Although financial and staff-related concerns have hindered the full-scale adoption of electronic health records (EHR) by physicians, the technology can help ob-gyns improve the quality, safety, and efficiency of the care they provide women, according to The American College of Obstetricians and Gynecologists (The College). The College cautions, however, that despite the many benefits of computerized patient records, even the best EHRs are not a substitute for listening to patients.
Computerized patient records were developed to replace the individual paper records for patients that have long been the office standard. EHRs have a multitude of benefits for physicians and patients. Electronic records help standardize patient care, procedures, and follow-up as well as assist doctors in complying with treatment guidelines. EHRs also can track and report medications, improve the legibility of prescriptions, and may reduce medication errors.
"The EHR represents a major change in how the health care field does business," said Patrice M. Weiss, MD, chair of The College's Committee on Patient Safety and Quality Improvement. EHRs efficiently handle a large amount of patient data, prescriptions, lab results, follow-up reminders, and evidence-based guideline recommendations for physicians. "Some physicians may feel that using paper charts with check-off boxes is quicker compared with having to enter data into an EHR. However, the ability to retrieve patient data and to share it easily becomes readily apparent," Dr. Weiss explained.
"Another benefit of the EHR is that it can help practices with proper billing and coding for procedures so that they get reimbursed more efficiently and without the hassle of recoding and resubmitting," said Dr. Weiss.
Electronic records benefit the patient because they can help provide safer, more effective health care. For instance, the EHR can flag abnormal test results which might have been missed and can track patients who miss follow-up appointments.
While the EHR assists physicians in a number of important ways, concerns about cost, software compatibility, training, and patient privacy rights issues, among others, have hindered widespread implementation. "One of the biggest hurdles is the financial investment of purchasing these systems," said Dr. Weiss. "But there are federal stimulus funds available that are intended to help practices and medical centers install and incorporate this new technology."
In addition to cost issues, learning to use EHR systems can be difficult. "The learning curve with this new technology is steep, so providers must be patient," Dr. Weiss pointed out. Office productivity will likely decrease until physicians and office staff become proficient in using the software. Additional staffing may be necessary until the system is fully implemented, according to The College.
Corrupted data and software incompatibility are a few of the known technology-related downsides to computerized record systems. "And, of course, when computer systems crash, as they sometimes do, access to the patient records will be affected," said Dr. Weiss. For these reasons, establishing an information technology (IT) support department with round-the-clock staff support is important. IT support is needed to regularly review updates to the system, train and assist physicians in using the system, and troubleshoot problems.
Committee Opinion #472, "Patient Safety and the Electronic Health Record," is published in the November 2010 issue of Obstetrics & Gynecology.
Source:
American College of Obstetricians and Gynecologists
суббота, 25 июня 2011 г.
среда, 22 июня 2011 г.
Why Do Women Get More Cavities Than Men?
Reproduction pressures and rising fertility explain why women suffered a more rapid decline in dental health than did men as humans transitioned from hunter-and-gatherers to farmers and more sedentary pursuits, says a University of Oregon anthropologist.
The conclusion follows a comprehensive review of records of the frequencies of dental cavities in both prehistoric and living human populations from research done around the world. A driving factor was dramatic changes in female-specific hormones, reports John R. Lukacs, a professor of anthropology who specializes in dental, skeletal and nutritional issues.
His conclusions are outlined in the October issue of Current Anthropology. The study examined the frequency of dental caries (cavities) by sex to show that women typically experience poorer dental health than men. Among research reviewed were studies previously done by Lukacs. Two clinical dental studies published this year (one done in the Philippines, the other in Guatemala) and cited in the paper, Lukacs said, point to the same conclusions and "may provide the mechanism through which the biological differences are mediated."
A change in food production by agrarian societies has been associated with an increase in cavities. Anthropologists have attributed men-women differences to behavioral factors, including a sexual division of labor and dietary preferences. However, Lukacs said, clinical and epidemiological literature from varied ecological and cultural settings reveals a clear picture of the impacts on women's oral health.
