The "morning after pill" may be a good option for individual women in crisis, but advance access to emergency contraception is no antidote for the national problem of unintended pregnancy.
Contrary to the fears of critics, the presence of Plan B does not provoke riskier sexual behavior.
According to a new review of studies, women who received an advance supply of birth control pills for emergency contraception had an equal chance of becoming pregnant as women who did not have early access to the pills.
The review draws conclusions from eight studies of more than 6,000 women in the United States, India and China.
Plan B is a well-known brand of emergency contraception pills, but many different types of birth control medication taken at higher doses can prevent pregnancy after sex. Treatment must begin within five days after unprotected sex - and sooner is better when it comes to EC.
"We had expected that easier access to emergency contraception could help women use the pills more quickly when they needed them, and that in turn - since EC is a time-relevant medication - this could help women avoid unintended pregnancy," said lead reviewer Chelsea Polis.
"Our review is really about the effectiveness of advance provision as a strategy to reduce unintended pregnancy at a population level," Polis said. "The review is not about the effectiveness of EC; that is a separate matter."
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.
In 2001, about half of pregnancies in the United States were unintended, according to the Centers for Disease Control and Prevention. Now, the United States is working to lower the unintended pregnancy rate to 30 percent by 2010. Princeton University demographer James Trussell says easier access to emergency contraception will not slow the rate of unintended pregnancy in the United States.
"For individual women, it is definitely a last chance to prevent pregnancy after unprotected sex. But it is not going to have a major population impact because people will never use it enough," he said.
The review found that emergency contraception use was higher among women given an advance supply of the birth control pills, but that increase in use did not translate to a drop in the pregnancy rate.
"Even though advance provision increased use, we don't know if women were using EC at the times when they were at risk for pregnancy, when it was really needed," Polis explains.
"If women aren't going to use Plan B when they are given it for free in a clinical trial and are counseled beforehand about using it every single time they have unprotected sex, then having to go to CVS and having to pay $45 each time - it isn't going to happen," Trussell said.
Nonetheless, Polis said her review is not an argument against easier access to emergency contraception.
"Women deserve the chance to protect themselves from unintended pregnancy and EC is a safe, effective way to do that. Emergencies like rape, contraceptive failure and unprotected sex occur, and easier access to EC eliminates a medically unwarranted barrier to taking emergency contraception within the recommended timeframe," she said. "So steps like making EC available over the counter are still incredibly important."
When advanced access to emergency contraception was first proposed, critics worried that a medicine cabinet stocked with pills to prevent pregnancy would lead some women to be more promiscuous, have riskier sex or not use condoms.
The Cochrane review counters those concerns.
"We found there was absolutely no difference in sexually transmitted infection rates between the two groups. There's absolutely no difference in terms of unprotected sex, condom use or changes in use of other contraceptive methods," Polis said. "So it appears that advance provision of EC has no harmful effects in terms of risky sexual behaviors."
By Taunya English, Associate Editor Health Behavior News Service
Polis CB, et al. Advance provision of emergency contraception for pregnancy prevention. (Review). Cochrane Database of Systematic Reviews 2007, Issue 2.
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit cochrane/ for more information.
Contact: Lisa Esposito
Center for the Advancement of Health
четверг, 7 июня 2012 г.
четверг, 31 мая 2012 г.
New Adult Model Of Rett Syndrome
An IRSF funded study published in the journal Science has shown that the childhood disorder Rett syndrome, can be reestablished in adult animals by "switching off" a critical disease causing gene in healthy adult animals. The gene was "switched off" in adult mice by use of a sophisticated genetic trick, resulting in the appearance of behaviors typically seen in Rett syndrome. The leading author Christopher McGraw, MD/PhD student, carried out the study in the laboratory of Dr. Huda Zoghbi, a renowned neuroscientist based at Baylor College of Medicine, and director of the Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital in Houston TX.
In 1999 Dr. Zoghbi's laboratory made a central discovery, identifying the causative link between mutations in the gene methyl-CpG-binding protein 2 (MeCP2) and Rett syndrome. This work led to other studies showing that MeCP2 protein is critical for the proper functioning of nerve cells during development and into adulthood. In 2007 a further study conducted by Dr. Adrian Bird, at Edinburgh University in the UK, showed the neurological symptoms of Rett syndrome can be reversed by reactivating MeCP2 in an adult mouse where the disease is already established. This work provided a critical proof of concept that symptoms of the disorder may be reversible in humans; however, to-date it was not known whether the early developmental period was important in establishing the course of the disease. This new study argues that early expression of the gene does not protect against the development of symptoms if the disease gene is later inactivated.
Commenting on the study, Dr. Zoghbi said "We did this experiment to see if providing MeCP2 early on in life, during critical periods of brain maturation, would be partially protective from loss of this protein in the adult brain. We were surprised to see that the nervous system had no detectable protection when MeCP2 was lost in adulthood. This affirmed that brain cells must have MeCP2 at all times to function normally."
There have been no effective pharmacological treatments developed to treat the disorder although new therapeutic trials are currently underway. This work suggests that therapies for Rett syndrome may need to be continuously maintained throughout the course of an individual's life.
Funding for this work was jointly provided by the National Institutes of Health, the Baylor College of Medicine Research Advocates for Student Scientists, the International Rett Syndrome Foundation, the Simons Foundation and the Rett Syndrome Research Trust.
About Rett Syndrome
Rett syndrome (RTT), a developmental neurological disorder, occurs almost exclusively in females. RTT results in severe movement and communication problems following apparently normal development for the first six to 18 months of life. Characteristic features of the disease include loss of speech and purposeful hand use, repetitive hand movements, abnormal walking, abnormal breathing, slowing in the rate of head growth and increased risk of seizures. Current treatment for girls with RTT includes physical and occupational therapy, speech therapy, and medication for seizures. There is no known cure for RTT. In 2007, researchers heralded a major breakthrough by reversing RTT symptoms in mouse models. RTT is considered a "Rosetta Stone" that is helping scientists understand multiple developmental neurological disorders, and shares genetic links with other conditions such as autism and schizophrenia.
Source:
Steve Bajardi
International Rett Syndrome Foundation
In 1999 Dr. Zoghbi's laboratory made a central discovery, identifying the causative link between mutations in the gene methyl-CpG-binding protein 2 (MeCP2) and Rett syndrome. This work led to other studies showing that MeCP2 protein is critical for the proper functioning of nerve cells during development and into adulthood. In 2007 a further study conducted by Dr. Adrian Bird, at Edinburgh University in the UK, showed the neurological symptoms of Rett syndrome can be reversed by reactivating MeCP2 in an adult mouse where the disease is already established. This work provided a critical proof of concept that symptoms of the disorder may be reversible in humans; however, to-date it was not known whether the early developmental period was important in establishing the course of the disease. This new study argues that early expression of the gene does not protect against the development of symptoms if the disease gene is later inactivated.
Commenting on the study, Dr. Zoghbi said "We did this experiment to see if providing MeCP2 early on in life, during critical periods of brain maturation, would be partially protective from loss of this protein in the adult brain. We were surprised to see that the nervous system had no detectable protection when MeCP2 was lost in adulthood. This affirmed that brain cells must have MeCP2 at all times to function normally."
There have been no effective pharmacological treatments developed to treat the disorder although new therapeutic trials are currently underway. This work suggests that therapies for Rett syndrome may need to be continuously maintained throughout the course of an individual's life.
Funding for this work was jointly provided by the National Institutes of Health, the Baylor College of Medicine Research Advocates for Student Scientists, the International Rett Syndrome Foundation, the Simons Foundation and the Rett Syndrome Research Trust.
About Rett Syndrome
Rett syndrome (RTT), a developmental neurological disorder, occurs almost exclusively in females. RTT results in severe movement and communication problems following apparently normal development for the first six to 18 months of life. Characteristic features of the disease include loss of speech and purposeful hand use, repetitive hand movements, abnormal walking, abnormal breathing, slowing in the rate of head growth and increased risk of seizures. Current treatment for girls with RTT includes physical and occupational therapy, speech therapy, and medication for seizures. There is no known cure for RTT. In 2007, researchers heralded a major breakthrough by reversing RTT symptoms in mouse models. RTT is considered a "Rosetta Stone" that is helping scientists understand multiple developmental neurological disorders, and shares genetic links with other conditions such as autism and schizophrenia.
Source:
Steve Bajardi
International Rett Syndrome Foundation
четверг, 24 мая 2012 г.
How Bisphenol A Induces Epigenetic Changes In Pregnant Mice That Cause Hormonal Imbalance In The Later Life Of Female Progeny
Here's more evidence that "safe" plastics are not as safe as once presumed: New research published online in The FASEB Journal (fasebj) suggests that exposure to Bisphenol A (BPA) during pregnancy leads to epigenetic changes that may cause permanent reproduction problems for female offspring. BPA, a common component of plastics used to contain food, is a type of estrogen that is ubiquitous in the environment.
"Exposure to BPA may be harmful during pregnancy; this exposure may permanently affect the fetus," said Hugh S. Taylor, Ph.D., co-author of the study from Yale University School of Medicine in New Haven, Connecticut. "We need to better identify the effects of environmental contaminants on not just crude measures such as birth defects, but also their effect in causing more subtle developmental errors."
Taylor and colleagues made this discovery by exposing fetal mice to BPA during pregnancy and examining gene expression and DNA in the uteruses of female fetuses. Results showed that BPA exposure permanently affected the uterus by decreasing regulation of gene expression. These epigenetic changes caused the mice to over-respond to estrogen throughout adulthood, long after the BPA exposure. This suggests that early exposure to BPA genetically "programmed" the uterus to be hyper-responsive to estrogen. Extreme estrogen sensitivity can lead to fertility problems, advanced puberty, altered mammary development and reproductive function, as well as a variety of hormone-related cancers. BPA has been widely used in plastics and other materials. Examples include use in water bottles, baby bottles, epoxy resins used to coat food cans, and dental sealants.
"The BPA baby bottle scare may be only the tip of the iceberg." said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "Remember how diethylstilbestrol (DES) caused birth defects and cancers in young women whose mothers were given such hormones during pregnancy. We'd better watch out for BPA, which seems to carry similar epigenetic risks across the generations. "
Source:
Cody Mooneyhan
Federation of American Societies for Experimental Biology
"Exposure to BPA may be harmful during pregnancy; this exposure may permanently affect the fetus," said Hugh S. Taylor, Ph.D., co-author of the study from Yale University School of Medicine in New Haven, Connecticut. "We need to better identify the effects of environmental contaminants on not just crude measures such as birth defects, but also their effect in causing more subtle developmental errors."
Taylor and colleagues made this discovery by exposing fetal mice to BPA during pregnancy and examining gene expression and DNA in the uteruses of female fetuses. Results showed that BPA exposure permanently affected the uterus by decreasing regulation of gene expression. These epigenetic changes caused the mice to over-respond to estrogen throughout adulthood, long after the BPA exposure. This suggests that early exposure to BPA genetically "programmed" the uterus to be hyper-responsive to estrogen. Extreme estrogen sensitivity can lead to fertility problems, advanced puberty, altered mammary development and reproductive function, as well as a variety of hormone-related cancers. BPA has been widely used in plastics and other materials. Examples include use in water bottles, baby bottles, epoxy resins used to coat food cans, and dental sealants.
"The BPA baby bottle scare may be only the tip of the iceberg." said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "Remember how diethylstilbestrol (DES) caused birth defects and cancers in young women whose mothers were given such hormones during pregnancy. We'd better watch out for BPA, which seems to carry similar epigenetic risks across the generations. "
Source:
Cody Mooneyhan
Federation of American Societies for Experimental Biology
четверг, 17 мая 2012 г.
