It is no secret that a good night's sleep can lead to a well-balanced and healthy lifestyle, but the age-old question of how to get a decent eight hours still remains. However, a University of Pittsburgh study finds that a happy marriage can lead to a better night's sleep for women. The findings are reported in the current issue of Behavioral Sleep Medicine.
The Pitt study finds that women who believe they have happy marriages reported less difficulty falling asleep, less likelihood of waking up during the night or too early in the morning and less restless sleep compared to women who report less happiness in their marriages.
"Women consistently report more sleep problems than men, but most research has focused on how husbands' sleep problems, such as sleep apnea or snoring, affect their wives' sleep quality," said Wendy Troxel, Ph.D., lead author and associate professor of psychiatry at the University of Pittsburgh School of Medicine. "These findings, however, provide an understanding of how having a happy and fulfilling marriage can affect women and their sleep habits."
The study examined the association between marital happiness and sleep disturbances in multiple ethnic groups of married or partnered women. Researchers found that Caucasian and African-American women had more sleep complaints than the Japanese, Hispanic and Chinese women. Caucasian and Japanese women reported the highest marital happiness.
In assessing the effects of marital happiness on sleep, the researchers took into account many other factors that might contribute to sleeplessness, such as a woman's social support network, depressive symptoms, economic hardship and employment status, alcohol and caffeine consumption, presence of children in the home, sexual activity, age and hormonal status. The results showed that even after taking into account all of these factors that are known to influence sleep, the level of marital happiness emerged as an independent risk factor for the existence of sleep disturbances.
"General social support was not associated with sleep disturbances, which suggests that there may be something specific about happiness in one's marriage that is associated with better sleep, rather than a general reflection of one's support network," added Dr. Troxel. "The findings further suggest that feeling happy in one's marriage may present benefits for sleep that go beyond being a "happy" or well-adjusted person."
Co-authors of the study include Daniel J. Buysse, M.D., Martica Hall, Ph.D., and Karen A. Matthews, Ph.D., from the University of Pittsburgh and the Western Psychiatric Institute and Clinic of UPMC.
Study participants were from the Study of Women's Health Across the Nation (SWAN), a multi-site study from seven sites across the country comprised of an ethnically diverse sample of middle-aged women, with grant support from the National Institutes of Health (NIH), the Department of Health and Human Services, the National Institute on Aging, the National Institute of Nursing Research and the NIH Office of Research on Women's Health. Dr. Troxel is supported by funding provided by the Pittsburgh Mind Body Center and an Early Career Award from the National Heart, Lung, and Blood Institute.
Western Psychiatric Institute and Clinic (WPIC) is considered to be one of the nation's foremost university-based psychiatric care facilities and one of the world's leading centers for research and treatment of mental health disorders. WPIC houses the Department of Psychiatry of the University of Pittsburgh School of Medicine and is the flagship of UPMC Behavioral Health, the psychiatric specialty division of the University of Pittsburgh Medical Center.
University of Pittsburgh Medical Center
суббота, 31 декабря 2011 г.
суббота, 24 декабря 2011 г.
Physician Performs First Whole Ovary Transplant In U.S.; Procedure Could Restore Fertility In Women With Cancer
Sherman Silber, director of the Infertility Center of St. Louis at St. Luke's Hospital, and colleagues last month performed the first complete ovary transplant in the U.S. on twin sisters and last week performed the procedure again on sisters who are not twins, the AP/Kansas City Star reports. According to the AP/Star, the procedure could restore hormone function in women experiencing early menopause because of cancer treatments or other causes (Taylor, AP/Kansas City Star, 2/13). More than 80% of fertile women who undergo chemotherapy for cancer treatment become infertile and experience premature menopause (Kaiser Daily Women's Health Policy Report, 6/8/05). It also is possible that the procedure could allow a woman diagnosed with cancer to freeze an ovary and have it returned to restore fertility after chemotherapy or radiation, the AP/Star reports. Physicians at Zhejiang Medical Science University in China earlier this decade reported a successful whole ovary transplant, but there has not been any published medical literature on the case (AP/Kansas City Star, 2/13). Silber and colleagues in April 2004 successfully removed an ovary from Melanie Morgan and transplanted tissue from it into her identical twin sister, Stephanie Yarber, who began experiencing menopause at age 14 and was unable to conceive naturally or through in vitro fertilization using donated eggs from Morgan. The physicians microsurgically sutured the outer tissue of the donated ovary -- which contains egg-producing follicles -- to each of Yarber's nonfunctioning ovaries. Yarber had a menstrual period 80 days after the transplant, and she gave birth to a healthy infant in June 2005 (Kaiser Daily Women's Health Policy Report, 6/8/05). Silber since has performed similar partial ovary transplant procedures on six other sets of twins, and he said that all of the women are ovulating and menstruating normally and that two of the women have delivered infants, the St. Louis Post-Dispatch reports. Silber said the women who have received partial transplants likely will have only two to five years of ovarian function but he added that he hopes the whole ovary transplants will function for decades because those organs have their own blood supply (Hesman Saey, St. Louis Post-Dispatch, 2/12).
Reaction
Some physicians are questioning whether the benefits of the procedure -- which include restored fertility and natural hormone production, which helps prevent osteoporosis and heart disease -- outweigh the procedure's risks, which include the side effects of antirejection drugs, the Post-Dispatch reports. Richard Gimpelson, former president of the American Association of Gynecologic Laparoscopists, said that legal, religious and ethical issues that do not apply to other organ transplants might become an issue for ovary transplants. "[O]ther organs are donated to save someone's life," Gimpelson said, adding, "The ovaries are [transplanted] to make someone's life complete. It's a little bit different" (St. Louis Post-Dispatch, 2/12). Pasquale Patrizio, who directs the fertility center at Yale University and is working on freezing and thawing ovaries to help women with cancer preserve their fertility, said that Silber's work will help determine "if the entire organ can be successfully retransplanted" (AP/Kansas City Star, 2/13).
"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.
суббота, 17 декабря 2011 г.
Press Briefing To Launch The Lancet's Sexual And Reproductive Health Series
A press briefing to launch The Lancet's sexual and reproductive health series will take place in London next Monday. The series highlights the global burden of ill health; every year, 340 million new patients acquire gonorrhoea, syphilis, chlamydia, or trichomonas, more than 120 million couples have an unmet need for contraception, 80 million women have unintended pregnancies, and an estimated 19 million women undergo unsafe abortions; 70 000 of them die as a result.
Contact:
The Lancet press office
The London School of Hygiene & Tropical Medicine Press Office
Contact: Lancet press office
Lancet
Contact:
The Lancet press office
The London School of Hygiene & Tropical Medicine Press Office
Contact: Lancet press office
Lancet
суббота, 10 декабря 2011 г.
Link Between Maternity Leave, Fewer C-Sections And Increased Breastfeeding
Two new studies led by researchers at the University of California, Berkeley, suggest that taking maternity leave before and after the birth of a baby is a good investment in terms of health benefits for both mothers and newborns.
One study found that women who started their leave in the last month of pregnancy were less likely to have cesarean deliveries, while another found that new mothers were more likely to establish breastfeeding the longer they delayed their return to work.
Both papers were part of the Juggling Work and Life During Pregnancy study, funded by the Maternal and Child Health Bureau of the U.S. Health Resources and Services Administration and led by Sylvia Guendelman, professor of maternal and child health at UC Berkeley's School of Public Health. The research takes a rare look into whether taking maternity leave can affect health outcomes in the United States.
"In the public health field, we'd like to decrease the rate of C-sections (cesarean deliveries) and increase the rate of breastfeeding," said Guendelman. "C-sections are really a costly procedure, leading to extended hospital stays and increased risks of complications from surgery, as well as longer recovery times for the mother. For babies, it is known that breastfeeding protects them from infection and may decrease the risk of SIDS (Sudden Infant Death Syndrome), allergies and obesity. What we're trying to say here is that taking maternity leave may make good health sense, as well as good economic sense."
The study on the use of antenatal leave - time off before delivery with the expectation of returning to the employer after giving birth - and the rate of C-sections is the first examination of birth outcomes in U.S. working women, the researchers said. It will appear in the January/February print edition of the journal Women's Health Issues.
The researchers analyzed data from 447 women who worked full-time in the Southern California counties of Imperial, Orange and San Diego, comparing those who took leave after the 35th week of pregnancy with those who worked throughout the pregnancy to delivery. Only women who gave birth to single babies with no congenital abnormalities were included in the analysis. They adjusted for sociodemographic factors such as income, age and type of occupation, as well as for various health measures such as high blood pressure, body mass index, amount of self-reported stress and average number of hours of sleep at night.
Using a combination of post-delivery telephone interviews and prenatal and birth records, the researchers found that women who took leave before they gave birth were almost four times less likely to have a primary C-section as women who worked through to delivery.
The study authors pointed out that the United States falls behind most industrialized countries in its support for job-protected paid maternity leave. The federal Family and Medical Leave Act provides for only unpaid leave of up to 12 weeks surrounding the birth or adoption of a child.
The bulk of studies on leave-taking and health outcomes from other countries suggest that taking leave prior to birth can be beneficial. The authors point to a macroanalysis of 17 countries in Europe that linked failure to take such leave with low birthweight and infant mortality. Rates of pre-term delivery were lower among female factory workers in France if the women took antenatal leave, and a study conducted in several industrialized countries found that paid leave, but not unpaid leave, significantly decreased low birthweight rates.
According to the U.S. Census, among working women who had their first birth between 2001 and 2003, only 28 percent took leave from their jobs before giving birth while an additional 22 percent quit their jobs. Twenty-six percent of women took no leave before birth.
"We don't have a culture in the United States of taking rest before the birth of a child because there is an assumption that the real work comes after the baby is born," said Guendelman. "People forget that mothers need restoration before delivery. In other cultures, including Latino and Asian societies, women are really expected to rest in preparation for this major life event."
The authors added that financial need may also deter women from taking leave in the last month of pregnancy. Only five states - California, Hawaii, New Jersey, New York, Rhode Island - and the territory of Puerto Rico offer some form of paid pregnancy leave, and none offer full replacement of the woman's salary.
The study on maternity leave and breastfeeding is in the January issue of the journal Pediatrics. Using data from 770 full-time working mothers in Southern California, researchers assessed whether maternity leave predicted breastfeeding establishment, defined in this study as breastfeeding for at least 30 days after delivery. Phone interviews were conducted 4.5 months, on average, after delivery.
In this study, women who had returned to work by the time of the interview took on average 10.3 weeks of maternity leave. Overall, 82 percent of mothers established breastfeeding within the first month after their babies were born. Among women who established breastfeeding, 65 percent were still breastfeeding at the time of the interview.
Researchers found that women who took less than six weeks of maternity leave had a four-fold greater risk of failure to establish breastfeeding compared with women who were still on maternity leave at the time of the interview. Women who took six to 12 weeks of maternity leave had a two-fold greater risk of failing to establish breastfeeding.
Having a managerial position or a job with autonomy and a flexible work schedule was linked with longer breastfeeding duration in the study. After 30 days, managers had a 40 percent lower chance of stopping breastfeeding, while those with an inflexible work schedule had a 50 percent higher chance of stopping.
Overall, the study found that returning to work within 12 weeks of delivery had a greater impact on breastfeeding establishment for women in non-managerial positions, with inflexible jobs or who reported high psychosocial distress, including serious arguments with a spouse or partner and unusual money problems.
"The findings suggest that if a woman postpones her return to work, she'll increase her chances of breastfeeding success, especially if she's got a job where she's on the clock and has less discretion with her time," said Guendelman. "Also, women who are in jobs where they have more authority may feel more empowered with how they use their time."
The American Academy of Pediatrics (AAP) recommends that babies be breastfed for at least the first year of life, and exclusively so for the first four to six months.
According to the AAP, increased breastfeeding has the potential for decreasing annual health costs in the U.S. by $3.6 billion and decreasing parental employee absenteeism, the environmental burden for disposal of formula cans and bottles, and energy demands for production and transport of formula.
The study authors noted that just having maternity leave benefits offered by an employer was not helpful in breastfeeding establishment unless the leave was actually used, indicating the importance of encouraging the use of maternity leave and making it economically feasible to take it.
"These new studies suggest that making it feasible for more working mothers to take maternity leave both before and after birth is a smart investment," said Guendelman.
Other co-authors of the paper in Women's Health Issues are Michelle Pearl and Steve Graham, senior research scientists at the Sequoia Foundation, a California-based non-profit organization focused on public health research; Alan Hubbard, UC Berkeley assistant professor of biostatistics; Dr. Nap Hosang, lecturer at UC Berkeley's Maternal and Child Health program and a practicing obstetrician; and Martin Kharrazi, research scientist supervisor in the California Department of Public Health Genetic Disease Screening Program.
In addition to Guendelman, Pearl, Graham and Kharrazi, the Pediatrics paper was co-authored by Jessica Lang Kosa, research associate, and Julia Goodman, former graduate student, both at UC Berkeley's School of Public Health.
The study published in Women's Health Issues received additional funding from the Center for Health Research at UC Berkeley. The paper in Pediatrics also received support from the UC Labor and Employment Research Fund and the UC Berkeley Institute for Research on Labor and Employment.
Source: Sarah Yang
University of California - Berkeley
One study found that women who started their leave in the last month of pregnancy were less likely to have cesarean deliveries, while another found that new mothers were more likely to establish breastfeeding the longer they delayed their return to work.
Both papers were part of the Juggling Work and Life During Pregnancy study, funded by the Maternal and Child Health Bureau of the U.S. Health Resources and Services Administration and led by Sylvia Guendelman, professor of maternal and child health at UC Berkeley's School of Public Health. The research takes a rare look into whether taking maternity leave can affect health outcomes in the United States.
"In the public health field, we'd like to decrease the rate of C-sections (cesarean deliveries) and increase the rate of breastfeeding," said Guendelman. "C-sections are really a costly procedure, leading to extended hospital stays and increased risks of complications from surgery, as well as longer recovery times for the mother. For babies, it is known that breastfeeding protects them from infection and may decrease the risk of SIDS (Sudden Infant Death Syndrome), allergies and obesity. What we're trying to say here is that taking maternity leave may make good health sense, as well as good economic sense."
The study on the use of antenatal leave - time off before delivery with the expectation of returning to the employer after giving birth - and the rate of C-sections is the first examination of birth outcomes in U.S. working women, the researchers said. It will appear in the January/February print edition of the journal Women's Health Issues.
The researchers analyzed data from 447 women who worked full-time in the Southern California counties of Imperial, Orange and San Diego, comparing those who took leave after the 35th week of pregnancy with those who worked throughout the pregnancy to delivery. Only women who gave birth to single babies with no congenital abnormalities were included in the analysis. They adjusted for sociodemographic factors such as income, age and type of occupation, as well as for various health measures such as high blood pressure, body mass index, amount of self-reported stress and average number of hours of sleep at night.
Using a combination of post-delivery telephone interviews and prenatal and birth records, the researchers found that women who took leave before they gave birth were almost four times less likely to have a primary C-section as women who worked through to delivery.
The study authors pointed out that the United States falls behind most industrialized countries in its support for job-protected paid maternity leave. The federal Family and Medical Leave Act provides for only unpaid leave of up to 12 weeks surrounding the birth or adoption of a child.
The bulk of studies on leave-taking and health outcomes from other countries suggest that taking leave prior to birth can be beneficial. The authors point to a macroanalysis of 17 countries in Europe that linked failure to take such leave with low birthweight and infant mortality. Rates of pre-term delivery were lower among female factory workers in France if the women took antenatal leave, and a study conducted in several industrialized countries found that paid leave, but not unpaid leave, significantly decreased low birthweight rates.
According to the U.S. Census, among working women who had their first birth between 2001 and 2003, only 28 percent took leave from their jobs before giving birth while an additional 22 percent quit their jobs. Twenty-six percent of women took no leave before birth.