"The role of female-specific factors has been denied by anthropologists, yet they attain considerable importance in the model proposed here, because the adoption of agriculture is associated with increased sedentism and fertility," Lukacs said. "I argue that the rise of agriculture increased demands on women's reproductive systems, contributing to an increase in fertility that intensified the negative impact of dietary change on women's oral health. The combined impacts of increased fertility, dietary changes and division of labor during the move into agricultural societies contributed to the widespread gender differential observed in dental caries rates today."
Lukacs' meta-analysis looked at both prehistoric anthropological and modern health records. He repeatedly found that increases in cavities go in favor of women in adulthood. Lukacs' review found that women's higher rates of cavities are influenced by three main changes:
Female sex hormones. Citing his own research published in 2006, he notes that these hormones and associated physiological factors can significantly impact cavity formation. A study on animals published in 1954 found that female estrogens, but not male androgens, were correlated to cavity rates. He argues for a cumulative effect of estrogens, including fluctuations at puberty and high levels during pregnancy that both promote cavities and dietary changes.
The biochemical composition and flow rate of saliva. Women produce less saliva than do men, reducing the removal of food residue from the teeth, and that during pregnancies the chemical composition changes, reducing saliva's antimicrobial capacity.
Food cravings, immune response and aversions during pregnancy. Lukacs points to findings that women crave high-energy, sweet foods during the third trimester, as well as an aversion to meat in first trimesters.
How the factors combine to contribute to higher risk of cavities in women as they age is not fully documented or understood, he wrote. "However, if hormonal and physiological factors work in an independent or additive manner, their impact on women's oral health could be significant. The fact that women's caries experience increases with age at a greater rate than men's in diverse ethnic groups from different ecological and cultural settings supports this interpretation."
The Alexander von Humboldt Foundation, American Institute of Indian Studies, American Philosophical Society, L.S.B. Leakey Foundation, National Geographic Society, National Science Foundation and Wenner-Gren Foundation for Anthropological Research supported the project.
About the University of Oregon
The University of Oregon is a world-class teaching and research institution and Oregon's flagship public university. The UO is a member of the Association of American Universities (AAU), an organization made up of 62 of the leading public and private research institutions in the United States and Canada. Membership in the AAU is by invitation only. The University of Oregon is one of only two AAU members in the Pacific Northwest.
The conclusion follows a comprehensive review of records of the frequencies of dental cavities in both prehistoric and living human populations from research done around the world. A driving factor was dramatic changes in female-specific hormones, reports John R. Lukacs, a professor of anthropology who specializes in dental, skeletal and nutritional issues.
His conclusions are outlined in the October issue of Current Anthropology. The study examined the frequency of dental caries (cavities) by sex to show that women typically experience poorer dental health than men. Among research reviewed were studies previously done by Lukacs. Two clinical dental studies published this year (one done in the Philippines, the other in Guatemala) and cited in the paper, Lukacs said, point to the same conclusions and "may provide the mechanism through which the biological differences are mediated."
A change in food production by agrarian societies has been associated with an increase in cavities. Anthropologists have attributed men-women differences to behavioral factors, including a sexual division of labor and dietary preferences. However, Lukacs said, clinical and epidemiological literature from varied ecological and cultural settings reveals a clear picture of the impacts on women's oral health.
"The role of female-specific factors has been denied by anthropologists, yet they attain considerable importance in the model proposed here, because the adoption of agriculture is associated with increased sedentism and fertility," Lukacs said. "I argue that the rise of agriculture increased demands on women's reproductive systems, contributing to an increase in fertility that intensified the negative impact of dietary change on women's oral health. The combined impacts of increased fertility, dietary changes and division of labor during the move into agricultural societies contributed to the widespread gender differential observed in dental caries rates today."