Public Citizen Petitions FDA To Ban Birth Control Pills Containing Hormone Desogestrel
The consumer advocacy group Public Citizen on Tuesday released a petition calling on FDA to ban oral contraceptives containing the hormone desogestrel because studies have shown they are twice as likely to cause blood clots without boosting protection against pregnancy, USA Today reports (Rubin, USA Today, 2/7). The pills cited in the petition include Ortho-McNeil's Ortho-Cept; Watson Pharmaceuticals' Reclipsen; Organon's Desogen; Barr Pharmaceuticals' Mircette, Velivet, Kariva and Apri-28; and some generic pills, according to Reuters (Heavey, Reuters, 2/6). The petition says many studies back to 1995 indicate that oral contraceptives containing desogestrel cause about 30 blood clot cases per 100,000 users annually, compared with 15 cases per 100,000 users of other oral contraceptives annually. More than 7.5 million prescriptions for oral contraceptives containing desogestrel were filled as of last year, according to the petition. Sidney Wolfe, director of Public Citizen's health research group, said that on the pills' labels, under the heading "Risks of Taking Oral Contraceptives," there is a warning "in barely perceptible four-point type" stating that the blood-clot risk might be higher in oral contraceptives that contain desogestrel than in other low-dose oral contraceptives (USA Today, 2/7). "By banning [desogestrel-containing] oral contraceptives, the FDA will potentially save hundreds of young women a year from developing venous thrombosis and its disabling and sometimes fatal consequences," the petition said (Reuters, 2/6). Public Citizen is posting a video explaining the petition on YouTube to spread its message to younger pill users. FDA spokesperson Susan Cruzan said the agency "will carefully review the petition" (AP/San Diego Union-Tribune, 2/6). Barr in a statement responding to the petition said, "The labeling that accompanies the company's oral contraceptive products provides all the necessary warnings and precautions for the appropriate use of the products." Ortho-McNeil in a statement said, "When used as labeled, Ortho-Cept is a safe and effective birth control choice" (USA Today, 2/7).
The petition is available online.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Mircette.
The petition is available online.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Mircette.
четверг, 10 мая 2012 г.
True Weight Underestimated By Obese And Overweight Mothers And Their Children
Overweight and obese mothers and their children think they weigh less than their actual weight, according to research reported at the American Heart Association's Nutrition, Physical Activity and Metabolism/Cardiovascular Disease Epidemiology and Prevention 2011 Scientific Sessions.
In the study of women and children in an urban, predominantly Hispanic population, most normal weight women and children in the study correctly estimated their body weight, but most obese women and children underestimated theirs.
"Obesity is a well-known risk factor for the development of many diseases, including heart disease and diabetes," said Nicole E Dumas, M.D., lead author and an internal medicine resident at Columbia University Medical Center in New York City. Dumas and colleagues surveyed women and their pre-adolescent children attending an urban, primary care center in New York City. They asked the subjects about their age, income, heart disease risk factors, and perceptions of their body size using silhouette images that corresponded to specific body mass index (BMI) types - for example, underweight, normal and overweight.
The researchers also recorded participants' height, weight and BMI, which is a measurement of body weight based on height. A BMI of 25-29 is overweight, and a BMI over 30 is obese.
The researchers found:
65.8 percent of the mothers surveyed were overweight or obese.
38.9 percent of children surveyed were overweight or obese.
81.8 percent of obese women underestimated their weight compared to 42.5 percent of overweight and 13.2 percent of normal weight women; similarly, 86 percent of overweight or obese children underestimated their weight compared to 15 percent of normal weight children.
Of mothers with overweight or obese children, almost half (47.5 percent) thought their children were of normal weight.
Children selected larger body images than those chosen by their mothers to describe an "ideal" or "healthy" body image for a woman.
41.4 percent of the children in the study thought their moms should lose weight.
"These findings imply that not only is obesity prevalent in urban America, but that those most affected by it are either unaware or underestimate their true weight," she said. "In addition, obesity has become an acceptable norm in some families. Strategies to overcome the obesity epidemic will need to address this barrier to weight loss."
Future research should include interventions that study the effect of increased accuracy of body image perception on weight loss among families.
Notes:
Co-authors are Robert R Sciacca, Eng.Sc.D.; Jennifer Decolongon, M.D.; Juviza K. Rodriguez, B.A.; and Elsa-Grace V Giardina, M.D.
Author disclosures are on the manuscript. The study was funded by the Department of Health and Human Services and the Arlene and Joseph Taub Foundation.
Source:
Darcy Spitz
American Heart Association
In the study of women and children in an urban, predominantly Hispanic population, most normal weight women and children in the study correctly estimated their body weight, but most obese women and children underestimated theirs.
"Obesity is a well-known risk factor for the development of many diseases, including heart disease and diabetes," said Nicole E Dumas, M.D., lead author and an internal medicine resident at Columbia University Medical Center in New York City. Dumas and colleagues surveyed women and their pre-adolescent children attending an urban, primary care center in New York City. They asked the subjects about their age, income, heart disease risk factors, and perceptions of their body size using silhouette images that corresponded to specific body mass index (BMI) types - for example, underweight, normal and overweight.
The researchers also recorded participants' height, weight and BMI, which is a measurement of body weight based on height. A BMI of 25-29 is overweight, and a BMI over 30 is obese.
The researchers found:
65.8 percent of the mothers surveyed were overweight or obese.
38.9 percent of children surveyed were overweight or obese.
81.8 percent of obese women underestimated their weight compared to 42.5 percent of overweight and 13.2 percent of normal weight women; similarly, 86 percent of overweight or obese children underestimated their weight compared to 15 percent of normal weight children.
Of mothers with overweight or obese children, almost half (47.5 percent) thought their children were of normal weight.
Children selected larger body images than those chosen by their mothers to describe an "ideal" or "healthy" body image for a woman.
41.4 percent of the children in the study thought their moms should lose weight.
"These findings imply that not only is obesity prevalent in urban America, but that those most affected by it are either unaware or underestimate their true weight," she said. "In addition, obesity has become an acceptable norm in some families. Strategies to overcome the obesity epidemic will need to address this barrier to weight loss."
Future research should include interventions that study the effect of increased accuracy of body image perception on weight loss among families.
Notes:
Co-authors are Robert R Sciacca, Eng.Sc.D.; Jennifer Decolongon, M.D.; Juviza K. Rodriguez, B.A.; and Elsa-Grace V Giardina, M.D.
Author disclosures are on the manuscript. The study was funded by the Department of Health and Human Services and the Arlene and Joseph Taub Foundation.
Source:
Darcy Spitz
American Heart Association
четверг, 3 мая 2012 г.
Progress Against Child Deaths Will Lag Until Family, Community Care Prioritized
Global efforts to tackle millions of preventable child and maternal deaths will fail to extend gains unless world leaders act now to pour more healthcare resources directly into families and communities, according to a new World Vision report launched recently.
"The Missing Link: Saving children's lives through family care" examines how the resources invested to achieve Millennium Development Goals (MDGs) 4 and 5 can go further toward saving the more than 8 million children under the age of five and 350,000 mothers who die each year, mostly from preventable causes. Undertaken by the international child-focused organization World Vision, the analysis distills several decades of field-based experience and research to recommend investing directly in care for families and the communities where they live.
"With only five years to go until the MDG target deadline, no one can afford to waste time or resources," said Kevin Jenkins, president and CEO of World Vision International. "Efforts will falter for the world's most impoverished, vulnerable children and their mothers until we focus our energies on bringing health care directly where they need it most - right to their homes and communities."
In 2000, world leaders adopted eight ambitious yet achievable goals aimed at halving extreme poverty and its effects. Known as the MDGs, their target deadline is 2015. Next week, world leaders, governments and NGOs convening for the 2010 UN General Assembly in New York will highlight progress, examine gaps and lessons learned and revitalize efforts on the MDGs, with Secretary General Ban Ki-Moon putting a special focus on women's and children's health.
MDGs 4 and 5, targeting the reduction of maternal and child mortality, lag far behind the other goals. This is in part because the people who most need care can't access it, say the authors of the World Vision report.
"Millions of children live and die beyond the reach of formal health services and clinics, of diseases that are easily prevented and treated when families are able to access effective, basic interventions as close to their homes as possible," said Martha Newsome, Global Director of Health and Nutrition for World Vision International. "This deadly gap makes family and community care a critical link in saving millions from preventable deaths, and an essential component required to strengthen health systems adequately."
World Vision's Child Health Now campaign, drawing upon lessons learned from the Christian humanitarian organization's 1,600+ community programs, encourages communities to express their rights to quality health care, and press local and national governments to meet their responsibilities for promoting health and ending preventable child deaths.
Although the number of deaths among children under the age of five has declined in recent years, the rate of decline - an estimated one-third reduction over 20 years - is insufficient to meet MDG 4, particularly in the regions of Sub-Saharan Africa, Southern Asia and Oceania, where most child deaths occur, according to estimates released today by UNICEF.
The results are dismal given that evidence shows millions of babies and toddlers could be saved from death each year through a small number of proven, cost-effective interventions such as skilled birth attendants, immunizations, mosquito nets and oral rehydration therapy.
"We know what works, why it works and how to do it," says Jenkins. "What we need to do now is to mobilize the necessary political will to put mothers, children, their families and communities front and centre of global development."
"Otherwise, too many children born today into poor, under-served communities won't survive the five years to the 2015 deadline, simply because they and their families don't have access to basic health services," said Jenkins.
A PDF of the report and multimedia resources (PSA on malnutrition, VNR and b-roll) are available here.
Source:
Geraldine Ryerson-Cruz
World Vision
"The Missing Link: Saving children's lives through family care" examines how the resources invested to achieve Millennium Development Goals (MDGs) 4 and 5 can go further toward saving the more than 8 million children under the age of five and 350,000 mothers who die each year, mostly from preventable causes. Undertaken by the international child-focused organization World Vision, the analysis distills several decades of field-based experience and research to recommend investing directly in care for families and the communities where they live.
"With only five years to go until the MDG target deadline, no one can afford to waste time or resources," said Kevin Jenkins, president and CEO of World Vision International. "Efforts will falter for the world's most impoverished, vulnerable children and their mothers until we focus our energies on bringing health care directly where they need it most - right to their homes and communities."
In 2000, world leaders adopted eight ambitious yet achievable goals aimed at halving extreme poverty and its effects. Known as the MDGs, their target deadline is 2015. Next week, world leaders, governments and NGOs convening for the 2010 UN General Assembly in New York will highlight progress, examine gaps and lessons learned and revitalize efforts on the MDGs, with Secretary General Ban Ki-Moon putting a special focus on women's and children's health.
MDGs 4 and 5, targeting the reduction of maternal and child mortality, lag far behind the other goals. This is in part because the people who most need care can't access it, say the authors of the World Vision report.
"Millions of children live and die beyond the reach of formal health services and clinics, of diseases that are easily prevented and treated when families are able to access effective, basic interventions as close to their homes as possible," said Martha Newsome, Global Director of Health and Nutrition for World Vision International. "This deadly gap makes family and community care a critical link in saving millions from preventable deaths, and an essential component required to strengthen health systems adequately."
World Vision's Child Health Now campaign, drawing upon lessons learned from the Christian humanitarian organization's 1,600+ community programs, encourages communities to express their rights to quality health care, and press local and national governments to meet their responsibilities for promoting health and ending preventable child deaths.
Although the number of deaths among children under the age of five has declined in recent years, the rate of decline - an estimated one-third reduction over 20 years - is insufficient to meet MDG 4, particularly in the regions of Sub-Saharan Africa, Southern Asia and Oceania, where most child deaths occur, according to estimates released today by UNICEF.
The results are dismal given that evidence shows millions of babies and toddlers could be saved from death each year through a small number of proven, cost-effective interventions such as skilled birth attendants, immunizations, mosquito nets and oral rehydration therapy.
"We know what works, why it works and how to do it," says Jenkins. "What we need to do now is to mobilize the necessary political will to put mothers, children, their families and communities front and centre of global development."
"Otherwise, too many children born today into poor, under-served communities won't survive the five years to the 2015 deadline, simply because they and their families don't have access to basic health services," said Jenkins.
A PDF of the report and multimedia resources (PSA on malnutrition, VNR and b-roll) are available here.
Source:
Geraldine Ryerson-Cruz
World Vision
четверг, 26 апреля 2012 г.