"We don't have a culture in the United States of taking rest before the birth of a child because there is an assumption that the real work comes after the baby is born," said Guendelman. "People forget that mothers need restoration before delivery. In other cultures, including Latino and Asian societies, women are really expected to rest in preparation for this major life event."
The authors added that financial need may also deter women from taking leave in the last month of pregnancy. Only five states - California, Hawaii, New Jersey, New York, Rhode Island - and the territory of Puerto Rico offer some form of paid pregnancy leave, and none offer full replacement of the woman's salary.
The study on maternity leave and breastfeeding is in the January issue of the journal Pediatrics. Using data from 770 full-time working mothers in Southern California, researchers assessed whether maternity leave predicted breastfeeding establishment, defined in this study as breastfeeding for at least 30 days after delivery. Phone interviews were conducted 4.5 months, on average, after delivery.
In this study, women who had returned to work by the time of the interview took on average 10.3 weeks of maternity leave. Overall, 82 percent of mothers established breastfeeding within the first month after their babies were born. Among women who established breastfeeding, 65 percent were still breastfeeding at the time of the interview.
Researchers found that women who took less than six weeks of maternity leave had a four-fold greater risk of failure to establish breastfeeding compared with women who were still on maternity leave at the time of the interview. Women who took six to 12 weeks of maternity leave had a two-fold greater risk of failing to establish breastfeeding.
Having a managerial position or a job with autonomy and a flexible work schedule was linked with longer breastfeeding duration in the study. After 30 days, managers had a 40 percent lower chance of stopping breastfeeding, while those with an inflexible work schedule had a 50 percent higher chance of stopping.
Overall, the study found that returning to work within 12 weeks of delivery had a greater impact on breastfeeding establishment for women in non-managerial positions, with inflexible jobs or who reported high psychosocial distress, including serious arguments with a spouse or partner and unusual money problems.
"The findings suggest that if a woman postpones her return to work, she'll increase her chances of breastfeeding success, especially if she's got a job where she's on the clock and has less discretion with her time," said Guendelman. "Also, women who are in jobs where they have more authority may feel more empowered with how they use their time."
The American Academy of Pediatrics (AAP) recommends that babies be breastfed for at least the first year of life, and exclusively so for the first four to six months.
According to the AAP, increased breastfeeding has the potential for decreasing annual health costs in the U.S. by $3.6 billion and decreasing parental employee absenteeism, the environmental burden for disposal of formula cans and bottles, and energy demands for production and transport of formula.
The study authors noted that just having maternity leave benefits offered by an employer was not helpful in breastfeeding establishment unless the leave was actually used, indicating the importance of encouraging the use of maternity leave and making it economically feasible to take it.
"These new studies suggest that making it feasible for more working mothers to take maternity leave both before and after birth is a smart investment," said Guendelman.
Other co-authors of the paper in Women's Health Issues are Michelle Pearl and Steve Graham, senior research scientists at the Sequoia Foundation, a California-based non-profit organization focused on public health research; Alan Hubbard, UC Berkeley assistant professor of biostatistics; Dr. Nap Hosang, lecturer at UC Berkeley's Maternal and Child Health program and a practicing obstetrician; and Martin Kharrazi, research scientist supervisor in the California Department of Public Health Genetic Disease Screening Program.
In addition to Guendelman, Pearl, Graham and Kharrazi, the Pediatrics paper was co-authored by Jessica Lang Kosa, research associate, and Julia Goodman, former graduate student, both at UC Berkeley's School of Public Health.
The study published in Women's Health Issues received additional funding from the Center for Health Research at UC Berkeley. The paper in Pediatrics also received support from the UC Labor and Employment Research Fund and the UC Berkeley Institute for Research on Labor and Employment.
Source: Sarah Yang
University of California - Berkeley
суббота, 26 ноября 2011 г.
First Estrogen-Only Low Dose Hormone Replacement Therapy (HRT) Available For Hysterectomised Women
Wyeth Pharmaceuticals has launched Premarin*0.3mg (conjugated
estrogens), the first low dose estrogen-only HRT, which contains less than
half the estrogen i.e. 0.3mg of standard Premarin* 0.625mg (conjugated
estrogens).1 This will give healthcare professionals a new option in
treating the menopausal symptoms of 1 in 5 women who undergo hysterectomy in
the UK before the age of 52.2 Until now, only unhysterectomised women
treated with combined progestogen/estrogen HRT, have had a low dose option.
HRT has been shown to be effective in relieving debilitating menopausal
symptoms such as hot flushes and night sweats.3 Current guidelines4
recommend that all women going through the menopause who are seeking
treatment should be offered a choice of HRT. Treatment with HRT should aim
to use the lowest effective dose for the shortest duration and should be
reviewed on an annual basis in light of any new knowledge and changes in
women's risk factors. Because every woman is different, treatment should be
tailored to an individual's need.
"For the hysterectomised woman the availability of new low dose
Premarin 0.3mg is a welcome addition. This new low dose option gives
practitioners more flexibility in treating these women and allows us to
tailor treatment to their individual needs," said Dr John Stevenson,
Consultant Physician, Imperial College London.
When the ovaries are removed during a hysterectomy, women will experience an
immediate menopause regardless of age. If the ovaries are left intact,
there is a 50% chance of the ovaries failing within five years of a
hysterectomy resulting in menopause.1
About Wyeth
Wyeth Pharmaceuticals, a division of Wyeth (NYSE:WYE), has leading products
in the areas of women's health care, central nervous system, inflammation,
transplantation, haemophilia, oncology, vaccines and nutritional products.
Wyeth has a diverse portfolio of biopharmaceutical products. Wyeth is one of
the world's largest research-driven pharmaceutical and healthcare products
companies. It is a leader in the discovery, development, manufacturing, and
marketing of pharmaceuticals, vaccines, biotechnology products and
nonprescription medicines that improve the quality of life for people
worldwide. The Company's major divisions include Wyeth Pharmaceuticals,
Wyeth Consumer Healthcare, and Fort Dodge Animal Health.
*Premarin is a Wyeth Trademark
References
1 Premarin 0.3mg. Summary of Product Characteristics. November 2006
2 Management of the Menopause: The Handbook. 4th edition. Rees M, Purdie DW.
BMS Publications Ltd and RSM Press Ltd 2006
3 Utian H, Shoupe D, et al. Relief of vasomotor symptoms and vaginal
atrophy with lower doses of conjugated equine estrogens and
medroxyprogesterone acetate. Fertil Steril 2001;75:1065-1079
4 Consensus Conference on Hormone Replacement Therapy. Royal College of
Physicians of Edinburgh. October 2003
wyeth
View drug information on Premarin.
estrogens), the first low dose estrogen-only HRT, which contains less than
half the estrogen i.e. 0.3mg of standard Premarin* 0.625mg (conjugated
estrogens).1 This will give healthcare professionals a new option in
treating the menopausal symptoms of 1 in 5 women who undergo hysterectomy in
the UK before the age of 52.2 Until now, only unhysterectomised women
treated with combined progestogen/estrogen HRT, have had a low dose option.
HRT has been shown to be effective in relieving debilitating menopausal
symptoms such as hot flushes and night sweats.3 Current guidelines4
recommend that all women going through the menopause who are seeking
treatment should be offered a choice of HRT. Treatment with HRT should aim
to use the lowest effective dose for the shortest duration and should be
reviewed on an annual basis in light of any new knowledge and changes in
women's risk factors. Because every woman is different, treatment should be
tailored to an individual's need.
"For the hysterectomised woman the availability of new low dose
Premarin 0.3mg is a welcome addition. This new low dose option gives
practitioners more flexibility in treating these women and allows us to
tailor treatment to their individual needs," said Dr John Stevenson,
Consultant Physician, Imperial College London.
When the ovaries are removed during a hysterectomy, women will experience an
immediate menopause regardless of age. If the ovaries are left intact,
there is a 50% chance of the ovaries failing within five years of a
hysterectomy resulting in menopause.1
About Wyeth
Wyeth Pharmaceuticals, a division of Wyeth (NYSE:WYE), has leading products
in the areas of women's health care, central nervous system, inflammation,
transplantation, haemophilia, oncology, vaccines and nutritional products.
Wyeth has a diverse portfolio of biopharmaceutical products. Wyeth is one of
the world's largest research-driven pharmaceutical and healthcare products
companies. It is a leader in the discovery, development, manufacturing, and
marketing of pharmaceuticals, vaccines, biotechnology products and
nonprescription medicines that improve the quality of life for people
worldwide. The Company's major divisions include Wyeth Pharmaceuticals,
Wyeth Consumer Healthcare, and Fort Dodge Animal Health.
*Premarin is a Wyeth Trademark
References
1 Premarin 0.3mg. Summary of Product Characteristics. November 2006
2 Management of the Menopause: The Handbook. 4th edition. Rees M, Purdie DW.
BMS Publications Ltd and RSM Press Ltd 2006
3 Utian H, Shoupe D, et al. Relief of vasomotor symptoms and vaginal
atrophy with lower doses of conjugated equine estrogens and
medroxyprogesterone acetate. Fertil Steril 2001;75:1065-1079
4 Consensus Conference on Hormone Replacement Therapy. Royal College of
Physicians of Edinburgh. October 2003
wyeth
View drug information on Premarin.
суббота, 19 ноября 2011 г.
Neb. Bill To Ban Abortion After 20 Weeks Could Start Legal Battle
A Nebraska bill (LB 1103) that would ban abortion after 20 weeks' gestation in nearly all cases could prompt a legal battle regarding its constitutionality, the Omaha World-Herald reports. The bill, introduced by Speaker of the Legislature Mike Flood (R), would allow abortion past 20 weeks only to save the woman's life or to "avert serious risk or substantial and irreversible physical impairment of a major bodily function." Current Nebraska law bans abortion after viability except to preserve the life or health of the woman.
Flood's bill claims there is "substantial evidence" that fetuses feel pain at 20 weeks and proposes to use the fetus' ability to feel pain, rather than viability, as the dividing line between legal and illegal abortion, the World-Herald reports. Flood said he introduced the measure to stop abortion provider LeRoy Carhart from performing procedures late in pregnancy. Carhart has said that he plans to offer late abortions at his Bellevue, Neb., clinic as a way to continue the work of George Tiller, a Kansas abortion provider who was killed last May (Stoddard, Omaha World-Herald, 1/22). Flood claims that the 2007 Supreme Court decision Gonzales v. Carhart, which upheld the federal Partial-Birth Abortion Ban Act of 2003, "clearly affirmed that the state has a legitimate and substantial interest in preserving fetal life and promoting respect for human life at all stages of pregnancy."
Lawmakers in several states have cited the 2007 decision to support legislation requiring women to receive certain information before abortion procedures. Janet Crepps of the Center for Reproductive Rights said the Nebraska bill goes much further and has several constitutional flaws. "The Supreme Court has drawn a clear line between requiring women to receive certain information and telling them they can't have abortions before viability," Crepps said. She added, "The Supreme Court has made clear there's no state interest that trumps a woman's interest in having an abortion before viability."
Carhart and other abortion-rights supporters also dispute Flood's assertions regarding fetal pain (Jenkins, AP/Columbus Telegram, 1/22). Carhart said he is prepared to fight Flood's bill in court, adding, "We've been to the Supreme Court twice. I have no problem going again" (Omaha World-Herald, 1/22).
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.
© 2010 The Advisory Board Company. All rights reserved.
суббота, 12 ноября 2011 г.
Concentrations Of Certain Toxins In Breast Milk Are Low, Study Finds
Nursing mothers worried about passing harmful chemicals to their infants through breast milk should be aware that the air inside their home may pose a greater health risk.
Researchers from Ohio State and Johns Hopkins universities measured the levels of harmful gases called "volatile organic compounds" (VOCs) in human milk and in the air inside the homes of three lactating mothers in inner-city Baltimore.
A nursing infant's exposure to VOCs from indoor air was 25- to 135-fold higher than what that infant ingested through breast milk. In fact, levels found in milk were far below the U.S. EPA's maximum contaminant levels for drinking water.
"I was worried that we were going to see a much larger contribution from milk, so I am tremendously relieved by these findings," said Timothy Buckley, the study's senior author and an associate professor of public health at Ohio State.
Although the study is small and provides just a preliminary assessment of VOC levels in human milk, it is one of the first studies of its kind in the United States in which researchers are able to quantify levels of these compounds in human milk.
"We ought to focus our efforts on reducing indoor air sources of these compounds," said Sungroul Kim, the study's lead author and a postdoctoral fellow with the Johns Hopkins Bloomberg School of Public Health.
Both Buckley and Kim stress that despite human milk's vulnerability to chemical contamination, the health benefits of nursing far outweigh the risks, and that breast milk is the best source of nutrition for a growing infant.
The findings currently appear online at the website for the journal Environmental Science & Technology. Buckley and Kim conducted the study with Rolf Halden, an assistant professor of public health at Johns Hopkins.
The researchers analyzed eight milk samples from three lactating mothers living in inner-city Baltimore. From May through July 2005, the mothers provided a milk sample each morning for three consecutive mornings. The women were asked to manually express milk into a glass jar and then seal the jar with a provided cap. The researchers also placed air samplers in the living rooms of the women's homes - each woman lived in a two-story row home on a busy street. Air samples were collected over the three days that coincided with milk collection.
The researchers analyzed the milk and indoor air samples for four VOCs - benzene, MTBE (methyl tertiary butyl ether), toluene and chloroform. Automobile exhaust is the primary source for benzene and MTBE, while toluene comes from car exhaust as well as consumer products such as glue, shoe polish, and paint thinner. Treated drinking water is the biggest source of chloroform inside most homes.
In the laboratory, the researchers transferred the milk samples to vials. They then inserted a syringe through the cap on the vial and into the air space between the cap and the milk. The VOCs in breast milk samples disperse into this air space, and the gases were collected with a needle coated with absorbent material. The researchers collected indoor air samples by passing air through a material that specifically absorbed the VOCs of interest.
Once they collected the VOCs, the researchers used gas chromatography-mass spectrometry to analyze the levels of each compound in the milk and indoor air samples. This analysis technique differentiates between various substances in a given sample.
The milk samples had higher concentrations of chloroform than any other of the three VOCs. Next came toluene, followed by benzene and MTBE. The researchers had also acquired five additional human milk samples from a milk bank in Raleigh, N.C., provided by anonymous donors. They ran these samples through the same tests, and found that the VOC levels in this milk were comparable to those of the Baltimore samples.
As there are no health-based guidelines or standards for chemicals in human milk, the researchers compared the concentrations in the milk samples to the U.S. EPA's safe drinking water standards. The levels of chloroform, benzene and toluene in milk were well below the EPA's maximum contaminant level for drinking water, by factors of 180, 40 and 2170, respectively. MTBE isn't specifically regulated in drinking water by the EPA.
"We were pleasantly surprised to see these relatively low concentrations of VOCs in human milk," said Buckley, who also chairs the Division of Environmental Health Sciences in Ohio State's College of Public Health. "Especially for inner-city settings, which is where VOC levels tend to be the highest."
The rank of VOC concentrations in indoor air differed from that in milk, with toluene levels ranking the highest followed by MTBE, chloroform and benzene. After comparing the level of VOCs in milk to the concentrations in the air, the researchers found that higher levels of toluene, benzene and MTBE in indoor air meant greater concentrations of the contaminants in breast milk. This suggests that the indoor air was the likely source for the VOCs that eventually get into the mother's breast milk.
However, the researchers did not see this relationship with chloroform.
"Chloroform exposure occurs not only through inhalation, but also through water ingestion and absorption through the skin while showering or bathing," Buckley said. "So in this case, exposure was probably poorly captured by the air samplers set up in the living rooms."