Lukacs' meta-analysis looked at both prehistoric anthropological and modern health records. He repeatedly found that increases in cavities go in favor of women in adulthood. Lukacs' review found that women's higher rates of cavities are influenced by three main changes:
Female sex hormones. Citing his own research published in 2006, he notes that these hormones and associated physiological factors can significantly impact cavity formation. A study on animals published in 1954 found that female estrogens, but not male androgens, were correlated to cavity rates. He argues for a cumulative effect of estrogens, including fluctuations at puberty and high levels during pregnancy that both promote cavities and dietary changes.
The biochemical composition and flow rate of saliva. Women produce less saliva than do men, reducing the removal of food residue from the teeth, and that during pregnancies the chemical composition changes, reducing saliva's antimicrobial capacity.
Food cravings, immune response and aversions during pregnancy. Lukacs points to findings that women crave high-energy, sweet foods during the third trimester, as well as an aversion to meat in first trimesters.
How the factors combine to contribute to higher risk of cavities in women as they age is not fully documented or understood, he wrote. "However, if hormonal and physiological factors work in an independent or additive manner, their impact on women's oral health could be significant. The fact that women's caries experience increases with age at a greater rate than men's in diverse ethnic groups from different ecological and cultural settings supports this interpretation."
The Alexander von Humboldt Foundation, American Institute of Indian Studies, American Philosophical Society, L.S.B. Leakey Foundation, National Geographic Society, National Science Foundation and Wenner-Gren Foundation for Anthropological Research supported the project.
About the University of Oregon
The University of Oregon is a world-class teaching and research institution and Oregon's flagship public university. The UO is a member of the Association of American Universities (AAU), an organization made up of 62 of the leading public and private research institutions in the United States and Canada. Membership in the AAU is by invitation only. The University of Oregon is one of only two AAU members in the Pacific Northwest.
вторник, 21 июня 2011 г.
Psychological Intervention Provides Enduring Health Benefits For Women With Breast Cancer
Stress-reducing psychological intervention helps to increase survival and quality of life among women with recurrent breast cancer over the long-term, according to results of a Phase III study published in Clinical Cancer Research, a journal of the American Association for Cancer Research.
"Patients in the intervention arm evidenced significant emotional improvement and more favorable immune responses in the year following recurrence diagnosis. In contrast, stress remained unabated and immunity significantly declined in the assessment-only group," said lead researcher Barbara L. Andersen, Ph.D., professor in the department of psychology at the Ohio State University, Columbus, and a researcher at the Ohio State University Comprehensive Cancer Center James Cancer Hospital and Solove Research Institute.
Psychological stress leads to disruptions in quality of life, health behaviors and immunity, all of which contribute to poorer health outcomes.
In a previously conducted study, The Stress and Immunity Breast Cancer Project, Andersen and colleagues reported that after an average of 11 years of follow-up, women who received psychological intervention had a 45 percent reduced risk of breast cancer recurrence, demonstrating positive effects. For this follow-up, they tested the same hypothesis with the endpoint being death from breast cancer.
Participants included 227 women with newly diagnosed Stage II or III breast cancer; they were randomized to receive a psychological intervention or assessment only. Psychological intervention included the following clinical objectives for patients: understand the nature of cancer stress; learn tangible ways to reduce stress and improve quality of life; maintain adherence and follow-up to cancer care; enhance communication with medical care providers; increase well-being during treatment, facilitate recovery and improve overall health.
During follow-up, 62 women were diagnosed with recurrent breast cancer. After recurrence, women who had earlier received the psychological intervention had a 59 percent reduction in the risk of dying of breast cancer.
According to Andersen, these results "show enduring benefits from the psychological intervention that were never previously considered or observed," and suggest that the intervention's mechanisms affected patients' risks for recurrence and for breast cancer death.
"Survival advantages occurred above and beyond the improvements from state-of-the-science oncology treatments received at an NCI-designated comprehensive cancer center," Andersen said. "An empirically supported psychological intervention for cancer patients can yield robust gains of enduring quality, and ones that may include important health benefits."
Sarah Gehlert, Ph.D., E. Desmond Lee professor of racial and ethnic diversity, The Brown School, Washington University, St. Louis, said the results of this study are unique because they provide longitudinal evidence of the benefits of psychological intervention in this study population, and are based on a solid theoretical base.