Photos Taken By HIV-Positive Women Help Them By Identifying Problems And Potential Solutions
A picture may be worth a thousand words, but for women living with human immunodeficiency virus (HIV), the virus that causes AIDS, a picture can help them deal with the challenges of living with the virus.
A University of Missouri researcher is completing a pilot project during which women living with HIV take photos to document their lives. The photos are used to engage women in critical discussions about their lives, identifying both social, mental, and physical challenges and possible solutions for the women. The photos will be presented at two special events. The first event will be held on March 3-6 in Columbia at the True/False Film Festival. The second event will be held on March 19 in St. Louis at the Regional Arts Commission to commemorate National Women and Girls HIV/AIDS Awareness Day.
"Women with HIV face more challenges than most intervention programs are designed to address," said Michelle Teti, assistant professor of health psychology in the MU School of Health Professions. "These women need to discuss more issues than merely how to have safe sex. Many live in poverty, with substandard housing and abusive partners. Helping women understand and address these issues is what this project is all about."
At the beginning of each project, Teti meets with the women as a group, gives each woman a digital camera, and instructs the women to go home and document their lives. Two weeks later, the group reconvenes, and each woman presents a few photos while discussing the meanings of the images. The women spend two additional weeks documenting their lives and reconvene to discuss the photos again, and plan a photo exhibit to share their work and ideas with others. Following the upcoming photo exhibitions, Teti plans to meet with the women to better understand the effect the project has had on their health.
Prior to coming to MU, Teti completed a similar project in Philadelphia. She presented the project's results at the American Public Health Association Conference last year.
"In Philadelphia, women used the photos to express themselves in different ways," Teti said. "Some women chose to combat the stereotype of what someone with HIV looks like by taking pictures of themselves looking beautiful and healthy. Another woman chose to take pictures of broken kitchen appliances and substandard living conditions to detail her horrible housing situation and used the pictures to advocate for help."
Teti said some women do not realize how dire their situations are until they document and discuss them. By realizing their problems, many women are able to resolve some issues. For example, the woman who depicted her difficult housing situation showed them to community members, who helped her find new housing.
Teti is working on the project through a grant from the Center for AIDS Prevention Studies, Training Program for Scientists Conducting Research to Reduce HIV/STI Health Disparities.
Source:
Christian Basi
University of Missouri-Columbia
A University of Missouri researcher is completing a pilot project during which women living with HIV take photos to document their lives. The photos are used to engage women in critical discussions about their lives, identifying both social, mental, and physical challenges and possible solutions for the women. The photos will be presented at two special events. The first event will be held on March 3-6 in Columbia at the True/False Film Festival. The second event will be held on March 19 in St. Louis at the Regional Arts Commission to commemorate National Women and Girls HIV/AIDS Awareness Day.
"Women with HIV face more challenges than most intervention programs are designed to address," said Michelle Teti, assistant professor of health psychology in the MU School of Health Professions. "These women need to discuss more issues than merely how to have safe sex. Many live in poverty, with substandard housing and abusive partners. Helping women understand and address these issues is what this project is all about."
At the beginning of each project, Teti meets with the women as a group, gives each woman a digital camera, and instructs the women to go home and document their lives. Two weeks later, the group reconvenes, and each woman presents a few photos while discussing the meanings of the images. The women spend two additional weeks documenting their lives and reconvene to discuss the photos again, and plan a photo exhibit to share their work and ideas with others. Following the upcoming photo exhibitions, Teti plans to meet with the women to better understand the effect the project has had on their health.
Prior to coming to MU, Teti completed a similar project in Philadelphia. She presented the project's results at the American Public Health Association Conference last year.
"In Philadelphia, women used the photos to express themselves in different ways," Teti said. "Some women chose to combat the stereotype of what someone with HIV looks like by taking pictures of themselves looking beautiful and healthy. Another woman chose to take pictures of broken kitchen appliances and substandard living conditions to detail her horrible housing situation and used the pictures to advocate for help."
Teti said some women do not realize how dire their situations are until they document and discuss them. By realizing their problems, many women are able to resolve some issues. For example, the woman who depicted her difficult housing situation showed them to community members, who helped her find new housing.
Teti is working on the project through a grant from the Center for AIDS Prevention Studies, Training Program for Scientists Conducting Research to Reduce HIV/STI Health Disparities.
Source:
Christian Basi
University of Missouri-Columbia
четверг, 19 апреля 2012 г.
Supreme Court Nominee Sotomayor Resumes Meetings With Senators; Confirmation Vote Still Unclear
Judge Sonia Sotomayor, President Obama's nominee for the Supreme Court, on Thursday will hold a third round of private meetings with senators who will be voting on her confirmation, the AP/Chicago Tribune reports. The AP/Tribune reports that by Friday, Sotomayor will have met with more than one-quarter of the Senate and a majority of members on the Senate Judiciary Committee, which will lead an as-yet-unscheduled set of hearings for her confirmation.
The Judiciary Committee is expected to receive and examine a large collection of documents for the hearings -- including Sotomayor's writings, speeches and unpublished rulings -- as part of a questionnaire response on personal and financial data, possible conflicts of interest and the procedure that led to her nomination. According to the AP/Tribune, the White House in recent days has been rallying support for Sotomayor, with first lady Michelle Obama on Wednesday talking about the nominee at a high school graduation (Hirschfeld Davis, AP/Chicago Tribune, 6/4).
Meanwhile, Senate Judiciary Committee Chair Patrick Leahy (D-Vt.) and ranking member Jeff Sessions (R-Ala.) on Wednesday failed to reach an agreement on a timeline for Sotomayor's confirmation hearings and vote, CongressDaily reports. According to CongressDaily, Democrats and Republicans generally are "at odds" over the issue, particularly over when the confirmation hearings should start (Friedman, CongressDaily, 6/3). Leahy said that he would like hearings to begin next month, with the goal of scheduling a confirmation vote before the month-long congressional recess that begins in early August. Sessions has called for the process to be spread out over the summer to allow committee members to analyze the large volume of Sotomayor's records, with hearings beginning in September (AP/Chicago Tribune, 6/4).
Leahy -- who will have the final say on the start of the hearings -- on Tuesday said that "it would be irresponsible to leave [Sotomayor] hanging out there" until September (CongressDaily, 6/3).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
The Judiciary Committee is expected to receive and examine a large collection of documents for the hearings -- including Sotomayor's writings, speeches and unpublished rulings -- as part of a questionnaire response on personal and financial data, possible conflicts of interest and the procedure that led to her nomination. According to the AP/Tribune, the White House in recent days has been rallying support for Sotomayor, with first lady Michelle Obama on Wednesday talking about the nominee at a high school graduation (Hirschfeld Davis, AP/Chicago Tribune, 6/4).
Meanwhile, Senate Judiciary Committee Chair Patrick Leahy (D-Vt.) and ranking member Jeff Sessions (R-Ala.) on Wednesday failed to reach an agreement on a timeline for Sotomayor's confirmation hearings and vote, CongressDaily reports. According to CongressDaily, Democrats and Republicans generally are "at odds" over the issue, particularly over when the confirmation hearings should start (Friedman, CongressDaily, 6/3). Leahy said that he would like hearings to begin next month, with the goal of scheduling a confirmation vote before the month-long congressional recess that begins in early August. Sessions has called for the process to be spread out over the summer to allow committee members to analyze the large volume of Sotomayor's records, with hearings beginning in September (AP/Chicago Tribune, 6/4).
Leahy -- who will have the final say on the start of the hearings -- on Tuesday said that "it would be irresponsible to leave [Sotomayor] hanging out there" until September (CongressDaily, 6/3).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
четверг, 12 апреля 2012 г.
Gender Bender, Do Gender Knee Implants Provide Better Outcomes?
A gender-specific total knee prosthesis was developed to more closely match the anatomy of the female knee, aiming to be a better fit resulting in better outcomes for women. However, a recent study in the Journal of Bone and Joint Surgery (JBJS) found that 85 women who received a gender-specific implant in one knee and a standard prosthesis in the other knee found no clinical benefits of the gender-specific knee.
"We conducted this study to investigate whether women derive less benefit, or perhaps less predictable benefit, from total knee replacement using a standard conventional total knee implant," said Young-Hoo Kim, M.D., orthopaedic surgeon and lead author of the study.
After receiving knee implants one gender-specific and one standard prosthesis the women were assessed for at least two years after surgery. The knees with the gender-specific implant and the knees with the standard implant had similar knee scores and similar range of motion while lying down (125 degrees for the knees with standard implants and 126 degrees for the knees with gender-specific implants). All patients except three were able to bend their knees at least 90 degrees.
Additionally, patient satisfaction with the implants was similar (8.3 points for the standard implants and 8.1 points for the gender-specific implants). A rating of 6 to 8 meant "satisfied," and a rating of 9 to 10 meant "fully satisfied."
Important findings included:
-- The majority of women in the study (71 females or 84 percent) had no preference between the two implants
-- eight women (9 percent) preferred the standard prosthesis, and
-- six (7 percent) preferred the gender-specific prosthesis.
Implantation prostheses of either design resulted in improved quality of life in terms of pain, walking distance, deformity, and function after surgery.
Although the gender-specific implants were specially designed to fit women, Dr. Kim's study showed that the standard prostheses fit women's knees better than the gender-specific implants. "Our data demonstrated that the standard prosthesis fit the distal part of the femur (where the thigh and knee connect) better than the gender-specific prosthesis did," said Dr. Kim, who is from The Joint Replacement Center of Korea, Ewha Women's University School of Medicine in South Korea. The gender-specific prosthesis was so small that it exposed more bone, which resulted in increased bleeding immediately after surgery.
Dr. Kim and his colleagues were surprised by the study results. "We indeed expected the gender-specific prostheses to outperform the standard prostheses," he said.
Because the women in the study did not have any clinical benefit from the gender-specific knee implants, Dr. Kim now recommends that women receive a properly sized standard total knee prosthesis. "We have learned that gender-specific total knee prostheses fail to show any clinical benefits. So, we feel that proper size standard total knee prostheses are needed for both men and women," he added.
Although patients were only followed for approximately two years, studies have shown that results after two years are similar to those seen five to ten years after total knee replacement. "Because the duration of follow-up was short, we can draw no conclusions about the advantage of the gender-specific prosthesis with regard to long-term function," Dr. Kim concluded.
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.
Source: American Academy of Orthopaedic Surgeons
"We conducted this study to investigate whether women derive less benefit, or perhaps less predictable benefit, from total knee replacement using a standard conventional total knee implant," said Young-Hoo Kim, M.D., orthopaedic surgeon and lead author of the study.
After receiving knee implants one gender-specific and one standard prosthesis the women were assessed for at least two years after surgery. The knees with the gender-specific implant and the knees with the standard implant had similar knee scores and similar range of motion while lying down (125 degrees for the knees with standard implants and 126 degrees for the knees with gender-specific implants). All patients except three were able to bend their knees at least 90 degrees.
Additionally, patient satisfaction with the implants was similar (8.3 points for the standard implants and 8.1 points for the gender-specific implants). A rating of 6 to 8 meant "satisfied," and a rating of 9 to 10 meant "fully satisfied."
Important findings included:
-- The majority of women in the study (71 females or 84 percent) had no preference between the two implants
-- eight women (9 percent) preferred the standard prosthesis, and
-- six (7 percent) preferred the gender-specific prosthesis.
Implantation prostheses of either design resulted in improved quality of life in terms of pain, walking distance, deformity, and function after surgery.
Although the gender-specific implants were specially designed to fit women, Dr. Kim's study showed that the standard prostheses fit women's knees better than the gender-specific implants. "Our data demonstrated that the standard prosthesis fit the distal part of the femur (where the thigh and knee connect) better than the gender-specific prosthesis did," said Dr. Kim, who is from The Joint Replacement Center of Korea, Ewha Women's University School of Medicine in South Korea. The gender-specific prosthesis was so small that it exposed more bone, which resulted in increased bleeding immediately after surgery.
Dr. Kim and his colleagues were surprised by the study results. "We indeed expected the gender-specific prostheses to outperform the standard prostheses," he said.