The indoor VOC levels measured in the current study are comparable to what has been reported in inner cities across the United States, the researchers say.
"Therefore, it's also likely that the levels of VOCs in human milk that we found are typical for lactating women living in urban areas," Buckley said.
VOCs are a fact of modern life - nearly every human on the planet has at least a trace of these compounds in their body. The focus should be on minimizing our exposure to their sources, Buckley said.
"With respect to automobile sources of air toxics, the level of traffic and your distance from that traffic both affect what you breathe," Buckley said. "The homes in our study were within five or six feet of busy roadways. Many inner-city residents may not have the choice to reside very far from these heavily used roads."
Grants from the Johns Hopkins NIEHS Center in Urban Environmental Health, the Johns Hopkins Center for a Livable Future and the U.S. EPA funded this work.
Contact: Timothy Buckley
Ohio State University
Researchers from Ohio State and Johns Hopkins universities measured the levels of harmful gases called "volatile organic compounds" (VOCs) in human milk and in the air inside the homes of three lactating mothers in inner-city Baltimore.
A nursing infant's exposure to VOCs from indoor air was 25- to 135-fold higher than what that infant ingested through breast milk. In fact, levels found in milk were far below the U.S. EPA's maximum contaminant levels for drinking water.
"I was worried that we were going to see a much larger contribution from milk, so I am tremendously relieved by these findings," said Timothy Buckley, the study's senior author and an associate professor of public health at Ohio State.
Although the study is small and provides just a preliminary assessment of VOC levels in human milk, it is one of the first studies of its kind in the United States in which researchers are able to quantify levels of these compounds in human milk.
"We ought to focus our efforts on reducing indoor air sources of these compounds," said Sungroul Kim, the study's lead author and a postdoctoral fellow with the Johns Hopkins Bloomberg School of Public Health.
Both Buckley and Kim stress that despite human milk's vulnerability to chemical contamination, the health benefits of nursing far outweigh the risks, and that breast milk is the best source of nutrition for a growing infant.
The findings currently appear online at the website for the journal Environmental Science & Technology. Buckley and Kim conducted the study with Rolf Halden, an assistant professor of public health at Johns Hopkins.
The researchers analyzed eight milk samples from three lactating mothers living in inner-city Baltimore. From May through July 2005, the mothers provided a milk sample each morning for three consecutive mornings. The women were asked to manually express milk into a glass jar and then seal the jar with a provided cap. The researchers also placed air samplers in the living rooms of the women's homes - each woman lived in a two-story row home on a busy street. Air samples were collected over the three days that coincided with milk collection.
The researchers analyzed the milk and indoor air samples for four VOCs - benzene, MTBE (methyl tertiary butyl ether), toluene and chloroform. Automobile exhaust is the primary source for benzene and MTBE, while toluene comes from car exhaust as well as consumer products such as glue, shoe polish, and paint thinner. Treated drinking water is the biggest source of chloroform inside most homes.
In the laboratory, the researchers transferred the milk samples to vials. They then inserted a syringe through the cap on the vial and into the air space between the cap and the milk. The VOCs in breast milk samples disperse into this air space, and the gases were collected with a needle coated with absorbent material. The researchers collected indoor air samples by passing air through a material that specifically absorbed the VOCs of interest.
Once they collected the VOCs, the researchers used gas chromatography-mass spectrometry to analyze the levels of each compound in the milk and indoor air samples. This analysis technique differentiates between various substances in a given sample.
The milk samples had higher concentrations of chloroform than any other of the three VOCs. Next came toluene, followed by benzene and MTBE. The researchers had also acquired five additional human milk samples from a milk bank in Raleigh, N.C., provided by anonymous donors. They ran these samples through the same tests, and found that the VOC levels in this milk were comparable to those of the Baltimore samples.
As there are no health-based guidelines or standards for chemicals in human milk, the researchers compared the concentrations in the milk samples to the U.S. EPA's safe drinking water standards. The levels of chloroform, benzene and toluene in milk were well below the EPA's maximum contaminant level for drinking water, by factors of 180, 40 and 2170, respectively. MTBE isn't specifically regulated in drinking water by the EPA.
"We were pleasantly surprised to see these relatively low concentrations of VOCs in human milk," said Buckley, who also chairs the Division of Environmental Health Sciences in Ohio State's College of Public Health. "Especially for inner-city settings, which is where VOC levels tend to be the highest."
The rank of VOC concentrations in indoor air differed from that in milk, with toluene levels ranking the highest followed by MTBE, chloroform and benzene. After comparing the level of VOCs in milk to the concentrations in the air, the researchers found that higher levels of toluene, benzene and MTBE in indoor air meant greater concentrations of the contaminants in breast milk. This suggests that the indoor air was the likely source for the VOCs that eventually get into the mother's breast milk.
However, the researchers did not see this relationship with chloroform.
"Chloroform exposure occurs not only through inhalation, but also through water ingestion and absorption through the skin while showering or bathing," Buckley said. "So in this case, exposure was probably poorly captured by the air samplers set up in the living rooms."
The indoor VOC levels measured in the current study are comparable to what has been reported in inner cities across the United States, the researchers say.
"Therefore, it's also likely that the levels of VOCs in human milk that we found are typical for lactating women living in urban areas," Buckley said.
VOCs are a fact of modern life - nearly every human on the planet has at least a trace of these compounds in their body. The focus should be on minimizing our exposure to their sources, Buckley said.
"With respect to automobile sources of air toxics, the level of traffic and your distance from that traffic both affect what you breathe," Buckley said. "The homes in our study were within five or six feet of busy roadways. Many inner-city residents may not have the choice to reside very far from these heavily used roads."
Grants from the Johns Hopkins NIEHS Center in Urban Environmental Health, the Johns Hopkins Center for a Livable Future and the U.S. EPA funded this work.
Contact: Timothy Buckley
Ohio State University
суббота, 5 ноября 2011 г.
Study Shows Carraguard Microbicidal Gel Fails To Protect Women From HIV Infection
The candidate vaginal microbicide gel Carraguard does not protect women from HIV infection, reports an Article in this week's edition of The Lancet, Stephanie Skoler-Karpoff and Barbara Friedland, Population Council, New York, USA, and colleagues.
Around 33.2 million people worldwide are living with HIV, of whom 68% live in sub-Saharan Africa; and in that region, women and girls are disproportionately affected, accounting for 61% of infections. Furthermore, in 15-24-year-olds, 90% of new HIV infections occur in girls and women. As a result, female-initiated HIV-prevention options, such as microbicides, are urgently need. In this randomised, placebo-controlled trial, the authors assessed Carraguard, a carrageenan-based compound developed by the Population Council.
The trial took place at three sites in South Africa, and involved 6,202 sexually active, HIV-negative women, who were assigned to receive Carraguard (3103 women) or a placebo gel of methylcelluose (3099). The women were instructed to use one applicator of gel plus a condom for each vaginal sex act. Participants were followed up for up to two years. The women visited a clinic every three months, which included testing for HIV presence and pregnancy, pelvic examinations, risk reduction counseling, and treatment for curable sexually transmitted infections and symptomatic vaginal infections. The primary outcome of the trial was time to seroconversion (HIV infection).
The researchers found that HIV incidence was 3.3 per 100-woman years in the Carraguard group (134 infections) and 3.8 per 100 woman-years in the placebo group (151 infections), with no significant difference in the time to serocoversion. Rates of self-reported gel use (96.2% Carraguard, 95.9% placebo) and condom use (64.1% both groups) at last sex acts were similar in both groups. On the basis of applicator testing, however, gel was estimated to have been used in only 42.1 % of sex acts on average (41.1% Carraguard, 43.1% placebo). Adverse events were similar in both groups; adverse events related to gel use and serious adverse events were similar in both groups.
The authors conclude: "This study did not show Carraguard's efficacy in prevention of male-to-female transmission of HIV, although no safety concerns were recorded. Low levels of gel use could have compromised the potential to detect a significant protective effect. Although the results from this and other completed microbicides efficacy trials have been disappointing, the search for female-controlled HIV-prevention methods must continue."
In an accompanying Comment, Dr Willard Cates and Dr Paul Feldblum, Family Health International, North Carolina, USA, say: "Whenever we develop effective new tools for HIV prevention, no single approach to prevention will suffice. Rather a combination of partly effective prevention approaches will be bundled into packages targeted to specific populations. This bundling will involve behavioural, biomedical, and structural interventions, each designed to reinforce the effect of the other. The cumulative influence of combination prevention is our hope for thwarting the spread of HIV."
Click here to see SUMMARY of ARTICLE online.
Source
Tony Kirby
Press Officer
The Lancet
32 Jamestown Road
Camden
London
NW1 7BY
thelancet
Around 33.2 million people worldwide are living with HIV, of whom 68% live in sub-Saharan Africa; and in that region, women and girls are disproportionately affected, accounting for 61% of infections. Furthermore, in 15-24-year-olds, 90% of new HIV infections occur in girls and women. As a result, female-initiated HIV-prevention options, such as microbicides, are urgently need. In this randomised, placebo-controlled trial, the authors assessed Carraguard, a carrageenan-based compound developed by the Population Council.
The trial took place at three sites in South Africa, and involved 6,202 sexually active, HIV-negative women, who were assigned to receive Carraguard (3103 women) or a placebo gel of methylcelluose (3099). The women were instructed to use one applicator of gel plus a condom for each vaginal sex act. Participants were followed up for up to two years. The women visited a clinic every three months, which included testing for HIV presence and pregnancy, pelvic examinations, risk reduction counseling, and treatment for curable sexually transmitted infections and symptomatic vaginal infections. The primary outcome of the trial was time to seroconversion (HIV infection).
The researchers found that HIV incidence was 3.3 per 100-woman years in the Carraguard group (134 infections) and 3.8 per 100 woman-years in the placebo group (151 infections), with no significant difference in the time to serocoversion. Rates of self-reported gel use (96.2% Carraguard, 95.9% placebo) and condom use (64.1% both groups) at last sex acts were similar in both groups. On the basis of applicator testing, however, gel was estimated to have been used in only 42.1 % of sex acts on average (41.1% Carraguard, 43.1% placebo). Adverse events were similar in both groups; adverse events related to gel use and serious adverse events were similar in both groups.
The authors conclude: "This study did not show Carraguard's efficacy in prevention of male-to-female transmission of HIV, although no safety concerns were recorded. Low levels of gel use could have compromised the potential to detect a significant protective effect. Although the results from this and other completed microbicides efficacy trials have been disappointing, the search for female-controlled HIV-prevention methods must continue."
In an accompanying Comment, Dr Willard Cates and Dr Paul Feldblum, Family Health International, North Carolina, USA, say: "Whenever we develop effective new tools for HIV prevention, no single approach to prevention will suffice. Rather a combination of partly effective prevention approaches will be bundled into packages targeted to specific populations. This bundling will involve behavioural, biomedical, and structural interventions, each designed to reinforce the effect of the other. The cumulative influence of combination prevention is our hope for thwarting the spread of HIV."
Click here to see SUMMARY of ARTICLE online.
Source
Tony Kirby
Press Officer
The Lancet
32 Jamestown Road
Camden
London
NW1 7BY
thelancet
суббота, 29 октября 2011 г.
Mammography May Increase Breast Cancer Risk In Some High-Risk Women
Low-dose radiation from annual mammography screening may increase breast cancer risk in women with genetic or familial predisposition to breast cancer, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
"For women at high risk for breast cancer, screening is very important, but a careful approach should be taken when considering mammography for screening young women, particularly under age 30," said Marijke C. Jansen-van der Weide, Ph.D., epidemiologist in the Department of Epidemiology and Radiology at University Medical Center Groningen in the Netherlands. "Further, repeated exposure to low-dose radiation should be avoided."
Women who are at high risk for breast cancer need to begin screening at a younger age, because they often develop cancer earlier than women at average risk. However, according to Dr. Jansen-van der Weide and colleagues, young women with familial or genetic predisposition to the disease may want to consider alternative screening methods to mammography, because the benefit of early tumor detection in this group of women may be offset by the potential risk of radiation-induced cancer.
According to the American Cancer Society, there is strong evidence supporting the benefits of mammography for women after age 40. However, there are conflicting reports regarding the benefits of mammography for women under 40. Alternative screening methods such as ultrasound and MRI may be made available to younger women, but are generally used as an adjunct to mammography.
The American Cancer Society recommends that some women at high risk (greater than 20 percent lifetime risk) should have MR imaging and mammography every year, typically beginning at age 30.
The researchers conducted an analysis of peer-reviewed, published medical research to determine if low-dose radiation exposure affects breast cancer risk among high-risk women. Out of 47 articles found on the topic, six were selected by the reviewers for inclusion in their analysis. Four studies looked at the effect of exposure to low-dose radiation among breast cancer gene mutation carriers, and two studies researched the effect of radiation on women with a family history of breast cancer. Using data from these studies, the researchers were able to calculate pooled odds ratios to estimate radiation-induced breast cancer risk.
The results showed that among all high-risk women in the study, average increased risk of breast cancer due to low-dose radiation exposure was 1.5 times greater than that of high-risk women not exposed to low-dose radiation. High-risk women exposed before age 20 or with five or more exposures were 2.5 times more likely to develop breast cancer than high-risk women not exposed to low-dose radiation.
"Our findings suggest that low-dose radiation increases breast cancer risk among these young high-risk women, and a careful approach is warranted," Dr. Jansen-van der Weide said.
She noted that this analysis is based on a small study sample and should be interpreted with caution. Dr. Jansen-van der Weide also pointed out that these results apply only to specific high-risk groups of women. Women at average risk were not assessed in this study.
In general, early detection with mammography and prompt treatment can significantly improve a woman's chances of survival. More than 90 percent of women whose breast cancer is found in an early stage will survive. For young, high-risk women and their doctors, it is important to weigh the benefits against any potential risk when making a decision about annual breast cancer screening with mammography.
Coauthors are Geertruida H. de Bock, Ph.D., Marcel J.W. Greuter, Ph.D., Liesbeth Jansen, M.D., Ph.D., Jan C. Oosterwijk, Ph.D., Ruud Pijnappel, M.D., Ph.D., and Matthijs Oudkerk, M.D., Ph.D.
Source
Radiological Society of North America
"For women at high risk for breast cancer, screening is very important, but a careful approach should be taken when considering mammography for screening young women, particularly under age 30," said Marijke C. Jansen-van der Weide, Ph.D., epidemiologist in the Department of Epidemiology and Radiology at University Medical Center Groningen in the Netherlands. "Further, repeated exposure to low-dose radiation should be avoided."
Women who are at high risk for breast cancer need to begin screening at a younger age, because they often develop cancer earlier than women at average risk. However, according to Dr. Jansen-van der Weide and colleagues, young women with familial or genetic predisposition to the disease may want to consider alternative screening methods to mammography, because the benefit of early tumor detection in this group of women may be offset by the potential risk of radiation-induced cancer.
According to the American Cancer Society, there is strong evidence supporting the benefits of mammography for women after age 40. However, there are conflicting reports regarding the benefits of mammography for women under 40. Alternative screening methods such as ultrasound and MRI may be made available to younger women, but are generally used as an adjunct to mammography.
The American Cancer Society recommends that some women at high risk (greater than 20 percent lifetime risk) should have MR imaging and mammography every year, typically beginning at age 30.
The researchers conducted an analysis of peer-reviewed, published medical research to determine if low-dose radiation exposure affects breast cancer risk among high-risk women. Out of 47 articles found on the topic, six were selected by the reviewers for inclusion in their analysis. Four studies looked at the effect of exposure to low-dose radiation among breast cancer gene mutation carriers, and two studies researched the effect of radiation on women with a family history of breast cancer. Using data from these studies, the researchers were able to calculate pooled odds ratios to estimate radiation-induced breast cancer risk.