"We currently have few empirically supported psychosocial interventions for use with women who have been diagnosed with breast cancer," she said. "An intervention that increased survival would be incredibly valuable. It represents a new tool for improving the lives of women with breast cancer."
Gehlert, who is not affiliated with this study, believes this research will provide a template for future health services research in breast cancer.
"Dr. Andersen's intervention provides a strong model for translation in breast cancer research," she said. "These results are extremely heartening, because it shows that a psychological intervention can have long-term positive effects."
Source: American Association for Cancer Research (AACR)
"Patients in the intervention arm evidenced significant emotional improvement and more favorable immune responses in the year following recurrence diagnosis. In contrast, stress remained unabated and immunity significantly declined in the assessment-only group," said lead researcher Barbara L. Andersen, Ph.D., professor in the department of psychology at the Ohio State University, Columbus, and a researcher at the Ohio State University Comprehensive Cancer Center James Cancer Hospital and Solove Research Institute.
Psychological stress leads to disruptions in quality of life, health behaviors and immunity, all of which contribute to poorer health outcomes.
In a previously conducted study, The Stress and Immunity Breast Cancer Project, Andersen and colleagues reported that after an average of 11 years of follow-up, women who received psychological intervention had a 45 percent reduced risk of breast cancer recurrence, demonstrating positive effects. For this follow-up, they tested the same hypothesis with the endpoint being death from breast cancer.
Participants included 227 women with newly diagnosed Stage II or III breast cancer; they were randomized to receive a psychological intervention or assessment only. Psychological intervention included the following clinical objectives for patients: understand the nature of cancer stress; learn tangible ways to reduce stress and improve quality of life; maintain adherence and follow-up to cancer care; enhance communication with medical care providers; increase well-being during treatment, facilitate recovery and improve overall health.
During follow-up, 62 women were diagnosed with recurrent breast cancer. After recurrence, women who had earlier received the psychological intervention had a 59 percent reduction in the risk of dying of breast cancer.
According to Andersen, these results "show enduring benefits from the psychological intervention that were never previously considered or observed," and suggest that the intervention's mechanisms affected patients' risks for recurrence and for breast cancer death.
"Survival advantages occurred above and beyond the improvements from state-of-the-science oncology treatments received at an NCI-designated comprehensive cancer center," Andersen said. "An empirically supported psychological intervention for cancer patients can yield robust gains of enduring quality, and ones that may include important health benefits."
Sarah Gehlert, Ph.D., E. Desmond Lee professor of racial and ethnic diversity, The Brown School, Washington University, St. Louis, said the results of this study are unique because they provide longitudinal evidence of the benefits of psychological intervention in this study population, and are based on a solid theoretical base.
"We currently have few empirically supported psychosocial interventions for use with women who have been diagnosed with breast cancer," she said. "An intervention that increased survival would be incredibly valuable. It represents a new tool for improving the lives of women with breast cancer."
Gehlert, who is not affiliated with this study, believes this research will provide a template for future health services research in breast cancer.
"Dr. Andersen's intervention provides a strong model for translation in breast cancer research," she said. "These results are extremely heartening, because it shows that a psychological intervention can have long-term positive effects."
Source: American Association for Cancer Research (AACR)
Texas Lawmakers Send Letter Asking Gov. Perry To Rescind Executive Order Mandating HPV Vaccination For Girls Entering Sixth Grade
Thirty-two Texas lawmakers on Thursday sent a letter to Gov. Rick Perry (R) reiterating their plea for him to rescind an executive order that would mandate vaccination against human papillomavirus for girls entering the sixth grade, the AP/Dallas Morning News reports (AP/Dallas Morning News, 2/9). Merck's HPV vaccine Gardasil and GlaxoSmithKline's HPV vaccine Cervarix in clinical trials have been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. FDA in July 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine. GSK in April plans to file for FDA approval of Cervarix, and it expects approval by the end of this year. Perry on Feb. 2 signed the executive order, which will affect approximately 365,000 girls annually. Perry said that parents who do not want their daughters to receive an HPV vaccine "for reasons of conscience, including religious beliefs," will be able to opt out of the requirement. Under the executive order, girls and women ages nine to 21 who are eligible for public assistance will be able to receive Gardasil at no cost beginning immediately. Perry spokesperson Krista Moody said the state would increase funding for existing health programs by $29.4 million annually to help cover the cost of the vaccine for low-income women and girls (Kaiser Daily Women's Health Policy Report, 2/6).