Because the women in the study did not have any clinical benefit from the gender-specific knee implants, Dr. Kim now recommends that women receive a properly sized standard total knee prosthesis. "We have learned that gender-specific total knee prostheses fail to show any clinical benefits. So, we feel that proper size standard total knee prostheses are needed for both men and women," he added.
Although patients were only followed for approximately two years, studies have shown that results after two years are similar to those seen five to ten years after total knee replacement. "Because the duration of follow-up was short, we can draw no conclusions about the advantage of the gender-specific prosthesis with regard to long-term function," Dr. Kim concluded.
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.
Source: American Academy of Orthopaedic Surgeons
четверг, 5 апреля 2012 г.
HHS Approves California Plan To Expand Coverage To Unborn Children
HHS Secretary Mike Leavitt today approved a proposal by California to extend health care coverage to pregnant women and their unborn children with family incomes of up to 300 percent of the federal poverty level. The state currently covers children ages 0-19 with family incomes of up to 250 percent of poverty.
The state estimates that 123,052 pregnant women and their unborn children will be eligible for coverage under this expansion of its State Children's Health Insurance Program (SCHIP).
"This new coverage will give California children a healthy start by providing access to prenatal care," Secretary Leavitt said. "Prenatal care can be a life-long determinant of health and we should do everything possible to make this care available to everyone."
Coverage of this type was authorized by a 2003 HHS regulation that defines a child as an individual under the age of 19 including the period from conception to birth.
"Prenatal care is one of the most effective ways to prevent low birth weight, premature delivery and other health problems that can be permanently disabling," said Centers for Medicare & Medicaid Services Administrator Mark B. McClellan, M.D., Ph.D. "Eight states have now expanded prenatal care services to more women, and we are ready to work with other states on similar programs to improve maternal and child health."
The federal poverty level for an individual for 2006 is $9,800 and $20,000 for a family of four.
California is the eighth state to adopt this policy. Other states include: Arkansas, Illinois, Massachusetts, Michigan, Minnesota, Rhode Island and Washington.
hhs
The state estimates that 123,052 pregnant women and their unborn children will be eligible for coverage under this expansion of its State Children's Health Insurance Program (SCHIP).
"This new coverage will give California children a healthy start by providing access to prenatal care," Secretary Leavitt said. "Prenatal care can be a life-long determinant of health and we should do everything possible to make this care available to everyone."
Coverage of this type was authorized by a 2003 HHS regulation that defines a child as an individual under the age of 19 including the period from conception to birth.
"Prenatal care is one of the most effective ways to prevent low birth weight, premature delivery and other health problems that can be permanently disabling," said Centers for Medicare & Medicaid Services Administrator Mark B. McClellan, M.D., Ph.D. "Eight states have now expanded prenatal care services to more women, and we are ready to work with other states on similar programs to improve maternal and child health."
The federal poverty level for an individual for 2006 is $9,800 and $20,000 for a family of four.
California is the eighth state to adopt this policy. Other states include: Arkansas, Illinois, Massachusetts, Michigan, Minnesota, Rhode Island and Washington.
hhs
четверг, 29 марта 2012 г.
AWHONN Wins Three Awards For Superior Publications
The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) is proud to announce it has won three awards in the 2007 "Association Trends" All-Media Contest. The annual contest is held to recognize the print, online, broadcast, electronic and audio/visual media work of associations nationwide.
AWHONN received the following:
- GOLD prize in the Informational/Promotional Piece category for the three-piece, "You Shall Find a Job!???? Fairy Godmother direct mail campaign for the Nursing Career Center. The campaign featured the Ella's story, from her graduation from nursing school through major milestones in her career. At each stage of her career, Ella's fairy godmother is on hand, advising her to visit www.NursingCareerCenter as she thought about new opportunities. The goal of the campaign was to build awareness for the Nursing Career Center as an online employment resource for nurses.
- SILVER prize in the Convention Registration Promotional Package category, for the 2007 Annual Convention Preliminary Program and collateral marketing pieces: "What Inspires You.???? The 2007 AWHONN convention theme was "Inspired to Excellence???? The campaign had a web-based interactive element in which people could submit what inspires them as a nurse and could see what other nurses had submitted to motivate and celebrate excellence among AWHONN members.
- BRONZE prize in the Catalog category, for the 2007 Resources Catalog. The AWHONN Resource Catalog underwent a major redesign in 2007, expanding the interior layout to highlight flagship products and adding more graphics and product photo displays. This attracted not only to add visual interest, but also gave customers a sense of the design, content and quality of the products in which they were interested.
AWHONN submitted only these entries and won in three of 28 categories among more than 400 entries. The list of winners appeared in the December 7, 2007 issue of Association Trends magazine.
About AWHONN
The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) was founded in 1969 and is the foremost nursing authority that advances the health care of women and newborns through advocacy, research and the creation of high quality, evidence-based standards of care.
AWHONN's 22,000 members worldwide are clinicians, educators and executives who serve as patient care advocates focusing on the needs of women and infants. A leader in professional development, AWHONN is the first and only association to be awarded the designation Premier Provider by the American Nurses Credentialing Center for innovation and excellence in Continuing Education.
Association of Women's Health, Obstetric and Neonatal Nurses
AWHONN received the following:
- GOLD prize in the Informational/Promotional Piece category for the three-piece, "You Shall Find a Job!???? Fairy Godmother direct mail campaign for the Nursing Career Center. The campaign featured the Ella's story, from her graduation from nursing school through major milestones in her career. At each stage of her career, Ella's fairy godmother is on hand, advising her to visit www.NursingCareerCenter as she thought about new opportunities. The goal of the campaign was to build awareness for the Nursing Career Center as an online employment resource for nurses.
- SILVER prize in the Convention Registration Promotional Package category, for the 2007 Annual Convention Preliminary Program and collateral marketing pieces: "What Inspires You.???? The 2007 AWHONN convention theme was "Inspired to Excellence???? The campaign had a web-based interactive element in which people could submit what inspires them as a nurse and could see what other nurses had submitted to motivate and celebrate excellence among AWHONN members.
- BRONZE prize in the Catalog category, for the 2007 Resources Catalog. The AWHONN Resource Catalog underwent a major redesign in 2007, expanding the interior layout to highlight flagship products and adding more graphics and product photo displays. This attracted not only to add visual interest, but also gave customers a sense of the design, content and quality of the products in which they were interested.
AWHONN submitted only these entries and won in three of 28 categories among more than 400 entries. The list of winners appeared in the December 7, 2007 issue of Association Trends magazine.
About AWHONN
The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) was founded in 1969 and is the foremost nursing authority that advances the health care of women and newborns through advocacy, research and the creation of high quality, evidence-based standards of care.
AWHONN's 22,000 members worldwide are clinicians, educators and executives who serve as patient care advocates focusing on the needs of women and infants. A leader in professional development, AWHONN is the first and only association to be awarded the designation Premier Provider by the American Nurses Credentialing Center for innovation and excellence in Continuing Education.
Association of Women's Health, Obstetric and Neonatal Nurses
четверг, 22 марта 2012 г.
Yeovil District Hospital Offering Women Sutureless Surgery For Vaginal Hysterectomies - England
Yeovil District Hospital is the first hospital in the South West of England to be able to offer women sutureless surgery for vaginal hysterectomies.
Thanks to the purchase of a new diathermy machine surgeons can now perform day case vaginal hysterectomies.
Consultant gynaecologist, Sharif Ismail said: "This is a new era in gynaecological surgical techniques and will reduce the operating time and the risks to the patient, reduce bleeding, the amount of pain relief which needs to be given after the operation and the post-operative stay. This not only benefits the patient but frees beds to enable the hospital to continue to reduce its waiting lists.
"Feedback from patients who participated in the trial phase was very positive and this prompted the hospital to introduce the technique to improve both health care and patient satisfaction."
Yeovil District Hospital NHS Foundation Trust provides acute care for a population of about 180,000, mostly in South Somerset, North and West Dorset, and parts of Mendip. Increasingly, however, patients are using patient choice and deciding to come to YDH from as far afield as London and Portsmouth.
Each year more than 30,000 patients are admitted as inpatients or day cases; more than 90,000 people attend outpatient appointments; around 40,000 people are treated in Accident and Emergency; and some 1,300 babies are born in the Maternity Unit. The Foundation Trust has over 7,000 members and over 1,800 staff.
Yeovil District Hospital NHS Foundation Trust
Thanks to the purchase of a new diathermy machine surgeons can now perform day case vaginal hysterectomies.
Consultant gynaecologist, Sharif Ismail said: "This is a new era in gynaecological surgical techniques and will reduce the operating time and the risks to the patient, reduce bleeding, the amount of pain relief which needs to be given after the operation and the post-operative stay. This not only benefits the patient but frees beds to enable the hospital to continue to reduce its waiting lists.
"Feedback from patients who participated in the trial phase was very positive and this prompted the hospital to introduce the technique to improve both health care and patient satisfaction."
Yeovil District Hospital NHS Foundation Trust provides acute care for a population of about 180,000, mostly in South Somerset, North and West Dorset, and parts of Mendip. Increasingly, however, patients are using patient choice and deciding to come to YDH from as far afield as London and Portsmouth.
Each year more than 30,000 patients are admitted as inpatients or day cases; more than 90,000 people attend outpatient appointments; around 40,000 people are treated in Accident and Emergency; and some 1,300 babies are born in the Maternity Unit. The Foundation Trust has over 7,000 members and over 1,800 staff.
Yeovil District Hospital NHS Foundation Trust
четверг, 15 марта 2012 г.
Mo. House Approves Amendment Allowing Pharmacies To Refuse To Stock EC, Medication Abortion Drugs
The Missouri House on Tuesday voted 115-43 to approve an amendment that would allow pharmacies to refuse to dispense emergency contraception or fill prescriptions, the Columbia Missourian reports. According to the Missourian, the bill specifically mentions the emergency contraceptive Plan B, which can prevent pregnancy if taken within 72 hours of sexual intercourse, and mifepristone, which is available by prescription only and used to induce abortion. Mifepristone is only available through a doctor and cannot be distributed by a pharmacy according to the Missourian.
The amendment, sponsored by state Rep. Ed Emery (R), prohibits lawsuits against pharmacies that do not carry the drugs and prevents the state from revoking the licenses of pharmacies that do not supply the medications. FDA recently announced that it would allow individuals ages 17 and older to purchase Plan B without a prescription (Wire, Columbia Missourian, 4/28). In addition, the amendment stipulates that pharmacies would not be required to advise people on how to obtain the medications. Current Missouri law does not address whether pharmacies must stock the drugs. According to the AP/Springfield News-Leader, Missouri's Senate already approved the original bill (S.B 296), which involves professional licensing regulations.
Many Democrats objected to Emery's amendment, arguing that the measure could hinder women's access to EC, especially for women in rural areas (Blank, AP/Springfield News-Leader, 4/28). Some Democrats also said that the amendment is an attempt to control women's bodies. "To implement a law like this, especially in a rural area, seems to me to put another road block before women," state Rep. Mary Still (D) said. According to Emery, the measure is needed to protect pharmacy owners who object to stocking EC and mifepristone (Columbia Missourian, 4/28).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
The amendment, sponsored by state Rep. Ed Emery (R), prohibits lawsuits against pharmacies that do not carry the drugs and prevents the state from revoking the licenses of pharmacies that do not supply the medications. FDA recently announced that it would allow individuals ages 17 and older to purchase Plan B without a prescription (Wire, Columbia Missourian, 4/28). In addition, the amendment stipulates that pharmacies would not be required to advise people on how to obtain the medications. Current Missouri law does not address whether pharmacies must stock the drugs. According to the AP/Springfield News-Leader, Missouri's Senate already approved the original bill (S.B 296), which involves professional licensing regulations.
Many Democrats objected to Emery's amendment, arguing that the measure could hinder women's access to EC, especially for women in rural areas (Blank, AP/Springfield News-Leader, 4/28). Some Democrats also said that the amendment is an attempt to control women's bodies. "To implement a law like this, especially in a rural area, seems to me to put another road block before women," state Rep. Mary Still (D) said. According to Emery, the measure is needed to protect pharmacy owners who object to stocking EC and mifepristone (Columbia Missourian, 4/28).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
четверг, 8 марта 2012 г.