The results showed that among all high-risk women in the study, average increased risk of breast cancer due to low-dose radiation exposure was 1.5 times greater than that of high-risk women not exposed to low-dose radiation. High-risk women exposed before age 20 or with five or more exposures were 2.5 times more likely to develop breast cancer than high-risk women not exposed to low-dose radiation.
"Our findings suggest that low-dose radiation increases breast cancer risk among these young high-risk women, and a careful approach is warranted," Dr. Jansen-van der Weide said.
She noted that this analysis is based on a small study sample and should be interpreted with caution. Dr. Jansen-van der Weide also pointed out that these results apply only to specific high-risk groups of women. Women at average risk were not assessed in this study.
In general, early detection with mammography and prompt treatment can significantly improve a woman's chances of survival. More than 90 percent of women whose breast cancer is found in an early stage will survive. For young, high-risk women and their doctors, it is important to weigh the benefits against any potential risk when making a decision about annual breast cancer screening with mammography.
Coauthors are Geertruida H. de Bock, Ph.D., Marcel J.W. Greuter, Ph.D., Liesbeth Jansen, M.D., Ph.D., Jan C. Oosterwijk, Ph.D., Ruud Pijnappel, M.D., Ph.D., and Matthijs Oudkerk, M.D., Ph.D.
Source
Radiological Society of North America
суббота, 22 октября 2011 г.
2008 American Society Of Breast Disease Pathfinder Lectures
The 2008 American Society of Breast Disease Pathfinder Lectures will be
delivered by two giants in the field of breast cancer - Mary-Claire King,
PhD, and Bernard Fisher, MD. The Pathfinder Lectures will be part of the
Society's Annual Symposium, April 10-12, 2008, at the Hilton San Diego
Resort, San Diego, California.
In announcing the recipients of the ASBD's only honorary recognition,
Society president Julio A. Ibarra, MD, noted that "through their research
and vision this year's honorees -- Mary-Claire King and Bernard Fisher --
have set the highest of standards and benefited the lives of millions of
women internationally."
Mary-Claire King is Professor of Medicine and Genetics and an American
Cancer Society professor at the University of Washington. She is best known
for discovering that BRCA1 mutations can cause hereditary breast cancer.
Dr. King's work changed historic views by finding a genetic marker for the
existence of BRCA1, which made possible gene location, testing, screening
and prophylactic procedures. Dr. King received her doctorate from the
University of California, Berkeley, where she taught from 1976 until 1995
before moving to the University of Washington.
Bernard Fisher, MD, is a recognized pioneer in the biology and treatment of
breast cancer. He was recently honored by the University of Pittsburgh,
where he serves as distinguished service professor of surgery and scientific
director of the National Surgical Adjuvant Breast and Bowel Project, which
he chaired from 1967 to 1994. Dr. Fisher work has led to an understanding of
breast cancer as a systemic disease that metastasizes unpredictably, and
that can be treated with a combination of conservative local treatment and
systemic therapy.
Established in 2006, the Pathfinder Lectures recognizes the innovators
worldwide who have combined research and clinical practice with an
interdisciplinary understanding to advance the fight against breast disease
and breast cancer. Previous recipients have included Ambassador Nancy
Brinker; Patricia Ganz, MD; Jay Harris, MD; Gabriel Hortobagyi, MD; Daniel
Kopans, MD; David Page, MD; Melvin Silverstein, MD; Laszlo Tabar, MD; and
Umberto Veronesi, MD.
About the American Society of Breast Disease
The American Society of Breast Disease is the leading professional medical
society in the United States to serve all physicians and allied
professionals committed to and advocating an interdisciplinary team approach
to breast cancer and disease management, prevention, early detection,
treatment, and research. The Society provides professional education
programs and advocates for improvements in breast healthcare.
American Society of Breast Disease
delivered by two giants in the field of breast cancer - Mary-Claire King,
PhD, and Bernard Fisher, MD. The Pathfinder Lectures will be part of the
Society's Annual Symposium, April 10-12, 2008, at the Hilton San Diego
Resort, San Diego, California.
In announcing the recipients of the ASBD's only honorary recognition,
Society president Julio A. Ibarra, MD, noted that "through their research
and vision this year's honorees -- Mary-Claire King and Bernard Fisher --
have set the highest of standards and benefited the lives of millions of
women internationally."
Mary-Claire King is Professor of Medicine and Genetics and an American
Cancer Society professor at the University of Washington. She is best known
for discovering that BRCA1 mutations can cause hereditary breast cancer.
Dr. King's work changed historic views by finding a genetic marker for the
existence of BRCA1, which made possible gene location, testing, screening
and prophylactic procedures. Dr. King received her doctorate from the
University of California, Berkeley, where she taught from 1976 until 1995
before moving to the University of Washington.
Bernard Fisher, MD, is a recognized pioneer in the biology and treatment of
breast cancer. He was recently honored by the University of Pittsburgh,
where he serves as distinguished service professor of surgery and scientific
director of the National Surgical Adjuvant Breast and Bowel Project, which
he chaired from 1967 to 1994. Dr. Fisher work has led to an understanding of
breast cancer as a systemic disease that metastasizes unpredictably, and
that can be treated with a combination of conservative local treatment and
systemic therapy.
Established in 2006, the Pathfinder Lectures recognizes the innovators
worldwide who have combined research and clinical practice with an
interdisciplinary understanding to advance the fight against breast disease
and breast cancer. Previous recipients have included Ambassador Nancy
Brinker; Patricia Ganz, MD; Jay Harris, MD; Gabriel Hortobagyi, MD; Daniel
Kopans, MD; David Page, MD; Melvin Silverstein, MD; Laszlo Tabar, MD; and
Umberto Veronesi, MD.
About the American Society of Breast Disease
The American Society of Breast Disease is the leading professional medical
society in the United States to serve all physicians and allied
professionals committed to and advocating an interdisciplinary team approach
to breast cancer and disease management, prevention, early detection,
treatment, and research. The Society provides professional education
programs and advocates for improvements in breast healthcare.
American Society of Breast Disease
суббота, 15 октября 2011 г.
Critical Health Care Does Not Reach Most Women And Children In High Mortality Countries, Despite Gains In Fighting Child Killer Diseases
Leading global health experts, policy-makers and parliamentarians are convening in Cape Town to address the urgent need for accelerated progress to reduce maternal, newborn and child deaths, if internationally-agreed targets are to be met.
According to the 2008 report Tracking Progress in Maternal, Newborn & Child Survival released, few of the 68 developing countries that account for 97% of maternal and child deaths worldwide are making adequate progress to provide critical health care needed to save the lives of women, infants and children. Parliamentarians attending the 118th Assembly of the Inter-Parliamentary Union in Cape Town will join global health experts and policy makers to discuss the role they can play in accelerating action to achieve Millennium Development Goals 4 and 5 on reducing child and maternal mortality.
Over 10 million women and children still die each year from causes which are largely preventable and treatable. The majority of maternal and child deaths occur in Africa and South Asia, with sub-Saharan Africa increasingly bearing the global burden of mortality. One in five children are born in sub-Saharan Africa, yet some 50% of all child deaths globally occur in the region, as do half of maternal deaths worldwide. In Niger, for example, women face a lifetime risk of dying in pregnancy or childbirth which is as high as one in seven.
Tracking Progress in Maternal, Newborn & Child Survival uses existing data to measure coverage of key interventions and approaches proven to reduce maternal and child mortality. The 2008 report highlights the rapid progress that many of the 68 countries are making in providing vaccinations, vitamin A supplementation coverage and insecticide-treated mosquito nets to prevent major killers such as measles and malaria.
Nonetheless, treatment for potentially fatal illnesses and other vital health services still fail to reach the majority of women and children according to the findings. These services are dependent on strong health systems that can provide 24-hour care within the community, at health clinics, and through a functioning referral system when more serious intervention is necessary. Access to these services is most critical at the time of birth and during the first two weeks of life which are riskiest for mother and infant.
Tracking Progress in Maternal, Newborn & Child Survival identifies a series of missed opportunities to save lives:
- Family planning: The unmet need for contraceptives is high. Only one-third of women in the 68 priority countries are using a modern contraceptive method - a proven means of boosting maternal and infant survival;
- Skilled care at birth: Only around half of women and newborns benefit from a skilled birth attendant at the time of birth, and even fewer receive care in the critical days and weeks after childbirth;
- Clinical care for sick children: Only about one-third of children with pneumonia - the biggest single killer of children - receive treatment;
- Nutrition: Undernutrition is the underlying cause of 3.5 million child deaths annually, and as many as 20 per cent of maternal deaths.
Despite these missed opportunities, the report also notes that a number of countries, including China, Haiti, Turkmenistan and several countries in sub-Saharan Africa, have made demonstrable progress in reducing deaths of children under-five in the past three years. Sixteen of the 68 Countdown priority countries are now 'on track' to achieve Millennium Development Goal 4.
To pave the way for a well-functioning 'continuum of care', governments and their partners must address obstacles such as weak health systems, funding shortages, and inequalities in access to care. The report findings show poor families missing out twice, on skilled care at birth and on care for newborns and children when they are ill. Other barriers include armed conflict and a high HIV prevalence, which together have erased any gains in child survival in at least 12 African countries.
Overall funding from donor governments for maternal, newborn and child health has increased in recent years, with Official Development Assistance (ODA) rising from US$2.1 billion to almost US$3.5 billion between 2003-2006, a 64 percent increase. This investment has resulted in significant health gains, notably to boost immunization levels and prevent malaria, Nonetheless, health systems for maternal, newborn and child health remain grossly under-funded in relation to the needs of priority countries. Total donor funding for maternal, newborn and child health still represents just 3% of total donor aid disbursements. Most donor assistance is delivered through specific projects and only 5% has been dedicated to general budget support in recipient countries.
The Countdown findings will be discussed during a three day conference in South Africa, from
17-19 April. The Countdown findings are also the subject of a special issue of the medical journal The Lancet.
Countdown to 2015: Maternal, Newborn and Child Survival is a collaborative effort of United Nations agencies, non-governmental organizations, universities, and other institutions and individuals established to track progress towards Millennium Development Goals 4 and 5, to reduce child and maternal mortality respectively. For more information, visit countdown2015mnch.
Countdown to 2015 partners: Aga Khan University, Australian Agency for International Development (AusAID), The Basic Support for Institutionalizing Child Survival (BASICS) Project, USAID, Bellagio Child Survival Group, Department for International Development, UK (DfID), Family Care International, International Paediatric Association, Johns Hopkins University, London School of Hygiene and Tropical Medicine, The Norwegian Agency for Development Cooperation (Norad), Save the Children, The Bill & Melinda Gates Foundation, The Lancet, The Partnership for Maternal, Newborn & Child Health, The World Bank, University College London Centre for International Health and Development, United Nations Population Fund (UNFPA, United Nations Children's Fund (UNICEF), Universidade Federal de Pelotas, University of Aberdeen, USAID and the World Health Organization.
For video b-roll : Visit thenewsmarket/unicef to access broadcast quality footage from Nepal ("Applying Life-Saving Interventions to Save Nepalese Newborns") and Senegal ("A Rural Healthcare Center Plays Key Role in Reducing Infant and Child Mortality").
Countdown to 2015: Maternal, Newborn and Child Survival
According to the 2008 report Tracking Progress in Maternal, Newborn & Child Survival released, few of the 68 developing countries that account for 97% of maternal and child deaths worldwide are making adequate progress to provide critical health care needed to save the lives of women, infants and children. Parliamentarians attending the 118th Assembly of the Inter-Parliamentary Union in Cape Town will join global health experts and policy makers to discuss the role they can play in accelerating action to achieve Millennium Development Goals 4 and 5 on reducing child and maternal mortality.
Over 10 million women and children still die each year from causes which are largely preventable and treatable. The majority of maternal and child deaths occur in Africa and South Asia, with sub-Saharan Africa increasingly bearing the global burden of mortality. One in five children are born in sub-Saharan Africa, yet some 50% of all child deaths globally occur in the region, as do half of maternal deaths worldwide. In Niger, for example, women face a lifetime risk of dying in pregnancy or childbirth which is as high as one in seven.
Tracking Progress in Maternal, Newborn & Child Survival uses existing data to measure coverage of key interventions and approaches proven to reduce maternal and child mortality. The 2008 report highlights the rapid progress that many of the 68 countries are making in providing vaccinations, vitamin A supplementation coverage and insecticide-treated mosquito nets to prevent major killers such as measles and malaria.
Nonetheless, treatment for potentially fatal illnesses and other vital health services still fail to reach the majority of women and children according to the findings. These services are dependent on strong health systems that can provide 24-hour care within the community, at health clinics, and through a functioning referral system when more serious intervention is necessary. Access to these services is most critical at the time of birth and during the first two weeks of life which are riskiest for mother and infant.
Tracking Progress in Maternal, Newborn & Child Survival identifies a series of missed opportunities to save lives:
- Family planning: The unmet need for contraceptives is high. Only one-third of women in the 68 priority countries are using a modern contraceptive method - a proven means of boosting maternal and infant survival;
- Skilled care at birth: Only around half of women and newborns benefit from a skilled birth attendant at the time of birth, and even fewer receive care in the critical days and weeks after childbirth;
- Clinical care for sick children: Only about one-third of children with pneumonia - the biggest single killer of children - receive treatment;
- Nutrition: Undernutrition is the underlying cause of 3.5 million child deaths annually, and as many as 20 per cent of maternal deaths.
Despite these missed opportunities, the report also notes that a number of countries, including China, Haiti, Turkmenistan and several countries in sub-Saharan Africa, have made demonstrable progress in reducing deaths of children under-five in the past three years. Sixteen of the 68 Countdown priority countries are now 'on track' to achieve Millennium Development Goal 4.
To pave the way for a well-functioning 'continuum of care', governments and their partners must address obstacles such as weak health systems, funding shortages, and inequalities in access to care. The report findings show poor families missing out twice, on skilled care at birth and on care for newborns and children when they are ill. Other barriers include armed conflict and a high HIV prevalence, which together have erased any gains in child survival in at least 12 African countries.
Overall funding from donor governments for maternal, newborn and child health has increased in recent years, with Official Development Assistance (ODA) rising from US$2.1 billion to almost US$3.5 billion between 2003-2006, a 64 percent increase. This investment has resulted in significant health gains, notably to boost immunization levels and prevent malaria, Nonetheless, health systems for maternal, newborn and child health remain grossly under-funded in relation to the needs of priority countries. Total donor funding for maternal, newborn and child health still represents just 3% of total donor aid disbursements. Most donor assistance is delivered through specific projects and only 5% has been dedicated to general budget support in recipient countries.
The Countdown findings will be discussed during a three day conference in South Africa, from
17-19 April. The Countdown findings are also the subject of a special issue of the medical journal The Lancet.
Countdown to 2015: Maternal, Newborn and Child Survival is a collaborative effort of United Nations agencies, non-governmental organizations, universities, and other institutions and individuals established to track progress towards Millennium Development Goals 4 and 5, to reduce child and maternal mortality respectively. For more information, visit countdown2015mnch.
Countdown to 2015 partners: Aga Khan University, Australian Agency for International Development (AusAID), The Basic Support for Institutionalizing Child Survival (BASICS) Project, USAID, Bellagio Child Survival Group, Department for International Development, UK (DfID), Family Care International, International Paediatric Association, Johns Hopkins University, London School of Hygiene and Tropical Medicine, The Norwegian Agency for Development Cooperation (Norad), Save the Children, The Bill & Melinda Gates Foundation, The Lancet, The Partnership for Maternal, Newborn & Child Health, The World Bank, University College London Centre for International Health and Development, United Nations Population Fund (UNFPA, United Nations Children's Fund (UNICEF), Universidade Federal de Pelotas, University of Aberdeen, USAID and the World Health Organization.