Letter, Bills, Reaction
Perry's order "usurped the legislative process," the letter -- signed by 31 Republican representatives and one Democratic representative -- said, adding, "While philosophic differences will dictate where our beliefs fall, no Texan would willfully abdicate their voice in the Legislature to a single office of their government" (AP/Dallas Morning News, 2/9). According to the Dallas Morning News, at least 26 of the 31 Texas senators also have signed a letter to Perry asking him to withdraw the order. The governor as chief executive officer of the state has constitutional ability to issue directives, Perry spokesperson Robert Black said. He added that lawmakers have the right to modify or rescind an executive order through legislation (Hoppe, Dallas Morning News, 2/8). Several bills have been filed this week to overturn Perry's order and to prevent the vaccine from being required for a student's admission to school, the San Antonio Express-News reports. Rep. Charlie Howard (R) has introduced a bill (HB 1115) that would block Perry's order (Elliot, San Antonio Express-News, 2/7). Rep. Dennis Bonnen (R) has introduced a duplicate bill (HB 1098) that would overturn the order, and state Sen. Jane Nelson (R) on Wednesday asked Texas Attorney General Greg Abbott (R) to issue an opinion on the legality of Perry's order (Kaiser Daily Women's Health Policy Report, 2/8).
Editorial
"Gardasil may well be the huge medical breakthrough it appears to be," but "a rush to make it mandatory, less than eight months after FDA approval, could have detrimental consequences," a USA Today editorial says. The "[s]cientific uncertainty" of Gardasil, the lack of public education about the vaccine and HPV being a sexually transmitted infection can "spark an anti-vaccine backlash that would result in fewer girls getting immunized against cervical cancer and other diseases," according to USA Today. "With more public education and real-life experience, these qualms may soon be overcome, and the vaccine may well deserve to be included on lists of required immunizations," the editorial says, adding, "For now, however, making [the vaccine] mandatory is premature." Sometimes, "promotion of a medical advance can move too fast for its own good," the editorial says, adding that the HPV vaccine "ought to be available at an affordable price to everyone who wants it after consulting with a doctor" (USA Today, 2/9).
Opinion Piece
"The executive order ... will help stop the spread of [HPV] and prevent cervical cancer in young women" and as "governor of Texas, I will do everything in my power to protect public health," Perry writes in a USA Today opinion piece. "Though some might argue that we should wait several years before requiring the vaccine, I believe such a delay unnecessarily risks the lives of young women," he writes. According to Perry, parents and guardians still will have the "final word" in deciding whether to vaccinate their children, and a "full debate will take place" before implementation rules are adopted in 19 months. If "Texas legislators want to debate and pass a different vaccine law, there is nothing standing in their way," Perry writes, concluding, "This is a rare opportunity to act, and as a pro-life governor, I will always take the side of protecting life" (Perry, USA Today, 2/9).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Cervarix [Human Papillomavirus Bivalent; Gardasil.
Pain Management Of Endometriosis: Conservative Approach Is First-Line Treatment
Ob-gyns recommend conservative nonsurgical treatment approaches for treating women with endometriosis-associated pain followed by more invasive procedures if these fail to alleviate pain, according to a newly updated Practice Bulletin published in the July issue of The American College of Obstetricians and Gynecologists' journal, Obstetrics & Gynecology. The Practice Bulletin "Management of Endometriosis" includes the latest recommendations on the incidence, diagnosis, and treatment of this common gynecologic health condition.