Physical Or Sexual Violence Often Accompanies Reproductive Coercion
Young women and teenage girls often face efforts by male partners to sabotage birth control or coerce pregnancy - including damaging condoms and destroying contraceptives - and these efforts, defined as "reproductive coercion," frequently are associated with physical or sexual violence, a study by a team of researchers led by UC Davis has found.
Published online today in the January issue of the journal Contraception, the study, "Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy," also found that among women who experienced both reproductive coercion and partner violence, the risk of unintended pregnancy doubled. The study is the first quantitative examination of the relationship between intimate partner violence, reproductive coercion and unintended pregnancy, the authors say.
"This study highlights an under-recognized phenomenon where male partners actively attempt to promote pregnancy against the will of their female partners," said lead study author Elizabeth Miller, an assistant professor of pediatrics in the UC Davis School of Medicine and a practitioner at UC Davis Children's Hospital. "Not only is reproductive coercion associated with violence from male partners, but when women report experiencing both reproductive coercion and partner violence, the risk for unintended pregnancy increases significantly."
Conducted between August 2008 and March 2009 at five reproductive health clinics in Northern California, the study involved approximately 1,300 English- and Spanish-speaking 16- to 29-year-old women who agreed to respond to a computerized survey about their experiences with relationships and pregnancy.
Study participants were asked questions about birth-control sabotage, pregnancy coercion and intimate partner violence to assess their experience of pregnancy coercion and birth control sabotage. Questions included:
"Has someone you were dating or going out with ever told you not to use any birth control" or "??¦ said he would leave you if you would not get pregnant?"
"Has someone you were dating or going out with ever taken off the condom while you were having sex so that you would get pregnant?"
Approximately one in five young women said they experienced pregnancy coercion and 15 percent said they experienced birth control sabotage. Over half the respondents - 53 percent - said they had experienced physical or sexual violence from an intimate partner. More than a third of the women who reported partner violence - 35 percent - also reported either pregnancy coercion or birth control sabotage.
"We have known about the association between partner violence and unintended pregnancy for many years," said Jay Silverman, the study's senior author and an associate professor of society, human development and health in the Harvard School of Public Health. "What this study shows is that reproductive coercion likely explains why unintended pregnancies are far more common among abused women and teens."
The study authors said the research underscores the importance of educating women seeking care about reproductive coercion, and ensuring that women who are seeking reproductive health services are offered counseling on ways to prevent pregnancy that are less vulnerable to partner interference, as well as connected to domestic violence-related services. The study also highlights the importance of working with young men to prevent both violence against female partners and coercion around pregnancy.
"This study confirms that women experiencing partner violence are more likely to have greater need for sexual and reproductive health services," Miller said. "Thus, clinical settings that offer reproductive health services likely offer the greatest opportunity to identify women experiencing partner violence and to ensure that women receive the counseling and support they may need." Comprehensive assessment in clinical settings for pregnancy coercion, birth control sabotage and intimate partner violence should be considered a priority in the context of family planning services. Moreover, public health efforts to reduce unintended pregnancy should ensure that discussions of reproductive coercion are included in pregnancy prevention programs, she said.
Other study authors include Michele Decker and Heather McCauley of the Harvard School of Public Health, Daniel Tancredi of UC Davis, Rebecca Levenson of the Family Violence Prevention Fund of San Francisco, and Jeffrey Waldman and Phyllis Schoenwald of the Planned Parenthood Shasta Diablo Affiliate.
The study was funded by the National Institute of Child Health and Human Development as well as by a UC Davis Health System Research Award and a Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Award to Miller.
Source:
Phyllis Brown
University of California - Davis - Health System
Published online today in the January issue of the journal Contraception, the study, "Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy," also found that among women who experienced both reproductive coercion and partner violence, the risk of unintended pregnancy doubled. The study is the first quantitative examination of the relationship between intimate partner violence, reproductive coercion and unintended pregnancy, the authors say.
"This study highlights an under-recognized phenomenon where male partners actively attempt to promote pregnancy against the will of their female partners," said lead study author Elizabeth Miller, an assistant professor of pediatrics in the UC Davis School of Medicine and a practitioner at UC Davis Children's Hospital. "Not only is reproductive coercion associated with violence from male partners, but when women report experiencing both reproductive coercion and partner violence, the risk for unintended pregnancy increases significantly."
Conducted between August 2008 and March 2009 at five reproductive health clinics in Northern California, the study involved approximately 1,300 English- and Spanish-speaking 16- to 29-year-old women who agreed to respond to a computerized survey about their experiences with relationships and pregnancy.
Study participants were asked questions about birth-control sabotage, pregnancy coercion and intimate partner violence to assess their experience of pregnancy coercion and birth control sabotage. Questions included:
"Has someone you were dating or going out with ever told you not to use any birth control" or "??¦ said he would leave you if you would not get pregnant?"
"Has someone you were dating or going out with ever taken off the condom while you were having sex so that you would get pregnant?"
Approximately one in five young women said they experienced pregnancy coercion and 15 percent said they experienced birth control sabotage. Over half the respondents - 53 percent - said they had experienced physical or sexual violence from an intimate partner. More than a third of the women who reported partner violence - 35 percent - also reported either pregnancy coercion or birth control sabotage.
"We have known about the association between partner violence and unintended pregnancy for many years," said Jay Silverman, the study's senior author and an associate professor of society, human development and health in the Harvard School of Public Health. "What this study shows is that reproductive coercion likely explains why unintended pregnancies are far more common among abused women and teens."
The study authors said the research underscores the importance of educating women seeking care about reproductive coercion, and ensuring that women who are seeking reproductive health services are offered counseling on ways to prevent pregnancy that are less vulnerable to partner interference, as well as connected to domestic violence-related services. The study also highlights the importance of working with young men to prevent both violence against female partners and coercion around pregnancy.
"This study confirms that women experiencing partner violence are more likely to have greater need for sexual and reproductive health services," Miller said. "Thus, clinical settings that offer reproductive health services likely offer the greatest opportunity to identify women experiencing partner violence and to ensure that women receive the counseling and support they may need." Comprehensive assessment in clinical settings for pregnancy coercion, birth control sabotage and intimate partner violence should be considered a priority in the context of family planning services. Moreover, public health efforts to reduce unintended pregnancy should ensure that discussions of reproductive coercion are included in pregnancy prevention programs, she said.
Other study authors include Michele Decker and Heather McCauley of the Harvard School of Public Health, Daniel Tancredi of UC Davis, Rebecca Levenson of the Family Violence Prevention Fund of San Francisco, and Jeffrey Waldman and Phyllis Schoenwald of the Planned Parenthood Shasta Diablo Affiliate.
The study was funded by the National Institute of Child Health and Human Development as well as by a UC Davis Health System Research Award and a Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Award to Miller.
Source:
Phyllis Brown
University of California - Davis - Health System
четверг, 1 марта 2012 г.
Women With Polycystic Ovary Syndrome May Be More Vulnerable To BPA
A recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM), found higher Bisphenol A (BPA) levels in women with polycystic ovary syndrome (PCOS) compared to controls. Furthermore, researchers found a statistically significant positive association between male sex hormones and BPA in these women suggesting a potential role of BPA in ovarian dysfunction.
BPA is a very common industrial compound used in food and drink packaging, plastic consumer products and dental materials. PCOS is the most common endocrine disorder of women of reproductive age and is characterized by excessive secretion of androgens which are masculinization-promoting hormones. The syndrome raises the risk of obesity, type 2 diabetes, infertility and heart disease.
"Our research shows that BPA may be more harmful to women with hormonal and fertility imbalances like those found in PCOS," said Evanthia Diamanti-Kandarakis, MD, PhD, study co-author and professor at the University of Athens Medical School in Greece. "These women should be alert to the potential risks and take care of themselves by avoiding excessive every-day consumption of food or drink from plastic containers."
In this study, researchers divided 71 women with PCOS and 100 healthy female control subjects into subgroups matched by age and body composition. Blood levels of BPA were nearly 60 percent higher in lean women with PCOS and more than 30 percent higher in obese women with the syndrome when compared to controls. Additionally, as BPA levels increased, so did concentrations of the male sex hormone testosterone and androstenedione, a steroid hormone that converts to testosterone.
"Excessive secretion of androgens, as seen in PCOS, interfere with BPA detoxification by the liver, leading to accumulation of blood levels of BPA," said Diamanti-Kandarakis. "BPA also affects androgen metabolism, creating a vicious circle between androgens and BPA."
Other researchers working on the study include: Eleni Kandaraki of Huddersfield Royal Infirmary Hospital in West Yorkshire, United Kingdom; Antonis Chatzigeorgiou, Sarantis Livadas, Eleni Palioura, Frangiscos Economou, Michael Koutsilieris and Sotiria Palimeri of National and Kapodistrian University of Athens in Greece; and Dimitrios Panidis of Aristotle University of Thessaloniki in Greece.
The article, "Endocrine disruptors and polycystic ovary syndrome (PCOS): Elevated serum levels of Bisphenol A in women with PCOS," appears in the March 2011 issue of JCEM.
Source:
Endocrine Society
BPA is a very common industrial compound used in food and drink packaging, plastic consumer products and dental materials. PCOS is the most common endocrine disorder of women of reproductive age and is characterized by excessive secretion of androgens which are masculinization-promoting hormones. The syndrome raises the risk of obesity, type 2 diabetes, infertility and heart disease.
"Our research shows that BPA may be more harmful to women with hormonal and fertility imbalances like those found in PCOS," said Evanthia Diamanti-Kandarakis, MD, PhD, study co-author and professor at the University of Athens Medical School in Greece. "These women should be alert to the potential risks and take care of themselves by avoiding excessive every-day consumption of food or drink from plastic containers."
In this study, researchers divided 71 women with PCOS and 100 healthy female control subjects into subgroups matched by age and body composition. Blood levels of BPA were nearly 60 percent higher in lean women with PCOS and more than 30 percent higher in obese women with the syndrome when compared to controls. Additionally, as BPA levels increased, so did concentrations of the male sex hormone testosterone and androstenedione, a steroid hormone that converts to testosterone.
"Excessive secretion of androgens, as seen in PCOS, interfere with BPA detoxification by the liver, leading to accumulation of blood levels of BPA," said Diamanti-Kandarakis. "BPA also affects androgen metabolism, creating a vicious circle between androgens and BPA."
Other researchers working on the study include: Eleni Kandaraki of Huddersfield Royal Infirmary Hospital in West Yorkshire, United Kingdom; Antonis Chatzigeorgiou, Sarantis Livadas, Eleni Palioura, Frangiscos Economou, Michael Koutsilieris and Sotiria Palimeri of National and Kapodistrian University of Athens in Greece; and Dimitrios Panidis of Aristotle University of Thessaloniki in Greece.
The article, "Endocrine disruptors and polycystic ovary syndrome (PCOS): Elevated serum levels of Bisphenol A in women with PCOS," appears in the March 2011 issue of JCEM.
Source:
Endocrine Society
четверг, 23 февраля 2012 г.
Highest Risk Factor For Colorectal Cancer Among Women Is Obesity
Research presented at the 72nd Annual Scientific Meeting of the American College of Gastroenterology found that obesity, among other important risk factors, was the strongest risk factor for colorectal cancer in women.
Joseph C. Anderson, MD of Stony Brook University in New York (and the University of Connecticut) and his colleagues examined data from 1,252 women who underwent colonoscopy. They classified patients according to their age, smoking history, family history of colorectal cancer, and body mass index (BMI). Obesity was defined as a BMI of 30 or higher. For smoking, patients were divided into three groups: heavy exposure, low exposure, and no exposure. Patients who were in the heavy exposure group included women who had smoked more than 10 "pack years" and who were currently smoking or had quit in the past 10 years.