For video b-roll : Visit thenewsmarket/unicef to access broadcast quality footage from Nepal ("Applying Life-Saving Interventions to Save Nepalese Newborns") and Senegal ("A Rural Healthcare Center Plays Key Role in Reducing Infant and Child Mortality").
Countdown to 2015: Maternal, Newborn and Child Survival
суббота, 8 октября 2011 г.
Three-Quarters Of Indian Maternal Deaths Preventable, Study Finds
Seventy-five percent of maternal deaths in India are preventable, according to a report released Wednesday by Human Rights Watch, the AP/Google News. The report also indicated that one in every 70 Indian women who reaches reproductive age will die from problems associated with pregnancy, childbirth or unsafe abortion. This maternal mortality rate is 16 times higher than Russia's and 10 times higher than China's, the report said. Lead researcher Aruna Kashyap said that in 2005, this translated into 117,000 deaths in India from maternal-related problems.
The study said that tens of thousands of Indian women die each year because of a weak medical system characterized by caste discrimination, poor planning, little accountability and limited access to emergency care. The report found that a large part of the problem is the lack of accountability for the high maternal mortality rate, with the government, hospitals and health workers all shifting blame. Factors contributing to maternal mortality range from poorly trained obstetrics staff to delivery charges that are out of reach for Indian villagers, many of whom live on less than $2 per day. Delivery, prenatal and postnatal care are supposed to be available at no cost, but clinics sometimes charge $10 for a delivery, plus $1 to cut the umbilical cord and $1 for cleaning the room.
Although India as a whole has seen a decline in maternal deaths in the past few years, some heavily populated areas "actually showed an increase in maternal mortality," the report stated, noting that even in areas where access to care seems to be improving, "significant disparities based on income, caste, place of residence and other arbitrary factors" continue to exist. In 2007, in six northern Indian states, 61% of maternal deaths were among Dalits -- or "untouchables" -- and indigenous people, the communities considered at the lowest rung of the Indian caste system, according to the report.
The report found that a large part of the problem is the lack of accountability for the high maternal mortality rate, with the government, hospitals and health wokers all shifting blame. Factors contributing to maternal mortality range from poorly trained obstetrics staff to delivery charges that are out of reach for Indian villagers, many of whom live on less than $2 per day. Delivery, prenatal and postnatal care are supposed to be avaiable at no cost, but clinics sometimes charge $10 for a delivery, plus $1 to cut the umbilical cord and $1 for cleaning the room.
The report's recommendations include requiring reporting of all pregnancy-related deaths to the government, investigation of those deaths and establishment of an obstetric emergency response system (Sullivan, AP/Google News, 10/7).
WSJ Examines Surrogacy in India
In related news, the Wall Street Journal on Thursday examined the proliferation of Indian surrogacy clinics, which serve both domestic and overseas couples. Since 2005, the number of surrogacy clinics has tripled to about 350 facilities throughout the country, according to Hrishikesh Pai, vice president of the Indian Society for Assisted Reproduction. Pai says that last year about 1,000 surrogate pregnancy attempts were made at the clinics and that this year, the figure is likely to increase to 1,500, with about one-third being made on behalf of international couples. According to the Journal, U.S. couples who use Indian surrogates often are motivated by the lower costs of overseas surrogacy.
The Indian Council of Medical Research, a government body, established surrogacy guidelines in 2005, and there are currently new laws under development that would increase standardization of contract terms, parental identification on birth certificates and compensation. The law also would require clinics to register surrogacy cases and report outcomes, the Journal reports. Critics of India's surrogacy say that new controls are necessary to avoid the exploitation of poor women (Cohen, Wall Street Journal, 10/8).
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.
суббота, 1 октября 2011 г.
Urethral Diverticulum: A New Complication Associated With Tension-Free Vaginal Tape
UroToday - Urethral diverticulum is an uncommon condition and not always easy to diagnose early. Some of the symptoms of this condition are quite common. The possibility of urethral diverticulum should be included in the evaluation of women with voiding dysfunction and pelvic disorders.
Unfortunately, there is often a delay in the diagnosis of urethral diverticulum. Usually the initial diagnosis is inaccurate as the symptom of post micturition incontinence can be frequently misdiagnosed.
The presented case supports the need for an accurate diagnostic work-up when there are symptoms consistent with urethral diverticulum, including urodynamic studies, cystography, cystoscopy, and intravaginal ultrasonography. Firstly, accurate diagnosis of the urethral diverticulum requires the inclusion of this condition in the differential diagnosis of pelvic dysfunctions. The insertion of a sub-midurethral tape in a patient suffering from stress urinary incontinence because of intrinsic sphincter deficiency probably predisposes the formation of urethral diverticulum.
The high pressure in the proximal urethra - especially when the urethra is obstructed and the bladder neck is open probably is the underlying mechanism for urethral diverticulum formation. This situation can be exacerbated when there are high detrusor pressures. Furthermore, dissection in the peri-urethral area itself can be an additional predisposing factor for urethral diverticulum.
Finally, another possibility leading to the formation of a symptomatic urethral diverticulum could be a pre-existing, small urethral diverticulum. So the need of a meticulous pre-operative evaluation to exclude the existence of this condition preoperatively is recommended.
Anastasios Athanasopoulos, MD as part of Beyond the Abstract on UroToday
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.
To access the latest urology news releases from UroToday, go to:
www.urotoday
Copyright © 2009 - UroToday
Unfortunately, there is often a delay in the diagnosis of urethral diverticulum. Usually the initial diagnosis is inaccurate as the symptom of post micturition incontinence can be frequently misdiagnosed.
The presented case supports the need for an accurate diagnostic work-up when there are symptoms consistent with urethral diverticulum, including urodynamic studies, cystography, cystoscopy, and intravaginal ultrasonography. Firstly, accurate diagnosis of the urethral diverticulum requires the inclusion of this condition in the differential diagnosis of pelvic dysfunctions. The insertion of a sub-midurethral tape in a patient suffering from stress urinary incontinence because of intrinsic sphincter deficiency probably predisposes the formation of urethral diverticulum.
The high pressure in the proximal urethra - especially when the urethra is obstructed and the bladder neck is open probably is the underlying mechanism for urethral diverticulum formation. This situation can be exacerbated when there are high detrusor pressures. Furthermore, dissection in the peri-urethral area itself can be an additional predisposing factor for urethral diverticulum.
Finally, another possibility leading to the formation of a symptomatic urethral diverticulum could be a pre-existing, small urethral diverticulum. So the need of a meticulous pre-operative evaluation to exclude the existence of this condition preoperatively is recommended.
Anastasios Athanasopoulos, MD as part of Beyond the Abstract on UroToday
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.
To access the latest urology news releases from UroToday, go to:
www.urotoday
Copyright © 2009 - UroToday
суббота, 24 сентября 2011 г.
Maternal Deaths: The Tip Of The Iceberg
In Australia more than one woman dies every fortnight as a result of childbearing - some could be preventable - according a study in published by Wiley-Blackwell in the Australian and New Zealand Journal of Obstetrics and Gynaecology.
The paper entitled "Making Pregnancy Safer in Australia: the Importance of Maternal Death review" outlines the maternal death monitoring and review process in Australia and presents the salient features from the recently published Australian maternal death report - calling for an improvement in the review process to prevent further avoidable maternal deaths.
"Despite being the marker of the health system's performance, maternal deaths appear to have low priority in Australia- due to poor resourcing and underreporting of deaths and Indigenous status. The monitoring and reporting system needs to be strengthened in rigor", says author of the paper, Associate Professor Sue Kildea, from Charles Darwin University's Graduate School for Health Practice.
The latest report shows Aboriginal and Torres Strait Islander women and rural and remote dwelling women are more at risk of maternal death in Australia. The importance of reviewing how and why women die in childbirth is hence brought to the fore. This study finds that leading causes of direct and indirect maternal deaths were infection, cardiac deaths, amniotic fluid embolism, psychiatric deaths, obstetric hemorrhage and hemorrhage from other causes. The paper emphasizes the need for key professionals like midwives, general practice obstetricians and obstetric specialists to work within effective health systems, to give women and newborns consistent access to skilled care throughout the reproductive cycle.
Maternal death review is an essential component of any maternity service. This study reinforces the need to further investigate Australia's review process, and to allocate more resources to improve the quality, timeliness and capacity of maternal death and severe maternal morbidity review in Australia." "We are not doing as well as other similar countries in this respect".
This paper is published in the April 2008 issue of Australian and New Zealand Journal of Obstetrics and Gynaecology (Vol. 48, Issue 2, 2008).
Please click here to view article online
About Australian and New Zealand Journal of Obstetrics and Gynaecology
The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. Please click here to view article online
About Wiley-Blackwell
Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley's Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit blackwellpublishing or interscience.wiley.
About Wiley
Founded in 1807, John Wiley & Sons, Inc. has been a valued source of information and understanding for 200 years, helping people around the world meet their needs and fulfill their aspirations. Since 1901, Wiley and its acquired companies have published the works of more than 350 Nobel laureates in all categories: Literature, Economics, Physiology/Medicine, Physics, Chemistry and Peace.
Our core businesses include scientific, technical, medical and scholarly journals, encyclopedias, books, and online products and services; professional/trade publishes books, subscription products, training materials, and online applications and websites; and educational materials for undergraduate and graduate students and lifelong learners. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's Web site can be accessed at wiley. The Company is listed on the New York Stock Exchange under the symbols JWa and JWb.
John Wiley & Sons, Inc.
The paper entitled "Making Pregnancy Safer in Australia: the Importance of Maternal Death review" outlines the maternal death monitoring and review process in Australia and presents the salient features from the recently published Australian maternal death report - calling for an improvement in the review process to prevent further avoidable maternal deaths.
"Despite being the marker of the health system's performance, maternal deaths appear to have low priority in Australia- due to poor resourcing and underreporting of deaths and Indigenous status. The monitoring and reporting system needs to be strengthened in rigor", says author of the paper, Associate Professor Sue Kildea, from Charles Darwin University's Graduate School for Health Practice.
The latest report shows Aboriginal and Torres Strait Islander women and rural and remote dwelling women are more at risk of maternal death in Australia. The importance of reviewing how and why women die in childbirth is hence brought to the fore. This study finds that leading causes of direct and indirect maternal deaths were infection, cardiac deaths, amniotic fluid embolism, psychiatric deaths, obstetric hemorrhage and hemorrhage from other causes. The paper emphasizes the need for key professionals like midwives, general practice obstetricians and obstetric specialists to work within effective health systems, to give women and newborns consistent access to skilled care throughout the reproductive cycle.
Maternal death review is an essential component of any maternity service. This study reinforces the need to further investigate Australia's review process, and to allocate more resources to improve the quality, timeliness and capacity of maternal death and severe maternal morbidity review in Australia." "We are not doing as well as other similar countries in this respect".
This paper is published in the April 2008 issue of Australian and New Zealand Journal of Obstetrics and Gynaecology (Vol. 48, Issue 2, 2008).
Please click here to view article online
About Australian and New Zealand Journal of Obstetrics and Gynaecology
The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. Please click here to view article online
About Wiley-Blackwell
Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley's Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit blackwellpublishing or interscience.wiley.
About Wiley
Founded in 1807, John Wiley & Sons, Inc. has been a valued source of information and understanding for 200 years, helping people around the world meet their needs and fulfill their aspirations. Since 1901, Wiley and its acquired companies have published the works of more than 350 Nobel laureates in all categories: Literature, Economics, Physiology/Medicine, Physics, Chemistry and Peace.
Our core businesses include scientific, technical, medical and scholarly journals, encyclopedias, books, and online products and services; professional/trade publishes books, subscription products, training materials, and online applications and websites; and educational materials for undergraduate and graduate students and lifelong learners. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's Web site can be accessed at wiley. The Company is listed on the New York Stock Exchange under the symbols JWa and JWb.
John Wiley & Sons, Inc.
суббота, 17 сентября 2011 г.
Opinion Pieces Examine Obama's Commitment To Reduce The Need For Abortion
The Atlanta Journal-Constitution on Wednesday published two opinion pieces debating whether President-elect Barack Obama will fulfill his pledge to reduce the need for abortions. Summaries appear below.
~ Alexia Kelley, Atlanta Journal-Constitution: "The time is ripe to break the abortion stalemate," Kelley, executive director and co-founder of Catholics in Alliance for the Common Good, writes in an opinion piece. Although Obama "supports a woman's right to choose an abortion, his commitment to poverty reduction, affordable health care and addressing the root causes of abortion is encouraging," Kelley writes. She continues that the Democratic Party's platform "[f]or the first time" includes references to the "essential role social and economic supports play in reducing abortion." This approach, as well as Obama's outreach to religious Americans, "bodes well for continued dialogue and the potential for new coalitions and fresh solutions," Kelley writes. She continues that officials should address economic and social issues through a "comprehensive abortion prevention strategy" to "make real progress reducing the number of abortions" in the U.S. According to Kelley, "Reducing the abortion rate by 95% in 10 years is an essential and achievable goal." However, she writes, "[p]eople of faith have a particular responsibility to both collaborate with and challenge the new administration" (Kelley, Atlanta Journal-Constitution, 1/14).
~ Jonathan Merritt, Atlanta Journal-Constitution: "In years past, abortion has been a black and white issue," Merritt, national spokesperson for the Southern Baptist Environment and Climate Initiative writes, adding that abortion-rights advocates "have been villainized as murderers" while abortion-rights opponents "have been called religious fanatics." Merritt writes that the abortion debate recently "has evolved with the inclusion of one simple word: reduction," adding that reduction has "struck a chord with Americans on both sides of the issue." Merritt asks whether Obama will "make good on his promises" to reduce the number of abortions, whether abortion reduction will be a "priority" for the Obama administration and whether Obama has the "resolve to spend the necessary political capital" to reduce abortion. Merritt writes, "Unfortunately, by all indications, the answer to each of these questions is 'no.'" He continues that "Obama has an abysmal record when it comes to abortion," citing Obama's statement in 2007 that he would sign the Freedom of Choice Act. According to Merritt, FOCA "would invalidate almost every restriction" on abortion and would result in "more abortion, not less." He adds that it would be "unfortunate for America" if Obama does not reduce abortion because "[b]oth pro- and antiabortion rights voters have finally found something on which we can agree." Merritt concludes, "If Obama wants to add another mark on the checklist under 'unprecedented and historical,' he will fulfill his promise to reduce the multitudinous number of abortions currently allowed by the United States" (Merritt, Atlanta Journal-Constitution, 1/14).
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.
~ Alexia Kelley, Atlanta Journal-Constitution: "The time is ripe to break the abortion stalemate," Kelley, executive director and co-founder of Catholics in Alliance for the Common Good, writes in an opinion piece. Although Obama "supports a woman's right to choose an abortion, his commitment to poverty reduction, affordable health care and addressing the root causes of abortion is encouraging," Kelley writes. She continues that the Democratic Party's platform "[f]or the first time" includes references to the "essential role social and economic supports play in reducing abortion." This approach, as well as Obama's outreach to religious Americans, "bodes well for continued dialogue and the potential for new coalitions and fresh solutions," Kelley writes. She continues that officials should address economic and social issues through a "comprehensive abortion prevention strategy" to "make real progress reducing the number of abortions" in the U.S. According to Kelley, "Reducing the abortion rate by 95% in 10 years is an essential and achievable goal." However, she writes, "[p]eople of faith have a particular responsibility to both collaborate with and challenge the new administration" (Kelley, Atlanta Journal-Constitution, 1/14).