Endometriosis is a chronic condition in which endometrial tissue that lines the inside of the uterus migrates outside of the uterus and attaches to the lining of the abdominal cavity and to internal organs inside the pelvis, including the ovaries, fallopian tubes, bladder, and bowel. The condition occurs in 6-10% of reproductive-age women. Endometriosis is a leading cause of chronic pelvic pain and a common cause of infertility, the two main symptoms. Some women with endometriosis have no symptoms, but for those that do, pain can range from mild to severe.
"We recommend starting with conservative approaches to treating women with endometriosis-associated pain," says Tommaso Falcone, MD, who led the document update. "For instance, continuous oral contraceptives and nonsteroidal anti-inflammatory drugs are effective. If these fail and further medical management is needed, then gonadotropin-releasing hormone agonists or progestins can help by suppressing the disease." Medical therapy, however, will not improve fertility for women trying to get pregnant since most of these drugs suppress ovulation. Medical therapy is effective while using it, but recurrence of pain symptoms is common after discontinuing the drugs. Surgery to remove endometriosis tissue helps improve pregnancy rates among infertile women, but it is difficult to predict by how much, said Dr. Falcone.
According to the College vaginal ultrasound is the best way to investigate the presence of endometriosis. The only definitive way to diagnose endometriosis is with laparoscopic surgery. Laparoscopy also can remove visible endometriosis lesions, but it is not 100% effective in helping pain. As with medical therapy, there is a high recurrence of symptoms in patients after laparoscopic surgery. Both laparoscopic surgery and long-term hormone suppression-typically with an oral contraceptive-will likely be needed to control pain.
The treatment of last resort for women with severe endometriosis is hysterectomy. "If a woman has completed having children and all other conservative treatments haven't worked to stop the pain, she may consider having her uterus removed," said Dr. Falcone. "If both ovaries are normal and all of the visible endometriosis is removed, then consideration should be given to conserving them." This way, Dr. Falcone noted, women won't suffer the consequences of a surgical menopause.
Even when both ovaries are removed, endometriosis symptoms can recur in some women, likely due to lesions that remain attached to the bowel. The Practice Bulletin notes that estrogen therapy after ovary removal does not appear to affect the risk of recurrence of endometriosis and can be safely considered to avoid an immediate surgical menopause.
Practice Bulletin #114, "Management of Endometriosis," is published in the July 2010 issue of Obstetrics & Gynecology.
Source:
American College of Obstetricians and Gynecologists
Endometriosis is a chronic condition in which endometrial tissue that lines the inside of the uterus migrates outside of the uterus and attaches to the lining of the abdominal cavity and to internal organs inside the pelvis, including the ovaries, fallopian tubes, bladder, and bowel. The condition occurs in 6-10% of reproductive-age women. Endometriosis is a leading cause of chronic pelvic pain and a common cause of infertility, the two main symptoms. Some women with endometriosis have no symptoms, but for those that do, pain can range from mild to severe.
"We recommend starting with conservative approaches to treating women with endometriosis-associated pain," says Tommaso Falcone, MD, who led the document update. "For instance, continuous oral contraceptives and nonsteroidal anti-inflammatory drugs are effective. If these fail and further medical management is needed, then gonadotropin-releasing hormone agonists or progestins can help by suppressing the disease." Medical therapy, however, will not improve fertility for women trying to get pregnant since most of these drugs suppress ovulation. Medical therapy is effective while using it, but recurrence of pain symptoms is common after discontinuing the drugs. Surgery to remove endometriosis tissue helps improve pregnancy rates among infertile women, but it is difficult to predict by how much, said Dr. Falcone.
According to the College vaginal ultrasound is the best way to investigate the presence of endometriosis. The only definitive way to diagnose endometriosis is with laparoscopic surgery. Laparoscopy also can remove visible endometriosis lesions, but it is not 100% effective in helping pain. As with medical therapy, there is a high recurrence of symptoms in patients after laparoscopic surgery. Both laparoscopic surgery and long-term hormone suppression-typically with an oral contraceptive-will likely be needed to control pain.
