HEALTH AGENCIES UPDATE

Valproate Pregnancy Risks Women who are pregnant should not take valproate sodium, valproic acid, or divalproex sodium to prevent migraine headaches, warned the US Food and Drug Administration (FDA) (http: //1.usa.gov/16caQrJ). The agencys warning is based on data from the Neurodevelopmental Effects of Antiepileptic Drugs study, which suggested that children whose mothers took these valproate-related drugs had IQs at age 6 years that were between 8 and 11 points lower than children exposed to other antiepileptic drugs. In 2011, the FDA issued a warning about the potential IQ-lowering effect of taking valproate during pregnancy when data from the study suggested lower IQs at age 3 years among children exposed to valproate products during pregnancy. The drugs are being recategorized as pregnancy category X agents when taken for preventing migraine, which indicates that the drugs risks outweigh their benefits for pregnant women taking them for this purpose. Valproate products will remain pregnancy category D agents for women taking those drugs for epilepsy or bipolar disorder, but the FDA recommends such use in pregnant women only if other medications are not effective or acceptable. Type 1 Diabetes Screening Individuals with a family history of type 1diabeteswhowanttoreceivefreescreening for the disease and participate in clinical research through a collaborative effort called TrialNet that is evaluating preventionstrategiescannowregisteronlineand receive initial screening near their homes, according to an announcement from the National Institute of Diabetes and Digestive and Kidney Diseases. Individuals with a family history of type 1 diabetes may register online for the initial round of screening at http: //www.diabetestrialnet.org, instead of traveling to one of the 200 TrialNet sites
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in North America, as was previously required. Those who are eligible will receive a kit they can take to a local laboratory for diabetes screening. The researchers anticipate that about 3 or 4 individuals per 100 screened will have antibodies associated with the

patients at 17 participating outpatient dialysisfacilitiesbeforeandaftertheimplementationofapackageofpreventionstrategies. At participating facilities, the rates of bloodstream infections and staff adherence to hand hygiene were monitored monthly,andcatheter-relatedcarewasaudited quarterly. Results of such monitoringweresharedwithstaff.Inaddition,use of chlorhexidine before central catheter insertion and reduction in the use of centralcatheters,whenappropriate,werepromoted. Patients and clinicians also were educated about infection prevention. Becausemostoftheparticipatingfacilitieswerebasedatnonprofithospitals,furtherstudiesareneededtoconfirmwhether the results may apply to dialysis centers more broadly, the authors cautioned. Nursing Careers for Veterans A new program aims to help veterans who served as medics or in other health care roles in the military leverage that experience to become nurses. The program was announced by the Department of Health and Human Services (HHS) Secretary Kathleen Sebelius at the White House Forum on Military Credentialing and Licensing in late April and is being administered by the Health Resources and Services Administration. The Veterans Bachelor of Science in Nursing Program will award $3 million to nursing schools to increase the numberofveteranswhoenrollinandcomplete nursing school. Participating schools will be encouraged to find ways to credit veterans for their military health training or fieldexperienceandtoprovidethemmentoring and support. Institutions that are interested in participating can find more information at http://grants.gov. According to a press release from HHS, the program is a response to the results of a White House report on the need to streamlinecredentialingandlicensingproceduresforservicemembers,veterans,and their spouses as they transition to civilian work.Bridget M. Kuehn, MSJ

To explore ways to prevent the onset of type 1 diabetes, researchers are recruiting individuals with a family history of the disorder to participate in free screening.

development of type 1 diabetes. These individuals will be contacted by one of the TrialNet research centers to discuss the results and may be invited to undergo further testing at a study center or to participate in a clinical trial of strategies to prevent or delay the onset of diabetes. Reducing Dialysis-Related Infections Dialysis facilities that participated in a quality improvement initiative developed by the US Centers for Disease Control and Prevention (CDC) reduced bloodstream infections among patients undergoing dialysis by 32% (http: //1.usa.gov/10TJaVl). Researchers from the CDC examined theratesofbloodstreaminfectionsamong

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