~ Jonathan Merritt, Atlanta Journal-Constitution: "In years past, abortion has been a black and white issue," Merritt, national spokesperson for the Southern Baptist Environment and Climate Initiative writes, adding that abortion-rights advocates "have been villainized as murderers" while abortion-rights opponents "have been called religious fanatics." Merritt writes that the abortion debate recently "has evolved with the inclusion of one simple word: reduction," adding that reduction has "struck a chord with Americans on both sides of the issue." Merritt asks whether Obama will "make good on his promises" to reduce the number of abortions, whether abortion reduction will be a "priority" for the Obama administration and whether Obama has the "resolve to spend the necessary political capital" to reduce abortion. Merritt writes, "Unfortunately, by all indications, the answer to each of these questions is 'no.'" He continues that "Obama has an abysmal record when it comes to abortion," citing Obama's statement in 2007 that he would sign the Freedom of Choice Act. According to Merritt, FOCA "would invalidate almost every restriction" on abortion and would result in "more abortion, not less." He adds that it would be "unfortunate for America" if Obama does not reduce abortion because "[b]oth pro- and antiabortion rights voters have finally found something on which we can agree." Merritt concludes, "If Obama wants to add another mark on the checklist under 'unprecedented and historical,' he will fulfill his promise to reduce the multitudinous number of abortions currently allowed by the United States" (Merritt, Atlanta Journal-Constitution, 1/14).
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.
суббота, 10 сентября 2011 г.
False Alarm At Breast Cancer Screening Causes Substantial Negative Psychological Impact
Today preventive medicine screening programs for cancers including breast cancer are recommended to the healthy population to reduce mortality of cancer. When women receive abnormal breast cancer screening results, later confirmed as false alarms, it causes anxiety, sense of dejection, sleeping problems, negative impact on behavior, and sexuality and exaggerated breast self examination. Women also feel less attractive and try to keep themselves busy to take their mind off things. Some women report sick leave as a consequence of the abnormal screening mammography.
The article "Validation Of A Condition-Specific Measure For Women Having An Abnormal Screening Mammography," by John Brodersen MD, GP, PhD student, Hanne Thorsen MD, PhD, and Svend Kreiner MSC appears in the July/August 2007 issue of Value in Health, the official journal of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR).
Currently used questionnaires are not able to measure all the harms related to screening. Therefore, a new questionnaire for women having an abnormal screening mammography was tested in a population of women attending breast cancer screening.
In most cancer screening programs thousands of screens have to occur to prevent one death of cancer, while hundreds will have false alarms. In breast cancer screenings, the ratio between prevented deaths and false alarms are 1:200. The inadequacy of the current information given to women at invitation to breast cancer screening combined with the substantial negative psychological impact from the large number of false alarms makes it important to improve the information of the benefits and harm of screening mammography so that women are able to make an informed choice.
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 3,000 clinicians, decision-makers, and researchers worldwide.
ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care resources wisely, fairly, and efficiently.
Value in Health Volume 10 Issue 4 - July/August 2007
ABSTRACT
ispor
The article "Validation Of A Condition-Specific Measure For Women Having An Abnormal Screening Mammography," by John Brodersen MD, GP, PhD student, Hanne Thorsen MD, PhD, and Svend Kreiner MSC appears in the July/August 2007 issue of Value in Health, the official journal of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR).
Currently used questionnaires are not able to measure all the harms related to screening. Therefore, a new questionnaire for women having an abnormal screening mammography was tested in a population of women attending breast cancer screening.
In most cancer screening programs thousands of screens have to occur to prevent one death of cancer, while hundreds will have false alarms. In breast cancer screenings, the ratio between prevented deaths and false alarms are 1:200. The inadequacy of the current information given to women at invitation to breast cancer screening combined with the substantial negative psychological impact from the large number of false alarms makes it important to improve the information of the benefits and harm of screening mammography so that women are able to make an informed choice.
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research and help health care leaders to make decisions that are solidly evidence-based. The journal is published bi-monthly and has a regular readership of over 3,000 clinicians, decision-makers, and researchers worldwide.
ISPOR is a nonprofit, international organization that strives to translate pharmacoeconomics and outcomes research into practice to ensure that society allocates scarce health care resources wisely, fairly, and efficiently.
Value in Health Volume 10 Issue 4 - July/August 2007
ABSTRACT
ispor
суббота, 3 сентября 2011 г.
Researcher Finds Link Between Chlamydia And Cervical Cancer
The human papillomavirus (HPV), an infectious disease of the skin and inner membranes, is considered one of the most common sexually transmitted diseases (STDs) in the world and a necessary agent of cervical cancer. Research now shows that Chlamydia increases this risk.
Jeff Korte, Ph.D., principal investigator of a National Cancer Institute funded study and assistant professor at the Medical University of South Carolina (MUSC), tracked HPV infections in 68 women with existing STDs to analyze the impact of genital infections over a two-year period. Korte found that HPV infections lasted longer if Chlamydia also was present. "HPV persistence is one of the most important risk factors for cervical cancer", said Korte. "If an HPV infection persists longer, it is more likely to be accompanied by a serious lesion and progress to cancer".
Prevention is through vaccination, which protects against the four HPV types. Since the majority of HPV-positive people contract the disease within a few years of sexual activity, there is a push to vaccinate young adolescents. Current vaccines have been approved for women ages nine to 26, but targeted to girls 11 to 13.
Though the HPV vaccine is a socially controversial issue, the spread of HPV is a major public health concern. Therefore, investigators from MUSC's College of Nursing and the Hollings Cancer Center Office of Prevention and Control are working on a National Cancer Institute funded study to determine perceptions about the HPV vaccine and identify both facilitators and barriers among specific demographics. "The HPV vaccine will change how we screen for cervical cancer in the United States," said Sharon Bond, study investigator and certified nurse midwife at MUSC. "The vaccines give us the capability to virtually eradicate a common cancer-causing virus that claims the lives of more than 250,000 women around the world every year."
About MUSC
Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 10,000 employees, including 1,300 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.3 billion. MUSC operates a 600-bed medical center, which includes a nationally recognized Children's Hospital and a leading Institute of Psychiatry. For more information on academic information or clinical services, visit musc.edu or muschealth.
Medical University of South Carolina
171 Ashley Ave.
Charleston, SC 29425
United States
musc.edu
Jeff Korte, Ph.D., principal investigator of a National Cancer Institute funded study and assistant professor at the Medical University of South Carolina (MUSC), tracked HPV infections in 68 women with existing STDs to analyze the impact of genital infections over a two-year period. Korte found that HPV infections lasted longer if Chlamydia also was present. "HPV persistence is one of the most important risk factors for cervical cancer", said Korte. "If an HPV infection persists longer, it is more likely to be accompanied by a serious lesion and progress to cancer".
Prevention is through vaccination, which protects against the four HPV types. Since the majority of HPV-positive people contract the disease within a few years of sexual activity, there is a push to vaccinate young adolescents. Current vaccines have been approved for women ages nine to 26, but targeted to girls 11 to 13.
Though the HPV vaccine is a socially controversial issue, the spread of HPV is a major public health concern. Therefore, investigators from MUSC's College of Nursing and the Hollings Cancer Center Office of Prevention and Control are working on a National Cancer Institute funded study to determine perceptions about the HPV vaccine and identify both facilitators and barriers among specific demographics. "The HPV vaccine will change how we screen for cervical cancer in the United States," said Sharon Bond, study investigator and certified nurse midwife at MUSC. "The vaccines give us the capability to virtually eradicate a common cancer-causing virus that claims the lives of more than 250,000 women around the world every year."
About MUSC
Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 10,000 employees, including 1,300 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.3 billion. MUSC operates a 600-bed medical center, which includes a nationally recognized Children's Hospital and a leading Institute of Psychiatry. For more information on academic information or clinical services, visit musc.edu or muschealth.
Medical University of South Carolina
171 Ashley Ave.
Charleston, SC 29425
United States
musc.edu
суббота, 27 августа 2011 г.
New Tool Assesses Body Image - Female College Students Rate Their Fatness, Muscularity
A promising new index can quickly gauge how women's perceptions of their bodies compares to the ideal, according to
research presented today at the 52nd American College of Sports Medicine (ACSM) Annual Meeting in Nashville, Tenn.
What's different, say the researchers who developed it, is that the Visual Rating Tool (VRT) looks at muscularity as well as
body fat. "Existing testing instruments were inadequate in some ways," said William J. Ryan, Ph.D., Exercise Physiologist.
"We wanted to look at muscularity as well as body fat." Jennifer Sanftner, Ph.D., Clinical Psychologist, said "Women have
been preoccupied with body fat for a long time. Interest in women's muscularity is something new."
Using 24 illustrations for body fat and eight for muscularity, the VRT asks each participant:
1. Which figure do you think you look like?
2. Which figure do you feel like most of the time?
3. Which figure would you most like to look like?
4. Which figure do you think society wants you to look like?
5. Which figure do you think men find most attractive?
6. Which figure do you think women find most attractive?
102 female students at Slippery Rock completed the VRT, the Eating Disorder Inventory-2 and the Multidimensional body
Self-Relations Questionnaire. 90 students returned two weeks later to re-take the VRT, which allowed researchers to measure
its test-retest reliability.
Researchers found a high degree of correlation between the new VRT and the established testing instruments. Dr. Sanftner
said, "With respect to body fat, the figures are highly reliable, particularly when asking 'What do you look like, and what
do you want to look like?' When it comes to muscularity, the correlations were lower."
Fluctuations in respondents' attitudes toward their muscularity didn't surprise co-researcher Patricia Pierce, Ph.D.,
Exercise Physiologist. "It depends on how one defines muscularity, she said. "Some women have a stigma against being
muscular, while others think 'I want to be more muscular.'" Further, said Dr. Sanftner, "Muscularity is a more
state-dependent issue. Today I may feel muscular after working out. Two weeks from now, I may feel different."
The VRT can be quickly administered by a clinician or personal trainer and lends itself to testing large numbers of people at
one time. Among other uses, it can call attention to risk factors for anorexia or bulimia. "The VRT is not a diagnostic tool
for eating disorders or body image disorders," said Dr. Ryan. "But, it provides information that might indicate a tendency of
someone at risk for body-image issues. If the figure they want to look like is very different from what they think they look
like, that might indicate a problem that needs professional attention."
While the VRT was validated using traditional college-age women, researchers say its applicability to other age groups has
not been proven. "The VRT is probably applicable to women in their 20s, 30s and 40s," said Dr. Ryan. "The figures we present
are general enough that women in that age range should be able to relate to them. This test may not be applicable to older
adults." High school students, he pointed out, comprise a wide range of development that presents special challenges.
In summing up the research team's goals in developing the VRT, Ryan said, "We hope to introduce an instrument that has some
validity. We'd like other people to use it, try to replicate our research and do other research."
ACSM's 52nd Annual Meeting is going on now at the Gaylord Opryland Resort and Convention Center. For more information on the
event, or to speak with ACSM Communications and Public Information staff, please call (615) 458-0996.
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More
than 20,000 international, national, and regional members are dedicated to promoting and integrating scientific research,
education, and practical applications of sports medicine and exercise science to maintain and enhance physical performance,
fitness, health, and quality of life.
NOTE: The conclusions outlined in this news release are those of the researchers only, and should not be construed as an
official statement of the American College of Sports Medicine.
FOR MORE INFORMATION: ACSM's 52nd Annual Meeting takes place June 1-4, 2005. After June 6, please call the ACSM
Communications and Public Information office at (317) 637-9200 ext. 117 or 127.
American College of Sports
Medicine
research presented today at the 52nd American College of Sports Medicine (ACSM) Annual Meeting in Nashville, Tenn.
What's different, say the researchers who developed it, is that the Visual Rating Tool (VRT) looks at muscularity as well as
body fat. "Existing testing instruments were inadequate in some ways," said William J. Ryan, Ph.D., Exercise Physiologist.
"We wanted to look at muscularity as well as body fat." Jennifer Sanftner, Ph.D., Clinical Psychologist, said "Women have
been preoccupied with body fat for a long time. Interest in women's muscularity is something new."
Using 24 illustrations for body fat and eight for muscularity, the VRT asks each participant:
1. Which figure do you think you look like?
2. Which figure do you feel like most of the time?
3. Which figure would you most like to look like?
4. Which figure do you think society wants you to look like?
5. Which figure do you think men find most attractive?
6. Which figure do you think women find most attractive?
102 female students at Slippery Rock completed the VRT, the Eating Disorder Inventory-2 and the Multidimensional body
Self-Relations Questionnaire. 90 students returned two weeks later to re-take the VRT, which allowed researchers to measure
its test-retest reliability.
Researchers found a high degree of correlation between the new VRT and the established testing instruments. Dr. Sanftner
said, "With respect to body fat, the figures are highly reliable, particularly when asking 'What do you look like, and what
do you want to look like?' When it comes to muscularity, the correlations were lower."
Fluctuations in respondents' attitudes toward their muscularity didn't surprise co-researcher Patricia Pierce, Ph.D.,
Exercise Physiologist. "It depends on how one defines muscularity, she said. "Some women have a stigma against being
muscular, while others think 'I want to be more muscular.'" Further, said Dr. Sanftner, "Muscularity is a more
state-dependent issue. Today I may feel muscular after working out. Two weeks from now, I may feel different."
The VRT can be quickly administered by a clinician or personal trainer and lends itself to testing large numbers of people at
one time. Among other uses, it can call attention to risk factors for anorexia or bulimia. "The VRT is not a diagnostic tool
for eating disorders or body image disorders," said Dr. Ryan. "But, it provides information that might indicate a tendency of
someone at risk for body-image issues. If the figure they want to look like is very different from what they think they look
like, that might indicate a problem that needs professional attention."
While the VRT was validated using traditional college-age women, researchers say its applicability to other age groups has
not been proven. "The VRT is probably applicable to women in their 20s, 30s and 40s," said Dr. Ryan. "The figures we present
are general enough that women in that age range should be able to relate to them. This test may not be applicable to older
adults." High school students, he pointed out, comprise a wide range of development that presents special challenges.
In summing up the research team's goals in developing the VRT, Ryan said, "We hope to introduce an instrument that has some
validity. We'd like other people to use it, try to replicate our research and do other research."
ACSM's 52nd Annual Meeting is going on now at the Gaylord Opryland Resort and Convention Center. For more information on the
event, or to speak with ACSM Communications and Public Information staff, please call (615) 458-0996.
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More
than 20,000 international, national, and regional members are dedicated to promoting and integrating scientific research,
education, and practical applications of sports medicine and exercise science to maintain and enhance physical performance,
fitness, health, and quality of life.
NOTE: The conclusions outlined in this news release are those of the researchers only, and should not be construed as an
official statement of the American College of Sports Medicine.
FOR MORE INFORMATION: ACSM's 52nd Annual Meeting takes place June 1-4, 2005. After June 6, please call the ACSM
Communications and Public Information office at (317) 637-9200 ext. 117 or 127.
American College of Sports
Medicine
суббота, 20 августа 2011 г.
Study Examines Rates Of Multiple Partners Among People In Non-Romantic Sexual Relationships
Seventeen percent of men and 5% of women in non-romantic sexual relationships report that they had multiple sexual partners during that relationship, which could promote the spread of sexually transmitted infections, according to a recent study in Perspectives on Sexual and Reproductive Health, HealthDay/USA Today reports.
For the study, Anthony Paik -- a sociologist at the University of Iowa College of Liberal Arts and Sciences -- and colleagues asked 783 heterosexual adults ages 18 through 60 how many people they were sexually involved with during their most recent non-romantic sexual relationship.
According to the study, 17% of women and 8% of men said that they had been monogamous during the relationship but that their partner had not. Twelve percent of women and 10% of men said that neither member of the relationship was monogamous.
Researchers also found that respondents who reported getting along with a partner's parents were more likely to be monogamous. Paik said this finding suggests that people are less likely to risk behavior that could damage a relationship when they consider the impact on their partner's family. The study also found that being in a sexual relationship with a friend increased the likelihood of having other sexual partners by 44% for women and 25% for men, while involvement with an acquaintance or stranger raised the likelihood by 30% for women and 43% for men (Preidt, HealthDay/USA Today, 4/8).