The treatment of last resort for women with severe endometriosis is hysterectomy. "If a woman has completed having children and all other conservative treatments haven't worked to stop the pain, she may consider having her uterus removed," said Dr. Falcone. "If both ovaries are normal and all of the visible endometriosis is removed, then consideration should be given to conserving them." This way, Dr. Falcone noted, women won't suffer the consequences of a surgical menopause.
Even when both ovaries are removed, endometriosis symptoms can recur in some women, likely due to lesions that remain attached to the bowel. The Practice Bulletin notes that estrogen therapy after ovary removal does not appear to affect the risk of recurrence of endometriosis and can be safely considered to avoid an immediate surgical menopause.
Practice Bulletin #114, "Management of Endometriosis," is published in the July 2010 issue of Obstetrics & Gynecology.
Source:
American College of Obstetricians and Gynecologists
Highlights From The June 2008 Journal Of The American Dietetic Association
The June 2008 issue of the Journal of the American Dietetic Association contains articles and research studies you may find of interest. Below is a summary of some of this month's articles.
"Freshman 15" May Be More Like "Freshman 5"
The "Freshman 15," the notion that students gain 15 pounds during their first year of college, may overstate students' actual weight gain, according to researchers at the University of Guelph, Canada. In a sample of 116 first-year female students, the average weight gain was 5.29 pounds.
While the students reported gaining less weight than the "Freshman 15," the researchers point out: "It is important to recognize that the increase of 5.29 lbs. occurred over a period of just six to seven months??¦Weight gain at this rate over an extended period of time could lead to overweight/obesity and is certainly cause for concern."
The students completed a dietary assessment using diet and lifestyle questions adapted from the National Longitudinal Survey of Children and Youth (Canada) and the U.S. Centers for Disease Control and Prevention National Youth Risk Behavior Survey.
The study found students reported increases in their body mass index from an average of 22.3 to 23.1; average percent body fat went from 23.8 to 25.6; and average waist circumference increased from 30.27 to 31.25 inches.
The proportion of participants with BMI measurements classified as either normal or underweight decreased from 79 to 75 percent and from eight to six percent, respectively. The proportion of students who were classified as overweight (BMI above 25) increased from 15 percent to 22 percent, while those who were obese (BMI at or above 30) remained constant at 3 percent.
Employees' Attitudes Affect Restaurants' Food Safety Practices
The attitudes of foodservice workers toward safety practices have a direct effect on foodborne illness occurrences in restaurants, according to researchers from Kansas State University.
The researchers surveyed 190 foodservice employees in 31 restaurants across three Midwestern states on their knowledge of and attitude toward three food safety measures that have the most substantial impact on public health: hand washing, using thermometers and proper handling of food contact surfaces. Only employees whose jobs directly involved food preparation tasks participated.
The researchers conclude that providing workers with training that does not target their attitudes may not improve food safety results. "While emphasis should be placed on training, it is also important to educate employees regarding positive outcomes of food safety such as decreasing patrons' risk of food borne illness, reducing the spread of microorganisms and keeping the work environment clean."
Additional research articles in the June Journal of the American Dietetic Association include:
Physical Activity Is Associated with Risk Factors for Chronic Disease across the Adult Life Cycle for Women
Motivators and Barriers to Healthful Eating and Physical Activity among Low-Income Overweight and Obese Mothers
Motivational Interviewing in Internet Groups: A Pilot Study for Weight Loss.
The Journal of the American Dietetic Association is the official research publication of the American Dietetic Association and is the premier peer-reviewed journal in the field of nutrition and dietetics.
The American Dietetic Association is the world's largest organization of food and nutrition professionals. ADA is committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy.
To locate a registered dietitian in your area, visit the American Dietetic Association at eatright/.
Source: Jennifer Starkey
American Dietetic Association
"Freshman 15" May Be More Like "Freshman 5"
The "Freshman 15," the notion that students gain 15 pounds during their first year of college, may overstate students' actual weight gain, according to researchers at the University of Guelph, Canada. In a sample of 116 first-year female students, the average weight gain was 5.29 pounds.