Although smoking posed a significant increased risk for colorectal neoplasia, researchers found that for women, obesity was the highest attributable risk factor for developing the disease. BMI accounted for one-fifth of all significant polyps detected during colonoscopy. Of those patients who had colorectal neoplasia, 20 percent were obese and 14 percent were smokers.
"Given the increasing number of obese patients in the U.S., identifying them as high risk may have important screening implications," said Dr. Anderson. "While obesity is positively associated with an increased risk of colorectal cancer, patients who lower their BMI could potentially reduce their risk of developing the disease in the future."
About Body Mass Index (BMI)
Body mass index, or BMI, is a measurement that determines the healthiness of a person's weight. The formula is related to the amount of fat a person carries and is calculated using the person's height and weight. A healthy BMI is between 18.5 and 24.9. People are considered underweight if their BMI is less than 18.5, overweight if their BMI is between 25 and 29.9, and obese if their BMI is 30 or higher.
About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 10,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients.
The ACG is committed to providing accurate, unbiased and up-to-date health information. Visit the ACG Web site American College of Gastroenterology
to access educational resources for patients and their families spanning the broad range of digestive diseases and conditions -- both common and not-so-common. Organized by disease, state and organ system, these educational materials, developed by ACG physician experts, are offered for the information and benefit of patients and the public.
Source: Rosanne Riesenman
American College of Gastroenterology
Joseph C. Anderson, MD of Stony Brook University in New York (and the University of Connecticut) and his colleagues examined data from 1,252 women who underwent colonoscopy. They classified patients according to their age, smoking history, family history of colorectal cancer, and body mass index (BMI). Obesity was defined as a BMI of 30 or higher. For smoking, patients were divided into three groups: heavy exposure, low exposure, and no exposure. Patients who were in the heavy exposure group included women who had smoked more than 10 "pack years" and who were currently smoking or had quit in the past 10 years.
Although smoking posed a significant increased risk for colorectal neoplasia, researchers found that for women, obesity was the highest attributable risk factor for developing the disease. BMI accounted for one-fifth of all significant polyps detected during colonoscopy. Of those patients who had colorectal neoplasia, 20 percent were obese and 14 percent were smokers.
"Given the increasing number of obese patients in the U.S., identifying them as high risk may have important screening implications," said Dr. Anderson. "While obesity is positively associated with an increased risk of colorectal cancer, patients who lower their BMI could potentially reduce their risk of developing the disease in the future."
About Body Mass Index (BMI)
Body mass index, or BMI, is a measurement that determines the healthiness of a person's weight. The formula is related to the amount of fat a person carries and is calculated using the person's height and weight. A healthy BMI is between 18.5 and 24.9. People are considered underweight if their BMI is less than 18.5, overweight if their BMI is between 25 and 29.9, and obese if their BMI is 30 or higher.
About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 10,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients.
The ACG is committed to providing accurate, unbiased and up-to-date health information. Visit the ACG Web site American College of Gastroenterology
to access educational resources for patients and their families spanning the broad range of digestive diseases and conditions -- both common and not-so-common. Organized by disease, state and organ system, these educational materials, developed by ACG physician experts, are offered for the information and benefit of patients and the public.
Source: Rosanne Riesenman
American College of Gastroenterology
четверг, 16 февраля 2012 г.
Mammography: Is It Right For Me? New Book Shines Light On Mammography Controversy
The subject of changing public advice over the years, mammography and the controversy over its use continue to cause confusion in the minds of many women. A new book for lay readers entitled "Understanding the Mammography Controversy: Science, Politics, and Breast Cancer Screening" (Praeger Press), by women's health expert Dr. Madelon L. Finkel of Weill Medical College of Cornell University, provides a comprehensive guide to mammography, the mammography controversy and breast health.
The book directly addresses the still-controversial issues, such as deciding when is the "right" time to have a mammogram, what is the "right" age for mammography (the body of evidence indicates a benefit for women aged 50 to 69) and whether mammography is useful at all (it is). While not perfect, mammography is the only population-based breast cancer screening method that has been shown to actually save lives.
"It's no wonder women are confused about mammography. Sensational media stories tout the latest scientific studies, often contradicting previous findings. Above all, women need to separate the facts from the myths in order to make informed decisions about their breast health," says Dr. Finkel, professor of clinical public health and director of the Office of Global Health Education at Weill Cornell Medical College.
This book includes a timeline that details the disagreement within the scientific community and changing public advice on mammography over the years.
"The mammography debate is still not yet settled. While the latest research shows that mammography can save lives, there is still no overall consensus on what age mammogram screening should be recommended, and even whether the benefits of mammogram screening outweigh the risks in the first place," says Dr. Finkel." Each woman must consider her personal risk factors, and in consultation with her doctor, decide when and how frequently mammography should be scheduled."
The book offers readers practical information, including how to give a breast self-exam, how to communicate with one's doctor, a list of support groups and organizations for breast cancer patients, and resources for clinical trials.
"Most women will not develop breast cancer in their lifetime, and for those who do, it's no longer a death sentence. Thanks to public awareness, screening, research and new treatment options, it has become a treatable, chronic illness," says Dr. Finkel.
"Understanding the Mammography Controversy: Science, Politics, and Breast Cancer Screening" received the highest rating from BookList. The book is dedicated to the author's mother, who died of breast cancer.
Dr. Madelon Finkel
Dr. Madelon Finkel has been involved in epidemiologic research and health-care policy studies for more than two decades. Her research has been focused on such women's health issues as teenage sexual behavior and hormone replacement therapy.
Dr. Finkel received an M.P.A. and Ph.D. in epidemiology and health services research from NYU. In addition to her titles at Weill Cornell Medical College, Dr. Finkel also holds the rank of professor of research in medicine at SUNY Stony Brook, and was a visiting professor at the School of Public Health, University of Sydney (Australia) in 2004. She is a member of the American College of Epidemiology, an advisor to the American Council on Science and Health, and a charter member of the Academy of Benefit Authors of the International Foundation of Employee Benefit Plans. Dr. Finkel was awarded the highest teaching honor at Weill Cornell, the Excellence in Teaching Award, in 2000 and 2005.
The Joan and Sanford I. Weill Medical College
The Joan and Sanford I. Weill Medical College -- located in New York City -- is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine. The Medical College, which is a principal academic affiliate of NewYork-Presbyterian Hospital, offers an innovative curriculum that integrates the teaching of basic and clinical sciences, problem-based learning, office-based preceptorships, and primary care and doctoring courses. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research in such areas as stem cells, genetics and gene therapy, geriatrics, neuroscience, structural biology, cardiovascular biology, AIDS, obesity, cancer and psychiatry -- and continue to delve ever-deeper into the molecular basis of disease in an effort to unlock the mysteries behind the human body and the malfunctions that result in serious medical disorders. Weill Cornell Medical College is the birthplace of many medical advances -- from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., and most recently, the world's first clinical trial for gene therapy for Parkinson's disease. Weill Cornell's Physician Organization includes 650 clinical faculty who provide the highest quality of care to patients.
Joan and Sanford I. Weill Medical College of Cornell University
nyp
The book directly addresses the still-controversial issues, such as deciding when is the "right" time to have a mammogram, what is the "right" age for mammography (the body of evidence indicates a benefit for women aged 50 to 69) and whether mammography is useful at all (it is). While not perfect, mammography is the only population-based breast cancer screening method that has been shown to actually save lives.
"It's no wonder women are confused about mammography. Sensational media stories tout the latest scientific studies, often contradicting previous findings. Above all, women need to separate the facts from the myths in order to make informed decisions about their breast health," says Dr. Finkel, professor of clinical public health and director of the Office of Global Health Education at Weill Cornell Medical College.
This book includes a timeline that details the disagreement within the scientific community and changing public advice on mammography over the years.
"The mammography debate is still not yet settled. While the latest research shows that mammography can save lives, there is still no overall consensus on what age mammogram screening should be recommended, and even whether the benefits of mammogram screening outweigh the risks in the first place," says Dr. Finkel." Each woman must consider her personal risk factors, and in consultation with her doctor, decide when and how frequently mammography should be scheduled."
The book offers readers practical information, including how to give a breast self-exam, how to communicate with one's doctor, a list of support groups and organizations for breast cancer patients, and resources for clinical trials.
"Most women will not develop breast cancer in their lifetime, and for those who do, it's no longer a death sentence. Thanks to public awareness, screening, research and new treatment options, it has become a treatable, chronic illness," says Dr. Finkel.
"Understanding the Mammography Controversy: Science, Politics, and Breast Cancer Screening" received the highest rating from BookList. The book is dedicated to the author's mother, who died of breast cancer.
Dr. Madelon Finkel
Dr. Madelon Finkel has been involved in epidemiologic research and health-care policy studies for more than two decades. Her research has been focused on such women's health issues as teenage sexual behavior and hormone replacement therapy.
Dr. Finkel received an M.P.A. and Ph.D. in epidemiology and health services research from NYU. In addition to her titles at Weill Cornell Medical College, Dr. Finkel also holds the rank of professor of research in medicine at SUNY Stony Brook, and was a visiting professor at the School of Public Health, University of Sydney (Australia) in 2004. She is a member of the American College of Epidemiology, an advisor to the American Council on Science and Health, and a charter member of the Academy of Benefit Authors of the International Foundation of Employee Benefit Plans. Dr. Finkel was awarded the highest teaching honor at Weill Cornell, the Excellence in Teaching Award, in 2000 and 2005.
The Joan and Sanford I. Weill Medical College
The Joan and Sanford I. Weill Medical College -- located in New York City -- is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine. The Medical College, which is a principal academic affiliate of NewYork-Presbyterian Hospital, offers an innovative curriculum that integrates the teaching of basic and clinical sciences, problem-based learning, office-based preceptorships, and primary care and doctoring courses. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research in such areas as stem cells, genetics and gene therapy, geriatrics, neuroscience, structural biology, cardiovascular biology, AIDS, obesity, cancer and psychiatry -- and continue to delve ever-deeper into the molecular basis of disease in an effort to unlock the mysteries behind the human body and the malfunctions that result in serious medical disorders. Weill Cornell Medical College is the birthplace of many medical advances -- from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., and most recently, the world's first clinical trial for gene therapy for Parkinson's disease. Weill Cornell's Physician Organization includes 650 clinical faculty who provide the highest quality of care to patients.
Joan and Sanford I. Weill Medical College of Cornell University
nyp
четверг, 9 февраля 2012 г.
Helping Teens Overcome Fears And Stigmas Of Mental Illness
When teens start experiencing changes in moods or emotions, they tend to fear sharing their blue days with their families and adults who can help them. As a consequence, they often suffer in silence.
Case Western Reserve University KL2 Clinical Research Scholar and Instructor Melissa Pinto-Foltz from the Frances Payne Bolton School of Nursing wants to find the magical elixir that helps teens speak up, seek help and then stick with treatments that get them feeling better.
"About one in five Americans has a mental illness, with half of these individuals first experiencing symptoms of mental illness in their teen years," she said.
Pinto-Foltz's research contributes to efforts nationwide to combat a public health issue, stigma and mental health literacy, made a priority in a U. S. Surgeon General's Report and the President's New Freedom Commission on Mental Health.
She found that a good way to reach teens to help them learn about mental illness and improve negative attitudes about mental illness was through their school.
She studied 156 girls in the 9th and 10th grade in a research project set in public high schools in Louisville, Ky. About half the group participated in a special national program called In Our Own Voice, offered by the National Alliance for Mental Illness, and the other half did not see the program.
More than 200,000 people across the U.S. have seen the In Our Own Voice program, which is frequently given in schools, churches and other community settings. The one-hour program involves learning through storytelling and changing attitudes through interacting with people who are in sustained recovery from mental illness. These individuals tell their personal stories of what it was like to first discover the illness and get through their recovery from the illness.
While the program is widely used across the U.S., no evidence exists that it is effective with teens, nor has the impact of the program been examined for an extended time period.
Pinto-Foltz used the In Our Own Voice program with the teens and reported her findings from the study, "Feasibility, Acceptability, and Initial Efficacy of a Knowledge-Contact Program to Reduce Mental Illness Stigma and Improve Mental Health Literacy in Adolescents," in Social Science and Medicine.