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.
© 2010 The Advisory Board Company. All rights reserved.
суббота, 13 августа 2011 г.
Videos Discuss Marie Stopes TV Ad, Access To Antiretrovirals, Family Planning In Africa
The following summarizes selected women's health related videos.
Marie Stopes Launches TV Ad: Fox News reported on a new British TV ad from Marie Stopes International that urges women with unplanned pregnancies to call a toll-free hotline for counseling. Antiabortion-rights groups are protesting the ad, which uses the slogan "Are You Late?" and does not mention the word "abortion." Three-fourths of the British public support the ad, according to Fox News (Palkot, Fox News, 5/24).
HBO Examines Impact of Antiretrovirals: On Monday, HBO and Product (RED) presented a documentary -- "The Lazarus Effect" -- about the transformative effects of antiretroviral drugs for people living with HIV. In an interview on MSNBC's "Morning Joe," (RED) CEO Susan Smith-Ellis said efforts by the Clinton Global Initiative and other groups have helped bring the cost of providing antiretrovirals to HIV-positive people from thousands of dollars annually to about 40 cents per day. In addition, in part because of initiatives from the Global Fund and the President's Emergency Plan for AIDS Relief, more than five million people worldwide now use the drugs, including about three million in sub-Saharan Africa, according to Smith-Ellis (Scarborough, "Morning Joe," 5/24).
Kristof Discusses Global Family Planning: A "Morning Joe" panel and the New York Times' Nicholas Kristof discussed his recent column on the lack of access to contraception in developing countries. Women in poor countries face multiple barriers to family planning, including cost, a lack of knowledge about contraception and rules that require a husband's permission for women to use birth control, Kristof said. "There is good evidence that if you invest in family planning in these countries, it actually pays for itself," he added (Scarborough et al., "Morning Joe," MSNBC, 5/20).
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.
суббота, 6 августа 2011 г.
Fast-Growing Gestational Tumors: Gynecologic Cancer Expert Helps Pinpoint Best Treatment
A clinical trial has sifted out the most effective single-drug chemotherapy regimen for quick-growing but highly curable cancers that arise from the placentas of pregnant women.
In the comparison trial for treating low-risk gestational trophoblastic neoplasia (GTN), researchers found that a biweekly dose of dactinomycin had a higher complete response rate than a weekly dose of methotrexate, the more commonly used drug. GTN is a group of rare tumors that involve abnormal growth of cells inside a woman's uterus.
"Both chemotherapy drugs are effective in treating this kind of neoplasia, but this trial proved that dactinomycin is the best first-line regimen," said Dr. David Scott Miller, who is the head of gynecologic oncology at UT Southwestern Medical Center and co-investigator on the study.
The trial, supported by grants from the National Cancer Institute to the Gynecologic Oncology Group, was published in the March issue of the Journal of Clinical Oncology.
Dr. Miller, professor of obstetrics and gynecology, chairs the uterine corpus committee of the Gynecologic Oncology Group. As group members, UT Southwestern specialists are able to offer patients access to national protocols supported by the institute.
Unlike cervical or endometrial cancers, which develop from cells of the uterus, trophoblastic neoplasia starts in the cells that would normally develop into the placenta during pregnancy. These tumors include hydatidiform moles, caused by over-production of the tissue that typically develops into the placenta, and choriocarcinoma, a quick-growing form of cancer in a woman's uterus.
There has been no consensus on which drug and regimen best treats GTN, and researchers found that such choices were highly institution-specific.
In this trial, researchers compared regimens of both cancer drugs in a sample of 216 women enrolled over an eight-year period. Adverse effects were minimal with either drug, but a biweekly dose of intravenous dactinomycin was superior to a weekly intramuscular injection of methotrexate in stopping the growth of cancerous cells in the uterus. Dactinomycin had a 70 percent complete response rate compared to 53 percent for methotrexate.
Study patients who received dactinomycin also required half the number of treatment cycles. Dactinomycin additionally was easy to administer and had low toxicity - a strong consideration for young reproductive-age women.
"Minimizing toxicity is essential in low-risk GTN, because these women have a high-cure rate and usually hope to have subsequent pregnancies," Dr. Miller said. "These tumors are much more common in developing countries, where access to more complicated chemotherapy regimens is limited. The Gynecological Oncology Group has sought to develop simpler but effective regimens that would lend themselves to use in low-resource settings."
Researchers said further trials comparing the biweekly dactinomycin regimen with other methotrexate regimens are warranted.
Source:
Robin Russell
UT Southwestern Medical Center
In the comparison trial for treating low-risk gestational trophoblastic neoplasia (GTN), researchers found that a biweekly dose of dactinomycin had a higher complete response rate than a weekly dose of methotrexate, the more commonly used drug. GTN is a group of rare tumors that involve abnormal growth of cells inside a woman's uterus.
"Both chemotherapy drugs are effective in treating this kind of neoplasia, but this trial proved that dactinomycin is the best first-line regimen," said Dr. David Scott Miller, who is the head of gynecologic oncology at UT Southwestern Medical Center and co-investigator on the study.
The trial, supported by grants from the National Cancer Institute to the Gynecologic Oncology Group, was published in the March issue of the Journal of Clinical Oncology.
Dr. Miller, professor of obstetrics and gynecology, chairs the uterine corpus committee of the Gynecologic Oncology Group. As group members, UT Southwestern specialists are able to offer patients access to national protocols supported by the institute.
Unlike cervical or endometrial cancers, which develop from cells of the uterus, trophoblastic neoplasia starts in the cells that would normally develop into the placenta during pregnancy. These tumors include hydatidiform moles, caused by over-production of the tissue that typically develops into the placenta, and choriocarcinoma, a quick-growing form of cancer in a woman's uterus.
There has been no consensus on which drug and regimen best treats GTN, and researchers found that such choices were highly institution-specific.
In this trial, researchers compared regimens of both cancer drugs in a sample of 216 women enrolled over an eight-year period. Adverse effects were minimal with either drug, but a biweekly dose of intravenous dactinomycin was superior to a weekly intramuscular injection of methotrexate in stopping the growth of cancerous cells in the uterus. Dactinomycin had a 70 percent complete response rate compared to 53 percent for methotrexate.
Study patients who received dactinomycin also required half the number of treatment cycles. Dactinomycin additionally was easy to administer and had low toxicity - a strong consideration for young reproductive-age women.
"Minimizing toxicity is essential in low-risk GTN, because these women have a high-cure rate and usually hope to have subsequent pregnancies," Dr. Miller said. "These tumors are much more common in developing countries, where access to more complicated chemotherapy regimens is limited. The Gynecological Oncology Group has sought to develop simpler but effective regimens that would lend themselves to use in low-resource settings."
Researchers said further trials comparing the biweekly dactinomycin regimen with other methotrexate regimens are warranted.
Source:
Robin Russell
UT Southwestern Medical Center
суббота, 30 июля 2011 г.
IRIN/PlusNews Examines Ritual In Guinea-Bissau Believed To Prevent Spread Of HIV
IRIN/PlusNews recently examined a ritual, known as tarbessadu, performed by traditional healers in Guinea-Bissau that many people in the country believe can prevent a woman who has given birth from contracting HIV. According to IRIN/PlusNews, traditional healers use a pig, half a sack of rice, black corn and five liters of sugarcane brandy to perform tarbessadu. Some say if a pregnant woman does not go through the ritual, she will contract HIV and transmit it to her male partner.
Tarbessadu is practiced primarily by the Balanta ethnic group, which accounts for about 20% of the country's 1.4 million residents, according to Ali Hizazi of the Italian nongovernmental organization Ceu e Terra, which works with pregnant HIV-positive women. Hizazi said that rituals, such as tarbessadu, are important to the people in Guinea-Bissau because little is known about HIV. The country's HIV prevalence is about 4%, IRIN/PlusNews reports. According to a 2006 survey, one-third of people in Guinea-Bissau believe HIV/AIDS depends on the will of God.
"People don't accept AIDS as a disease, so they attribute it to something women failed to do, or did wrong, and for which they are being punished," Hizazi said, adding, "Blame is internalized because the man just doesn't accept this responsibility. He thinks that the woman's promiscuity is what has led him to be punished by God by becoming infected." The 2006 survey also found that most Guineans would end a relationship if their partner tested positive for HIV, which makes many pregnant women reluctant to be tested, according to IRIN/PlusNews.
In addition, there are only two health care facilities in the country that offer services to prevent mother-to-child HIV transmission, IRIN/PlusNews reports. Paulo Mendes -- president of the National Secretariat for the Fight Against AIDS, or SNLS -- said, "It's hard for us to plan prophylactic treatment against mother-to-child transmission in a regular manner, due to the hardships we face in terms of human, financial and material resources." It also is difficult to closely monitor women and infants for up to 18 months after delivery, according to IRIN/PlusNews. Ceu e Terra was able to monitor about 800 infants between 2002 and 2006 in Guinea-Bissau, which was less than 50% of the infants born to HIV-positive women during that time period. "Many mothers either become desperate, turn to alternative medicine or simply fail to comprehend the gravity of the situation," Oscar Basisio, president of Ceu e Terra, said.
Additional data from SNLS found that 75% of the 4,124 pregnant women who received information on HIV testing during prenatal visits in the first half of last year agreed to be tested for the virus. The tests results showed that 217 of the women were HIV-positive and that 42% of their partners agreed to be tested (IRIN/PlusNews, 1/28).
Reprinted with kind 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.
Tarbessadu is practiced primarily by the Balanta ethnic group, which accounts for about 20% of the country's 1.4 million residents, according to Ali Hizazi of the Italian nongovernmental organization Ceu e Terra, which works with pregnant HIV-positive women. Hizazi said that rituals, such as tarbessadu, are important to the people in Guinea-Bissau because little is known about HIV. The country's HIV prevalence is about 4%, IRIN/PlusNews reports. According to a 2006 survey, one-third of people in Guinea-Bissau believe HIV/AIDS depends on the will of God.
"People don't accept AIDS as a disease, so they attribute it to something women failed to do, or did wrong, and for which they are being punished," Hizazi said, adding, "Blame is internalized because the man just doesn't accept this responsibility. He thinks that the woman's promiscuity is what has led him to be punished by God by becoming infected." The 2006 survey also found that most Guineans would end a relationship if their partner tested positive for HIV, which makes many pregnant women reluctant to be tested, according to IRIN/PlusNews.
In addition, there are only two health care facilities in the country that offer services to prevent mother-to-child HIV transmission, IRIN/PlusNews reports. Paulo Mendes -- president of the National Secretariat for the Fight Against AIDS, or SNLS -- said, "It's hard for us to plan prophylactic treatment against mother-to-child transmission in a regular manner, due to the hardships we face in terms of human, financial and material resources." It also is difficult to closely monitor women and infants for up to 18 months after delivery, according to IRIN/PlusNews. Ceu e Terra was able to monitor about 800 infants between 2002 and 2006 in Guinea-Bissau, which was less than 50% of the infants born to HIV-positive women during that time period. "Many mothers either become desperate, turn to alternative medicine or simply fail to comprehend the gravity of the situation," Oscar Basisio, president of Ceu e Terra, said.
Additional data from SNLS found that 75% of the 4,124 pregnant women who received information on HIV testing during prenatal visits in the first half of last year agreed to be tested for the virus. The tests results showed that 217 of the women were HIV-positive and that 42% of their partners agreed to be tested (IRIN/PlusNews, 1/28).
Reprinted with kind 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.
суббота, 23 июля 2011 г.
New York Times Analyzes Ford's Decision Not To Challenge Gillibrand For N.Y. Senate Seat
The New York Times on Tuesday examined how former Rep. Harold Ford (D-Tenn.) came to concede that a campaign against Sen. Kirsten Gillibrand (D-N.Y.) in the Democratic primary "would be a brutal fight dominated by endless debates about when he began paying taxes as a New Yorker and the sincerity of his support for gay marriage and abortion rights." After weeks of courting Democratic donors and traveling the state to meet with voters, Ford announced on Monday that he would not challenge Gillibrand in the primary.
According to the Times, "Ford knew that some liberals would attack his relatively conservative voting record but, those he spoke with said, he was taken aback by the depth of the anger he encountered from advocates for abortion rights and gay marriage." Reporters uncovered examples of Ford describing himself as "pro-life" during his time in the House. Ford responded that he has always supported abortion rights, and he hoped to put the matter to rest. However, his earlier statements on abortion continued to attract attention, and Ford "was dumbfounded that it kept tripping him up," a Ford friend told the Times. Some New York officials also questioned Ford's experience in politics and his ability to fund a meaningful campaign against Gillibrand.
Ford met with Kelli Conlin, the president of NARAL Pro-Choice New York, in an attempt to "neutralize a foe," the Times reports. Conlin asked Ford for clarification of his abortion views and legislative history, including his support for a bill to limit abortion later in pregnancy even if the woman's health is in jeopardy. Ford responded by asking why NARAL did not excoriate Gillibrand for supporting the Senate's health reform bill (HR 3590), which includes restrictions on health insurance coverage of abortion. At the meeting's conclusion, Ford said that he hoped to meet with Conlin again to ask for her group's support if he chose to run, to which Conlin replied, "We can never support you if you take these positions." Ford "looked shocked" by her response, according to a person in the room at the time (Barbaro [1], New York Times, 3/2).
Zuckerman Will Not Challenge Gillibrand
In related news, billionaire publisher and real estate developer Mortimer Zuckerman announced Tuesday that he will not challenge Gillibrand for the Senate seat this year, despite growing speculation that he would run in November's election. Zuckerman, who likely would have run as a self-financed Republican candidate, considered Gillibrand vulnerable and told friends that he thought his status as a political outsider would be valuable in the election (Barbaro [2], New York Times, 3/2).
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.
© 2010 The Advisory Board Company. All rights reserved.
суббота, 16 июля 2011 г.
Fast Pharmacy Access To The Morning-after Pill Could Prevent 10% More Unwanted Pregnancies
Pharmacies who provide fast and convenient access to the morning-after pill could be helping to prevent 10 per cent more unwanted pregnancies, according to a study in the latest British Journal of Clinical Pharmacology.
UK researchers from South West Kent Primary Care Trust and the University of Bradford looked at 203 females aged from 13 to 20 who got the medication from family planning clinics and community pharmacies.
They discovered that those who went to a pharmacy to get the morning-after pill obtained it more than twice as quickly as those who went to their local clinic - in 16 hours rather than 41.
Figures from the World Health Organization suggest that taking emergency contraception up to 24 hours after unprotected sex prevents 95 per cent of pregnancies, while taking it between 24 and 48 hours later prevents 85 per cent.
The study also found that:
Older teenagers tended to seek help quicker, with 14 year-olds taking almost four times as long (37 hours) as 20 year-olds (10 hours).
The time it took to get the morning-after pill from family planning clinics was much more consistent, with the majority waiting between 38 and 42 hours.
72 per cent of those who obtained the morning-after pill from clinics were aged between 15 and 17, while 74 per cent who went to pharmacies were between 16 and 18.
25 per cent visited the pharmacy over the weekend and 26 per cent on a Monday.
Two-thirds of girls under 16 said they needed the morning-after pill because they hadn't used any contraception. The other third blamed split condoms.
Two-thirds of those in the 16 plus age group sought the morning-after pill because they had had a contraception failure - either the condom had split or they had missed taking the pill.
"The UK currently has the highest rate of teenage pregnancies in Western Europe and the highest rate of live births among teenagers" says Dr Kay Marshall from the School of Pharmacy at the University of Bradford.
"The morning-after pill - often referred to by health professionals as emergency hormonal contraception - has long been recognised as a safe and effective method of preventing unintended pregnancies.
