly skin fragments or clothing fibers stuck to the skin.

According to the report, the physical ailments were manifestations of “delusional infestation.”

From a recent article in WebMD, individuals with delusional infestation tend to be hyper-aware of normal body sensations and interpret them as medical illness.  The article notes, “This stress has real physical effects on the body and leads to a spiral of worsening physical symptoms…”

The suggestion that thoughts and stress can be manifested as physical maladies may be counterintuitive to anatomy-based medicine, but research increasingly supports the idea. For instance, The Washington Post reported, ”Nocebos[inert pills provided with a negative expectation] often cause a physical effect, but it’s not a physically produced effect,” said Irving Kirsch, a psychologist at the University of Connecticut in Storrs who studies the ways that expectations influence what people experience.

The CDC study, published by the open-access journal PLoS One, is available online.

The CDC also has an information page about Morgellons Disease.

The idea that the condition may be more mental than physical has always been unpopular among those who identify themselves with the disease. It has impelled them to fight on two fronts – working to gain credibility and help from the medical community and fighting the unfortunate stigma of mental illness.  With the significant setback of the CDC report, how many may be wondering, what next?  

I have compassion for those suffering from Morgellons.  No one should have to live with the painful symptoms or the mental anguish of feeling isolated, abandoned and uncared for. Yet, perhaps it’s time to consider the mental nature of the condition. Yet, perhaps it’s time to consider the mental nature of the condition. But I’m not proposing psychotherapy – but a spiritual approach.”

For instance, in the recent Jan. 29 issue of the Concord Monitor, a woman describes her recovery from disease as she changed her thought to a more prayerful perspective.  Shifting thought away from the body to seeking a greater understanding of her spiritual nature worked for her.

As the mental factors of many diseases become more widely understood, spiritual treatments, such as Christian Science, that focus on thought can be a valuable resource. The MRF website reports that fear and hopelessness are common among those who suffer from Morgellons. Working spiritually to lessen and eliminate these unhealthy mental states may be the best next step.

This article first appeared on Blogcritics.

A retired architect, Bill Scott writes about spirituality and health for Blogcritics.org and also serves as the Christian Science Committee on Publication for Washington State.

by Lena Groeger

The fine is just the latest of more than a dozen the Red Cross has racked up in the last decade.

In 2003, a federal court, frustrated by repeated blood safety violations by the Red Cross, gave the FDA the power to fine the organization.

Forty-six million dollars in penalties later, many of the same violations — understaffing, ineffective screening of donors, failure to recall infected blood — are outlined in the recent letter the FDA sent to the executive vice president of Biomedical Services for the Red Cross.

The 32-page letter describes hundreds of violations over several months in 2010 at 16 Red Cross facilities across the country, and details how the Red Cross repeatedly failed to properly track and record information about donors and blood units.

(To see a history of Red Cross fines and many of the documents cited in this article go to ProPublica’s timeline of Red Cross fines.)

For example, the agency failed to notify health departments when donors had infectious diseases such as HIV and syphilis, failed to add new donors with infected blood to a national list of people who aren’t allowed to donate, and failed to review records of donors who had bad reactions, such as a 16-year-old who lost consciousness and fell to the floor after giving a unit of blood.

It also failed to follow written procedures, such as the case of a phlebotomist in Arizona who stuck herself with a needle before sticking a donor with the same needle to draw blood. The case went unreported for a month, because a staff member “was not aware of the need to immediately notify a Medical Director,” according to the inspection letter.

In a recent statement, the Red Cross said it was disappointed that the FDA issued the fine for “an inspection conducted so long ago” and noted that it has “already taken corrective steps to address those matters and that improvements in operations have been made.”

In an email to ProPublica, a Red Cross spokeswoman also said there is no evidence that these violations endangered any patients, adding that the blood supply is safer than it has ever been.

The spokeswoman said the agency has made significant improvements, including reducing the number of problems system-wide by at least 65 percent, and is investing in technology upgrades.

For example, the agency recently upgraded software and computer equipment at blood drives to better collect and track donor information.

The FDA’s letter laying out the fines says the Red Cross “has known of these continuing problems and has failed to take adequate steps to correct them.”

The FDA also noted that “many of the violations recounted in this letter are virtually identical to violations charged in previous [letters].” In June 2010 the FDA imposed a $16 million penalty on the Red Cross for the same type of violations.

The chronic problems raise the question of whether penalties are working at all.

The Red Cross has been making promises and failing to keep them for over a decade, according to Sidney Wolfe, who heads the health research group at the consumer watchdog organization Public Citizen.

Wolfe said he wrote to head of the FDA in 2000, urging it to hold the Red Cross in contempt of court. A federal court first put the Red Cross under government supervision in 1993 after finding blood safety lapses. A decade later, in 2003, the court empowered the FDA to impose fines.

“But fast-forward nine years ahead, and we have the same violations,” Wolfe said.

If the Red Cross disagrees with an assessment, it can ask the FDA to reevaluate the penalty, but in most cases the fine only changes by a few thousand dollars.

Most of the recent problems inspectors cited have to do with managing records and tracking blood donors. The Red Cross says it is unaware of any infections or deaths that stemmed from problems noted in the report, and that “serious problems” account for only three percent of the total problems found.

The FDA doesn’t think that’s good enough.

“FDA cannot definitively say there was never any danger to the blood supply since the violations can create conditions that could lead to potential safety consequences,” said FDA spokeswoman Patricia El-Hinnawy.

The government requires that the Red Cross (like any blood services operation) have multiple safeguards for its blood services.

That includes asking a donor questions to identify any risks, checking his or her name against a national list of people who aren’t allowed to give blood, testing for infectious diseases, keeping track of blood units so infected blood isn’t released, and investigating any deviations from standards.

Because blood transfusions always carry a degree of risk, the FDA considers every step in that process critical to minimizing problems.

“Failure of an individual safeguard does not automatically translate into the release of unsafe products,” an FDA spokeswoman told ProPublica in an email, “however, it may increase the potential for risk.”

In 2008, the Red Cross consolidated its blood work to two facilities: one in Charlotte, N.C., and the other in Philadelphia. The offices are in charge of managing, tracking and, if need be, recalling blood.

But according to the inspection letter, both offices have been chronically understaffed, and simply haven’t been able to carry out their required functions in a timely or effective manner. As of 2010, the offices had a backlog of about 18,000 donor management cases.

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