"We tell stories every day to friends, family and co-workers," she said. "The whole idea behind this approach is that people learn about the world through stories, and interacting with people with mental illness may violate previously held stereotypes. We wanted to see if teens responded to these interactions with and stories told by people with mental illness in such a way that it decreased stigma associated with mental illness and improved their knowledge of mental illness."
She followed participants four times over 10 weeks: first to study what stigmas and knowledge they had about mental illness, then in response to the In Our Own Voice program. She conducted follow-up interviews shortly after girls saw the program and again at weeks 4 and 8 to see if there were changes in the their level of stigma associated with mental illness and whether their knowledge of mental illness increased.
Pinto-Foltz's 10-week study found that the girls liked and learned from the In Our Own Voice storytelling program, but the program was too short to change some of the girls' stigmas that they would be more accepting of individuals with mental illness.
"This was our first assessment of In Our Own Voice as it's currently given, and it's a starting point to tackle stigma and improve mental health literacy among adolescents using existing approaches," she said.
In the future, she added that we can increase our chance of combating stigma and increasing mental health knowledge by providing more opportunities for adolescents to interact with the presenters following the program.
She suggested continued interaction with the presenters through projects with the girls or visits to their health classes for further discussions about mental illness.
"The girls were eager for more interaction with the presenters," Pinto-Foltz explained. "They kept asking me when the presenters would return to tell more stories. After the program, the girls had many lingering questions about mental illness. Increasing their interaction with the presenters would allow an opportunity to clarify their questions about mental illness, increase their comfort in interacting with individuals with mental illness, and decrease stigma."
Meanwhile in the follow-up with the girls at four and eight weeks, Pinto-Foltz found that girls who participated in In Our Own Voice had improved mental health knowledge when compared to the girls who did not receive the program.
Stigma levels for both groups remained the same, calling for further examination of approaches to tackle this important and pervasive problem, Pinto-Foltz said.
This research was support by the Midwest Nursing Research Society and the Iota Chapter of Sigma Theta Tau.
Source:
Susan Griffith
Case Western Reserve University
Case Western Reserve University KL2 Clinical Research Scholar and Instructor Melissa Pinto-Foltz from the Frances Payne Bolton School of Nursing wants to find the magical elixir that helps teens speak up, seek help and then stick with treatments that get them feeling better.
"About one in five Americans has a mental illness, with half of these individuals first experiencing symptoms of mental illness in their teen years," she said.
Pinto-Foltz's research contributes to efforts nationwide to combat a public health issue, stigma and mental health literacy, made a priority in a U. S. Surgeon General's Report and the President's New Freedom Commission on Mental Health.
She found that a good way to reach teens to help them learn about mental illness and improve negative attitudes about mental illness was through their school.
She studied 156 girls in the 9th and 10th grade in a research project set in public high schools in Louisville, Ky. About half the group participated in a special national program called In Our Own Voice, offered by the National Alliance for Mental Illness, and the other half did not see the program.
More than 200,000 people across the U.S. have seen the In Our Own Voice program, which is frequently given in schools, churches and other community settings. The one-hour program involves learning through storytelling and changing attitudes through interacting with people who are in sustained recovery from mental illness. These individuals tell their personal stories of what it was like to first discover the illness and get through their recovery from the illness.
While the program is widely used across the U.S., no evidence exists that it is effective with teens, nor has the impact of the program been examined for an extended time period.
Pinto-Foltz used the In Our Own Voice program with the teens and reported her findings from the study, "Feasibility, Acceptability, and Initial Efficacy of a Knowledge-Contact Program to Reduce Mental Illness Stigma and Improve Mental Health Literacy in Adolescents," in Social Science and Medicine.
"We tell stories every day to friends, family and co-workers," she said. "The whole idea behind this approach is that people learn about the world through stories, and interacting with people with mental illness may violate previously held stereotypes. We wanted to see if teens responded to these interactions with and stories told by people with mental illness in such a way that it decreased stigma associated with mental illness and improved their knowledge of mental illness."
She followed participants four times over 10 weeks: first to study what stigmas and knowledge they had about mental illness, then in response to the In Our Own Voice program. She conducted follow-up interviews shortly after girls saw the program and again at weeks 4 and 8 to see if there were changes in the their level of stigma associated with mental illness and whether their knowledge of mental illness increased.
Pinto-Foltz's 10-week study found that the girls liked and learned from the In Our Own Voice storytelling program, but the program was too short to change some of the girls' stigmas that they would be more accepting of individuals with mental illness.
"This was our first assessment of In Our Own Voice as it's currently given, and it's a starting point to tackle stigma and improve mental health literacy among adolescents using existing approaches," she said.
In the future, she added that we can increase our chance of combating stigma and increasing mental health knowledge by providing more opportunities for adolescents to interact with the presenters following the program.
She suggested continued interaction with the presenters through projects with the girls or visits to their health classes for further discussions about mental illness.
"The girls were eager for more interaction with the presenters," Pinto-Foltz explained. "They kept asking me when the presenters would return to tell more stories. After the program, the girls had many lingering questions about mental illness. Increasing their interaction with the presenters would allow an opportunity to clarify their questions about mental illness, increase their comfort in interacting with individuals with mental illness, and decrease stigma."
Meanwhile in the follow-up with the girls at four and eight weeks, Pinto-Foltz found that girls who participated in In Our Own Voice had improved mental health knowledge when compared to the girls who did not receive the program.
Stigma levels for both groups remained the same, calling for further examination of approaches to tackle this important and pervasive problem, Pinto-Foltz said.
This research was support by the Midwest Nursing Research Society and the Iota Chapter of Sigma Theta Tau.
Source:
Susan Griffith
Case Western Reserve University
четверг, 2 февраля 2012 г.
Outcomes For Robotic-Assisted Hysterectomy Similar To Conventional Laparoscopy, Study Finds
Two methods of performing a minimally invasive hysterectomy -- either by a surgeon alone or with assistance of robotic equipment -- produced similar, positive outcomes in women with endometrial cancer, according to a study in the journal Obstetrics & Gynecology, Reuters reports. The study's authors said both methods proved superior to the traditional open procedure, which involves a relatively large abdominal incision.
More than 40,000 women are diagnosed with endometrial cancer in the U.S. every year. Treatment usually involves a hysterectomy -- the surgical removal of the uterus -- and often the removal of lymph nodes to determine the stage of the cancer.
The conventional minimally invasive procedure is performed through laparoscopy, using a small incision and a video camera, but it requires intensive training on the part of the surgeon. The robot, though adding a few thousand dollars to the procedure's price, provides better vision, improves range of motion and uses more intuitive movements.
The study found that both minimally invasive techniques resulted in longer operations but shorter hospital stays, compared with the open procedure. The robotic surgery caused about half as much blood loss as the standard laparoscopy. There were no differences in complications among the three techniques.
"Robotics increases the chance that a hysterectomy can be done by laparoscopy," Tommaso Falcone of the Cleveland Clinic said. "However, if the surgeon is skilled enough to do the hysterectomy without the robot by laparoscopy, then the outcomes will be similar," he said (Peeples, Reuters, 11/29).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families.
© 2010 National Partnership for Women & Families. All rights reserved.
четверг, 26 января 2012 г.
Federal Judge Rejects Motions To Dismiss Trial Against Convicted Murderer Kopp
U.S. District Judge Richard Arcara on Thursday rejected all defense motions to dismiss the upcoming federal trial against convicted murderer James Kopp and ruled that Kopp cannot discuss his antiabortion views during the trial, the AP/Jackson News-Tribune reports (Thompson, AP/Jackson News-Tribune, 12/7). Kopp in 2003 was convicted under state second-degree murder charges and sentenced to 25 years to life in prison for murdering Buffalo, N.Y., abortion provider Barnett Slepian in 1998. In the upcoming trial, he faces charges of violating the federal Freedom of Access to Clinic Entrances Act. The federal charges could carry a sentence of life in prison without parole. Kopp's former attorney, John Humann, had filed a motion to suppress Kopp's confession to the murder despite Kopp's objection. Kopp subsequently made a request to represent himself, which Arcara granted in May. Prosecutors had asked Arcara to prohibit buttons or T-shirts displaying abortion-related slogans in the courtroom. They also attempted to prevent Kopp from explaining his reasons for opposing abortion, describing the experiences of former abortion patients and how fetuses develop or showing the jury pictures of aborted fetuses (Kaiser Daily Women's Health Policy Report, 7/19). Arcara ruled that Kopp cannot discuss his antiabortion views or offer abortion-related photographs or testimony because they are irrelevant (AP/Jackson News-Tribune, 12/7). Arcara has tentatively scheduled the federal trial for Jan. 3, 2007 (Kaiser Daily Women's Health Policy Report, 7/19).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
четверг, 19 января 2012 г.
Partner Assistance Allows ADPH To Continue Serving Women At High Risk Of Breast And Cervical Cancer
Thanks to the generosity of the Joy to Life Foundation and the Susan G. Komen for the Cure,
North Central Alabama Affiliate, the Alabama Department of Public Health can continue to fund
the screening of high-risk women for breast and cervical cancer through June 30.
In the past seven months the Alabama Breast and Cervical Cancer Early Detection Program
has served 10,000 women, the number of women ordinarily served during an entire year. All
program appropriations have been depleted because of this unprecedented demand for
services. To avoid completely suspending the program, the two nonprofit organizations have
stepped forward to provide funding for screening high-risk women.
"We are very appreciative of the donation of private funds by the Joy to Life Foundation and the
Susan G. Komen for the Cure, North Alabama Affiliate," said Dr. Donald Williamson, state
health officer. "We would have been forced to suspend services were it not for their donations
that will carry the program through the next five months. Last year alone more than 150
medically underserved women were diagnosed with breast and cervical cancer through this
program, and more than 1,700 women have been diagnosed since this program began in 1996."
Early detection of these cancers saves lives. Breast cancer screening services include clinical
breast examinations and mammograms. Cervical cancer screening services include pelvic
exams and Pap smears. If an abnormality is detected, diagnostic testing for both cancers may
include an ultrasound, biopsy or colposcopy.
To be eligible for screening, the individual must be female, have an income at or below 200
percent of the federal poverty level, and have no insurance or be underinsured. In addition, the
patient must be age 40-64 and have an abnormal clinical breast exam, or age 50-64 and never
had a mammogram in her lifetime, or have not had a Pap smear in the past five years
Funding for screening services is provided by the Centers for Disease Control and Prevention,
State of Alabama, and the National Breast Cancer Foundation. Aside from provision of new
funds, Joy to Life and Komen have been providing funding for mammograms to women under
50 years of age for several years.
Program services are provided by more than 400 contracted physicians, surgeons, radiologists
and facilities across the state committed to providing services to underserved women. These
providers agree to accept a reduced rate for their services, they also agree to submit required
data regarding services they provide for submission to the CDC.
In addition to the Joy to Life Foundation and Susan G. Komen for the Cure, North Alabama
Affiliate, other partners include the American Cancer Society, Deep South Network, REACH US/
REACH 2010 Coalition, the University of Alabama at Birmingham's Comprehensive Cancer
Center, the University of South Alabama Mitchell Cancer Institute, Southeast Alabama Regional
Medical Center, Avon Foundation's Butterfly Project, and many others.
Source:
Alabama Department of Public Health
North Central Alabama Affiliate, the Alabama Department of Public Health can continue to fund
the screening of high-risk women for breast and cervical cancer through June 30.
In the past seven months the Alabama Breast and Cervical Cancer Early Detection Program
has served 10,000 women, the number of women ordinarily served during an entire year. All
program appropriations have been depleted because of this unprecedented demand for
services. To avoid completely suspending the program, the two nonprofit organizations have
stepped forward to provide funding for screening high-risk women.
"We are very appreciative of the donation of private funds by the Joy to Life Foundation and the
Susan G. Komen for the Cure, North Alabama Affiliate," said Dr. Donald Williamson, state
health officer. "We would have been forced to suspend services were it not for their donations
that will carry the program through the next five months. Last year alone more than 150
medically underserved women were diagnosed with breast and cervical cancer through this
program, and more than 1,700 women have been diagnosed since this program began in 1996."