"The name is a bit misleading, because it can actually be taken within 72 hours of unprotected sex, not just the morning after. But as the effectiveness of the morning-after pill declines significantly with time - it works best if taken within 24 hours - it's essential that it can be obtained as soon as possible.
"We believe that the females in our study were able to access the pill much more quickly from local pharmacists as they tend to be open outside normal working hours and at weekends."
The morning-after pill has traditionally been provided free in the UK by family doctors and family planning clinics. It became available over-the-counter
at pharmacies in 2001.
Selected community pharmacists can now provide it free of charge to females under 20 as long as they feel that all the appropriate conditions have been satisfied and that she is competent to make the decision to take it.
This is an important development, especially for young girls who can't afford to pay the over-the-counter cost, which recently increased to ?25.
Pharmacists providing the item free are required to submit a return to the Primary Care Trust, which includes the age of the client and the number of hours between unprotected sex or contraception failure and dispensing.
The researchers collated data from 116 pharmacy request forms and compared them with 87 requests for emergency contraception from two of the busiest family planning clinics in the Primary Care Trust area.
"Our study suggests that community pharmacists are providing a valuable role in preventing unwanted pregnancies by supplying the morning-after pill and backing this up with advice on contraception and sexual health" says Gaye Lewington from SouthWest Kent Primary Care Trust, which oversees and commissions local health services in the area.
"Recent studies have suggested that allowing pharmacies to supply the morning-after pill does not compromise contraceptive practice or sexual behaviour. This is very important because encouraging females to practice safe sex is just as much a priority as preventing unwanted pregnancies.
"It is essential that the morning-after pill is available promptly if a female feels there is a pregnancy risk, but it is also very important that it continues to be seen as an emergency measure rather than an alternative to using contraception as a matter of routine."
About the BLACKWELL PUBLISHING LTD
In serving the worlds of scholarship, teaching and professional practice we take a holistic approach. Those who write textbooks with us are often breaking new ground in scholarship at the same time. We develop books for students which take account of the latest research and we aim to make the journals we publish as accessible as possible. We support the range of activities in which our authors are engaged and the universities and associations which support them. No other publisher does as much for readers and academic societies as we do.
BLACKWELL PUBLISHING LTD
108 Cowley Road
Oxford OX4 1JF
blackwellpublishing/
UK researchers from South West Kent Primary Care Trust and the University of Bradford looked at 203 females aged from 13 to 20 who got the medication from family planning clinics and community pharmacies.
They discovered that those who went to a pharmacy to get the morning-after pill obtained it more than twice as quickly as those who went to their local clinic - in 16 hours rather than 41.
Figures from the World Health Organization suggest that taking emergency contraception up to 24 hours after unprotected sex prevents 95 per cent of pregnancies, while taking it between 24 and 48 hours later prevents 85 per cent.
The study also found that:
Older teenagers tended to seek help quicker, with 14 year-olds taking almost four times as long (37 hours) as 20 year-olds (10 hours).
The time it took to get the morning-after pill from family planning clinics was much more consistent, with the majority waiting between 38 and 42 hours.
72 per cent of those who obtained the morning-after pill from clinics were aged between 15 and 17, while 74 per cent who went to pharmacies were between 16 and 18.
25 per cent visited the pharmacy over the weekend and 26 per cent on a Monday.
Two-thirds of girls under 16 said they needed the morning-after pill because they hadn't used any contraception. The other third blamed split condoms.
Two-thirds of those in the 16 plus age group sought the morning-after pill because they had had a contraception failure - either the condom had split or they had missed taking the pill.
"The UK currently has the highest rate of teenage pregnancies in Western Europe and the highest rate of live births among teenagers" says Dr Kay Marshall from the School of Pharmacy at the University of Bradford.
"The morning-after pill - often referred to by health professionals as emergency hormonal contraception - has long been recognised as a safe and effective method of preventing unintended pregnancies.
"The name is a bit misleading, because it can actually be taken within 72 hours of unprotected sex, not just the morning after. But as the effectiveness of the morning-after pill declines significantly with time - it works best if taken within 24 hours - it's essential that it can be obtained as soon as possible.
"We believe that the females in our study were able to access the pill much more quickly from local pharmacists as they tend to be open outside normal working hours and at weekends."
The morning-after pill has traditionally been provided free in the UK by family doctors and family planning clinics. It became available over-the-counter
at pharmacies in 2001.
Selected community pharmacists can now provide it free of charge to females under 20 as long as they feel that all the appropriate conditions have been satisfied and that she is competent to make the decision to take it.
This is an important development, especially for young girls who can't afford to pay the over-the-counter cost, which recently increased to ?25.
Pharmacists providing the item free are required to submit a return to the Primary Care Trust, which includes the age of the client and the number of hours between unprotected sex or contraception failure and dispensing.
The researchers collated data from 116 pharmacy request forms and compared them with 87 requests for emergency contraception from two of the busiest family planning clinics in the Primary Care Trust area.
"Our study suggests that community pharmacists are providing a valuable role in preventing unwanted pregnancies by supplying the morning-after pill and backing this up with advice on contraception and sexual health" says Gaye Lewington from SouthWest Kent Primary Care Trust, which oversees and commissions local health services in the area.
"Recent studies have suggested that allowing pharmacies to supply the morning-after pill does not compromise contraceptive practice or sexual behaviour. This is very important because encouraging females to practice safe sex is just as much a priority as preventing unwanted pregnancies.
"It is essential that the morning-after pill is available promptly if a female feels there is a pregnancy risk, but it is also very important that it continues to be seen as an emergency measure rather than an alternative to using contraception as a matter of routine."
About the BLACKWELL PUBLISHING LTD
In serving the worlds of scholarship, teaching and professional practice we take a holistic approach. Those who write textbooks with us are often breaking new ground in scholarship at the same time. We develop books for students which take account of the latest research and we aim to make the journals we publish as accessible as possible. We support the range of activities in which our authors are engaged and the universities and associations which support them. No other publisher does as much for readers and academic societies as we do.
BLACKWELL PUBLISHING LTD
108 Cowley Road
Oxford OX4 1JF
blackwellpublishing/
суббота, 9 июля 2011 г.
Many Benefits From Cardiac Rehab, Yet Many Women Don't Participate
People who participate in cardiac rehabilitation cut their chances of dying of heart disease by nearly 30 percent in the subsequent two to five years, according to the August issue of Mayo Clinic Women's HealthSource. Other proven results include less stress, less pain, reduced risk of future heart problems and improved ability to return to work and participate in social activities.
Yet, fewer than one-third of people who are eligible for cardiac rehab actually participate. Women, minorities and older people in particular are under-represented. Women, especially older women, are less likely to be referred for cardiac rehab and, when referred, less likely to attend.
Cardiac rehab programs are tailored to meet individual needs, but typically include medical evaluation, counseling, training and support to adopt the lifestyle changes that will help prevent future heart problems. Elements typically include:
Increasing exercise: Exercise strengthens heart muscles, so it can pump more blood with less effort. An optimal goal for most people is 45 to 60 minutes of exercise a day, with strength training two to three times a week.
Modifying risk factors: Patients develop a plan to address the risks that contribute to heart disease, including smoking, obesity, diabetes, high blood pressure or high cholesterol.
Nutrition: Patients work with a dietitian to learn about heart-healthy meal planning and eating, with an emphasis on plenty of fruits and vegetables and foods low in saturated fats, trans fats, cholesterol, refined sugar and salt.
Psychological health: Cardiac rehabilitation often includes treatment for mental health concerns, as well as emotional support. Depression is very common after a heart attack or other cardiac event, and women are particularly vulnerable. Patients also may experience anxiety, anger and social isolation; all can contribute to further heart problems.
Cardiac rehab is most often recommended for patients who've had a heart attack. It's also helpful for those who have had coronary bypass surgery, angioplasty, stents or pacemaker placement, heart valve surgery, or a heart or lung transplant. People with heart failure, chest pain (angina), peripheral artery disease or congenital cardiovascular disease also can benefit.
Source:
Mayo Clinic Women's HealthSource
Yet, fewer than one-third of people who are eligible for cardiac rehab actually participate. Women, minorities and older people in particular are under-represented. Women, especially older women, are less likely to be referred for cardiac rehab and, when referred, less likely to attend.
Cardiac rehab programs are tailored to meet individual needs, but typically include medical evaluation, counseling, training and support to adopt the lifestyle changes that will help prevent future heart problems. Elements typically include:
Increasing exercise: Exercise strengthens heart muscles, so it can pump more blood with less effort. An optimal goal for most people is 45 to 60 minutes of exercise a day, with strength training two to three times a week.
Modifying risk factors: Patients develop a plan to address the risks that contribute to heart disease, including smoking, obesity, diabetes, high blood pressure or high cholesterol.
Nutrition: Patients work with a dietitian to learn about heart-healthy meal planning and eating, with an emphasis on plenty of fruits and vegetables and foods low in saturated fats, trans fats, cholesterol, refined sugar and salt.
Psychological health: Cardiac rehabilitation often includes treatment for mental health concerns, as well as emotional support. Depression is very common after a heart attack or other cardiac event, and women are particularly vulnerable. Patients also may experience anxiety, anger and social isolation; all can contribute to further heart problems.
Cardiac rehab is most often recommended for patients who've had a heart attack. It's also helpful for those who have had coronary bypass surgery, angioplasty, stents or pacemaker placement, heart valve surgery, or a heart or lung transplant. People with heart failure, chest pain (angina), peripheral artery disease or congenital cardiovascular disease also can benefit.
Source:
Mayo Clinic Women's HealthSource
суббота, 2 июля 2011 г.
Adolescent Girls More Active If Neighborhoods Have Parks
Adolescent girls who live within half a mile of a public park are significantly more physically active than other girls, University of North Carolina at Chapel Hill researchers have found.
The study found that physical activity was higher for girls who lived within a mile of parks and showed highest levels among girls who lived less than one-half mile from a park, said Dr. Diane Catellier, a study investigator and research associate professor of biostatistics in the UNC School of Public Health. The researchers found that girls only got about 114 minutes a week of intense physical activity outside of school hours, or about 16 minutes a day.
Dr. Deborah Cohen, a senior natural scientist at RAND Corporation and lead author of the study, said the U.S. surgeon general recommends that all children and adolescents get at least 60 minutes of exercise a day. "We still have a long way to go in encouraging girls to be active."
The results appear in the November 2006 issue of Pediatrics. The study was led by the RAND Corporation, a nonprofit research organization. Researchers from UNC-Chapel Hill, the University of Arizona, the University of South Carolina and San Diego State University participated. Funding was provided by the National Heart, Lung and Blood Institute, part of the National Institutes of Health.
In the wake of growing national concern about increasing rates of obesity and health problems brought about by Americans' diets and sedentary lifestyles, the study findings could have implications for both males and females in other age groups as well, Catellier said.
"The study suggests that having access to parks in neighborhoods and communities can make a significant difference in the level of physical activity girls get," Catellier said. "More research may show that the trend is also true for boys and others in a neighborhood. We believe neighborhood parks are particularly important for adolescents who are too young to drive."
To examine the relationship between parks and physical activity, the researchers used baseline data from the Trial of Activity for Adolescent Girls. The trial is a national research study led by the UNC School of Public Health focusing on middle school girls.
The study team tracked 1,556 girls in the sixth grade in six cities and counted the average number of public parks within a half-mile radius of the homes of girls in the cities. The girls were fitted with accelerometers - devices that measure physical activity - and were monitored for six days.
The study sites include Minneapolis, Minn. (2.2 parks within a half-mile radius of participants); Baltimore, Md. and Washington, D.C. (1.8 parks); San Diego, Calif. (1.2 parks); New Orleans, La. (0.9 parks); Columbia, S.C. (0.7 parks); and Tucson, Ariz. (0.34 parks).
The researchers found that parks with active amenities such as basketball courts, playgrounds and walking paths were associated with more physical activity than parks with passive amenities, such as picnic areas and lawn games.
The study suggests that communities should make parks a higher priority, particularly ones with amenities like running tracks or walking paths, Catellier said. Previous studies have shown that girls become less physically active once they reach adolescence, and that girls are generally less physically active than boys, she said.
Study authors include: Dr. Kelly R. Evenson, research associate professor of epidemiology at the UNC School of Public Health, J. Scott Ashwood, Molly M. Scott and Adrian Overton, of RAND; Dr. Lisa Staten, co-director of the Southwest Center for Community Health Promotion and associate professor of family and child health at the Mel and Enid Zuckerman College of Public Health at the University of Arizona; Dr. Dwayne Porter, associate professor and graduate director of environmental health sciences at the Arnold School of Public Health, University of South Carolina; and Dr. Thomas L. McKenzie, professor emeritus of exercise and nutritional sciences at San Diego State University.
Contact: Becky Oskin
University of North Carolina at Chapel Hill
The study found that physical activity was higher for girls who lived within a mile of parks and showed highest levels among girls who lived less than one-half mile from a park, said Dr. Diane Catellier, a study investigator and research associate professor of biostatistics in the UNC School of Public Health. The researchers found that girls only got about 114 minutes a week of intense physical activity outside of school hours, or about 16 minutes a day.
Dr. Deborah Cohen, a senior natural scientist at RAND Corporation and lead author of the study, said the U.S. surgeon general recommends that all children and adolescents get at least 60 minutes of exercise a day. "We still have a long way to go in encouraging girls to be active."
The results appear in the November 2006 issue of Pediatrics. The study was led by the RAND Corporation, a nonprofit research organization. Researchers from UNC-Chapel Hill, the University of Arizona, the University of South Carolina and San Diego State University participated. Funding was provided by the National Heart, Lung and Blood Institute, part of the National Institutes of Health.
In the wake of growing national concern about increasing rates of obesity and health problems brought about by Americans' diets and sedentary lifestyles, the study findings could have implications for both males and females in other age groups as well, Catellier said.
"The study suggests that having access to parks in neighborhoods and communities can make a significant difference in the level of physical activity girls get," Catellier said. "More research may show that the trend is also true for boys and others in a neighborhood. We believe neighborhood parks are particularly important for adolescents who are too young to drive."
To examine the relationship between parks and physical activity, the researchers used baseline data from the Trial of Activity for Adolescent Girls. The trial is a national research study led by the UNC School of Public Health focusing on middle school girls.
The study team tracked 1,556 girls in the sixth grade in six cities and counted the average number of public parks within a half-mile radius of the homes of girls in the cities. The girls were fitted with accelerometers - devices that measure physical activity - and were monitored for six days.
The study sites include Minneapolis, Minn. (2.2 parks within a half-mile radius of participants); Baltimore, Md. and Washington, D.C. (1.8 parks); San Diego, Calif. (1.2 parks); New Orleans, La. (0.9 parks); Columbia, S.C. (0.7 parks); and Tucson, Ariz. (0.34 parks).
The researchers found that parks with active amenities such as basketball courts, playgrounds and walking paths were associated with more physical activity than parks with passive amenities, such as picnic areas and lawn games.
The study suggests that communities should make parks a higher priority, particularly ones with amenities like running tracks or walking paths, Catellier said. Previous studies have shown that girls become less physically active once they reach adolescence, and that girls are generally less physically active than boys, she said.
Study authors include: Dr. Kelly R. Evenson, research associate professor of epidemiology at the UNC School of Public Health, J. Scott Ashwood, Molly M. Scott and Adrian Overton, of RAND; Dr. Lisa Staten, co-director of the Southwest Center for Community Health Promotion and associate professor of family and child health at the Mel and Enid Zuckerman College of Public Health at the University of Arizona; Dr. Dwayne Porter, associate professor and graduate director of environmental health sciences at the Arnold School of Public Health, University of South Carolina; and Dr. Thomas L. McKenzie, professor emeritus of exercise and nutritional sciences at San Diego State University.
Contact: Becky Oskin
University of North Carolina at Chapel Hill
Подписаться на:
Комментарии (Atom)