Early detection of these cancers saves lives. Breast cancer screening services include clinical
breast examinations and mammograms. Cervical cancer screening services include pelvic
exams and Pap smears. If an abnormality is detected, diagnostic testing for both cancers may
include an ultrasound, biopsy or colposcopy.
To be eligible for screening, the individual must be female, have an income at or below 200
percent of the federal poverty level, and have no insurance or be underinsured. In addition, the
patient must be age 40-64 and have an abnormal clinical breast exam, or age 50-64 and never
had a mammogram in her lifetime, or have not had a Pap smear in the past five years
Funding for screening services is provided by the Centers for Disease Control and Prevention,
State of Alabama, and the National Breast Cancer Foundation. Aside from provision of new
funds, Joy to Life and Komen have been providing funding for mammograms to women under
50 years of age for several years.
Program services are provided by more than 400 contracted physicians, surgeons, radiologists
and facilities across the state committed to providing services to underserved women. These
providers agree to accept a reduced rate for their services, they also agree to submit required
data regarding services they provide for submission to the CDC.
In addition to the Joy to Life Foundation and Susan G. Komen for the Cure, North Alabama
Affiliate, other partners include the American Cancer Society, Deep South Network, REACH US/
REACH 2010 Coalition, the University of Alabama at Birmingham's Comprehensive Cancer
Center, the University of South Alabama Mitchell Cancer Institute, Southeast Alabama Regional
Medical Center, Avon Foundation's Butterfly Project, and many others.
Source:
Alabama Department of Public Health
четверг, 12 января 2012 г.
Human Papilloma Virus Vaccine Effective In Women Aged 24-45 Not Previously Exposed
An article published Online First and in an upcoming edition of The Lancet reports that women aged between 24 and 45 can be protected by the human papilloma virus (HPV) vaccine, if they have not been already infected by the virus. The report is the work of Dr Nubia Mu?±oz, from the National Institute of Cancer, Bogot??, Colombia, and collaborators.
Over the last thirty years, sexual behavior has changed. The age of the first marriage is rising, divorce rates are augmenting. As a result, premarital intercourse and having a new sexual partner around middle-age are common behaviors. The HPV virus is transmitted through sexual intercourse and can lead to cervical cancer or other cervical disease. It could be beneficial for older women to receive vaccination against the HPV virus. The women who participated in the randomized trial did not have a history of cervical disease or cancer or genital warts, caused by HPV types 6, 11, 16 and 18. The first group of women received the quadrivalent HPV vaccine and the second group received placebo (at day 1 and months 2 and 6).
There were a total of 1911 women in the first group and 1908 in the second group. The first endpoint for assessment was infection for six months or more, and cervical and external genital disease due to HPV 6, 11, 16, 18. The second was the same but genital disease was due to HPV 16 and 18 only. The average of follow-up time was of 2.2 years. No further data was analyzed at the end of the four year trial. Among the women, specific populations were analyzed.
The per-protocol population of ideal participants included 1615 women who were given the vaccine and 1607 receiving placebo. From day 1 and up to month seven, they all tested negative for the appropriate vaccine HPV type. Within one year, they all had to receive three vaccine doses. They were required to have one or more follow-up visits after month seven. Research showed that there were four cases of infection or disease in the vaccine group compared to forty one in the placebo group. Researchers observed the vaccine proved to have 91 percent effectiveness against all four virus strains (the percent reduction in incidence rate in the vaccine group compared to the placebo group). In the evaluation of the HPV 16 and 18 only, four cases occurred in the vaccine group compared with 23 in the placebo group (vaccine efficiency of 83 percent). When women who had not been completely vaccinated and had already existing HPV infection were included in the analysis, vaccine efficacy against all four HPV types was lower (31 percent). Effectiveness was of 24 percent when it was specifically against types HPV 16 and 18.
The authors write: "Lower effectiveness (about 30%) detected in the mixed population (susceptible women and those who have already acquired HPV infection or HPV-associated disease) suggests that the public health effect of vaccinating women aged 25-45 years will be smaller than that recorded after vaccinating susceptible adolescents. This notion will be assessed in future cost-benefit analyses."
Although there were two target outcomes of the trial, the researchers observed that in general, the women reaching the endpoint had infections, rather than cervical or genital disease. As a result, the high vaccine efficacy in the intention-to-treat population was mostly as a result of efficacy against infection.
The authors explain: "Maximum effect from prophylactic HPV vaccination programmes will be achieved in women who are susceptible to infection and disease related to vaccine HPV types (those not previously exposed). Notably, most adult women enrolled in the current study remained susceptible to vaccine HPV types at entry. Almost all women enrolled were susceptible to three or four vaccine HPV types, and about a third were positive to HPV 6, 11, 16, or 18 at baseline by serological or DNA testing; therefore about two-thirds were susceptible to all four vaccine HPV types. Most women who were HPV positive were positive to only one HPV type, meaning that the quadrivalent HPV vaccine could still potentially benefit these women via protection against vaccine HPV types with which they are not infected with."
They write in conclusion: "The quadrivalent HPV vaccine is efficacious in women aged 24??????"45 years not infected with the relevant HPV types at enrolment."
"Safety, immunogenicity, and efficacy of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine in women aged 24-45 years: a randomised, double-blind trial"
Nubia Mu?±oz, Ricardo Manalastas Jr, Punee Pitisuttithum, Damrong Tresukosol, Joseph Monsonego, Kevin Ault, Christine Clavel, Joaquin Luna, Evan Myers, Sara Hood, Oliver Bautista, Janine Bryan, Frank J Taddeo, Mark T Esser, Scott Vuocolo, Richard M Haupt, Eliav Barr, Alfred Saah
DOI: 10.1016/S0140-6736(09)60691-7
thelancet
Stephanie Brunner (B.A.)
Over the last thirty years, sexual behavior has changed. The age of the first marriage is rising, divorce rates are augmenting. As a result, premarital intercourse and having a new sexual partner around middle-age are common behaviors. The HPV virus is transmitted through sexual intercourse and can lead to cervical cancer or other cervical disease. It could be beneficial for older women to receive vaccination against the HPV virus. The women who participated in the randomized trial did not have a history of cervical disease or cancer or genital warts, caused by HPV types 6, 11, 16 and 18. The first group of women received the quadrivalent HPV vaccine and the second group received placebo (at day 1 and months 2 and 6).
There were a total of 1911 women in the first group and 1908 in the second group. The first endpoint for assessment was infection for six months or more, and cervical and external genital disease due to HPV 6, 11, 16, 18. The second was the same but genital disease was due to HPV 16 and 18 only. The average of follow-up time was of 2.2 years. No further data was analyzed at the end of the four year trial. Among the women, specific populations were analyzed.
The per-protocol population of ideal participants included 1615 women who were given the vaccine and 1607 receiving placebo. From day 1 and up to month seven, they all tested negative for the appropriate vaccine HPV type. Within one year, they all had to receive three vaccine doses. They were required to have one or more follow-up visits after month seven. Research showed that there were four cases of infection or disease in the vaccine group compared to forty one in the placebo group. Researchers observed the vaccine proved to have 91 percent effectiveness against all four virus strains (the percent reduction in incidence rate in the vaccine group compared to the placebo group). In the evaluation of the HPV 16 and 18 only, four cases occurred in the vaccine group compared with 23 in the placebo group (vaccine efficiency of 83 percent). When women who had not been completely vaccinated and had already existing HPV infection were included in the analysis, vaccine efficacy against all four HPV types was lower (31 percent). Effectiveness was of 24 percent when it was specifically against types HPV 16 and 18.
The authors write: "Lower effectiveness (about 30%) detected in the mixed population (susceptible women and those who have already acquired HPV infection or HPV-associated disease) suggests that the public health effect of vaccinating women aged 25-45 years will be smaller than that recorded after vaccinating susceptible adolescents. This notion will be assessed in future cost-benefit analyses."
Although there were two target outcomes of the trial, the researchers observed that in general, the women reaching the endpoint had infections, rather than cervical or genital disease. As a result, the high vaccine efficacy in the intention-to-treat population was mostly as a result of efficacy against infection.
The authors explain: "Maximum effect from prophylactic HPV vaccination programmes will be achieved in women who are susceptible to infection and disease related to vaccine HPV types (those not previously exposed). Notably, most adult women enrolled in the current study remained susceptible to vaccine HPV types at entry. Almost all women enrolled were susceptible to three or four vaccine HPV types, and about a third were positive to HPV 6, 11, 16, or 18 at baseline by serological or DNA testing; therefore about two-thirds were susceptible to all four vaccine HPV types. Most women who were HPV positive were positive to only one HPV type, meaning that the quadrivalent HPV vaccine could still potentially benefit these women via protection against vaccine HPV types with which they are not infected with."
They write in conclusion: "The quadrivalent HPV vaccine is efficacious in women aged 24??????"45 years not infected with the relevant HPV types at enrolment."
"Safety, immunogenicity, and efficacy of quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine in women aged 24-45 years: a randomised, double-blind trial"
Nubia Mu?±oz, Ricardo Manalastas Jr, Punee Pitisuttithum, Damrong Tresukosol, Joseph Monsonego, Kevin Ault, Christine Clavel, Joaquin Luna, Evan Myers, Sara Hood, Oliver Bautista, Janine Bryan, Frank J Taddeo, Mark T Esser, Scott Vuocolo, Richard M Haupt, Eliav Barr, Alfred Saah
DOI: 10.1016/S0140-6736(09)60691-7
thelancet
Stephanie Brunner (B.A.)
четверг, 5 января 2012 г.
In Postmenopausal Women Height Loss May Indicate Spinal Fracture
Loss of height in postmenopausal women may indicate a vertebral fracture, states an article in CMAJ (Canadian Medical Association Journal).
Height loss is common as people age and is associated with back pain. Causes include changes in the curvature of the spine, narrowing of intervertebral discs and vertebral fractures. Two-thirds of adults have back pain at any time. Diagnosing these treatable disorders, however, sparks controversy because it is not known if the benefits outweigh the harm of unnecessary radiographs.
Researchers from France conducted a study to compare postmenopausal women and analyze reasons for height loss. The study included 1779 randomly selected general practitioners who were each asked to recruit five female patients over the age of 60. A total of 8610 patients were included in the study.
"We observed a mean loss of height of 4.5 cm since early adulthood in a large population of postmenopausal women in primary care practices," write Dr. Karine Briot, H??pital Cochin and Universit?© Paris Descartes, Paris, France and coauthors. "We found that the risk of an existing vertebral fracture was significantly higher among patients with a height loss of at least 4 cm."
The authors conclude that measurement of height loss could be an accurate method for detecting vertebral fractures. Actual height of women was different from what the patients reported. General practitioners need to measure patients and not rely on estimates.
Source:
Kim Barnhardt
Canadian Medical Association Journal
Height loss is common as people age and is associated with back pain. Causes include changes in the curvature of the spine, narrowing of intervertebral discs and vertebral fractures. Two-thirds of adults have back pain at any time. Diagnosing these treatable disorders, however, sparks controversy because it is not known if the benefits outweigh the harm of unnecessary radiographs.
Researchers from France conducted a study to compare postmenopausal women and analyze reasons for height loss. The study included 1779 randomly selected general practitioners who were each asked to recruit five female patients over the age of 60. A total of 8610 patients were included in the study.
"We observed a mean loss of height of 4.5 cm since early adulthood in a large population of postmenopausal women in primary care practices," write Dr. Karine Briot, H??pital Cochin and Universit?© Paris Descartes, Paris, France and coauthors. "We found that the risk of an existing vertebral fracture was significantly higher among patients with a height loss of at least 4 cm."
The authors conclude that measurement of height loss could be an accurate method for detecting vertebral fractures. Actual height of women was different from what the patients reported. General practitioners need to measure patients and not rely on estimates.
Source:
Kim Barnhardt
Canadian Medical Association Journal
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