While the students reported gaining less weight than the "Freshman 15," the researchers point out: "It is important to recognize that the increase of 5.29 lbs. occurred over a period of just six to seven months??¦Weight gain at this rate over an extended period of time could lead to overweight/obesity and is certainly cause for concern."
The students completed a dietary assessment using diet and lifestyle questions adapted from the National Longitudinal Survey of Children and Youth (Canada) and the U.S. Centers for Disease Control and Prevention National Youth Risk Behavior Survey.
The study found students reported increases in their body mass index from an average of 22.3 to 23.1; average percent body fat went from 23.8 to 25.6; and average waist circumference increased from 30.27 to 31.25 inches.
The proportion of participants with BMI measurements classified as either normal or underweight decreased from 79 to 75 percent and from eight to six percent, respectively. The proportion of students who were classified as overweight (BMI above 25) increased from 15 percent to 22 percent, while those who were obese (BMI at or above 30) remained constant at 3 percent.
Employees' Attitudes Affect Restaurants' Food Safety Practices
The attitudes of foodservice workers toward safety practices have a direct effect on foodborne illness occurrences in restaurants, according to researchers from Kansas State University.
The researchers surveyed 190 foodservice employees in 31 restaurants across three Midwestern states on their knowledge of and attitude toward three food safety measures that have the most substantial impact on public health: hand washing, using thermometers and proper handling of food contact surfaces. Only employees whose jobs directly involved food preparation tasks participated.
The researchers conclude that providing workers with training that does not target their attitudes may not improve food safety results. "While emphasis should be placed on training, it is also important to educate employees regarding positive outcomes of food safety such as decreasing patrons' risk of food borne illness, reducing the spread of microorganisms and keeping the work environment clean."
Additional research articles in the June Journal of the American Dietetic Association include:
Physical Activity Is Associated with Risk Factors for Chronic Disease across the Adult Life Cycle for Women
Motivators and Barriers to Healthful Eating and Physical Activity among Low-Income Overweight and Obese Mothers
Motivational Interviewing in Internet Groups: A Pilot Study for Weight Loss.
The Journal of the American Dietetic Association is the official research publication of the American Dietetic Association and is the premier peer-reviewed journal in the field of nutrition and dietetics.
The American Dietetic Association is the world's largest organization of food and nutrition professionals. ADA is committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy.
To locate a registered dietitian in your area, visit the American Dietetic Association at eatright/.
Source: Jennifer Starkey
American Dietetic Association
Study Examines How Medicaid Managed Care In California Affects Prenatal Care, Birth Outcomes
"Does Managed Care Hurt Health? Evidence From Medicaid Mothers," Review of Economics and Statistics: Medicaid managed care in California has reduced the quality of prenatal care for pregnant women and increased the risk of low birthweight, premature birth and neonatal death, according to the study. Anna Aizer of Brown University and the National Bureau of Economic Research and colleagues used a longitudinal database of women in California to determine whether MMC had any effect on the quality of prenatal care and birth outcomes. According to the study, MMC was associated with large declines in the utilization of prenatal care among women under Medi-Cal or county organized health systems. The implementation of MMC also was associated with low birth weight, shorter gestation periods and neonatal death among the same women. "These results provide strong evidence that health care providers responded to managed care incentives to reduce costs by limiting care and suggest that these limitations in care had negative effects on infant births," the researchers write. They added that these "negative effects may have been especially pronounced in this population because the plans' incentive to provide preventive care was effectively removed" (Aizer et al., Review of Economics and Statistics, August 2007).
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.
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.
Federal Embryonic Stem Cell Policy Undermining Research, Researchers Testify; Senate Democrats Expected To Pass Own Version Of Bill
Three leading stem cell researchers, including a NIH official, at a Senate hearing on Friday said that restrictions on federal funding for human embryonic stem cell research are affecting scientists' ability to make advances in the field and that alternatives to embryonic stem cells are not as equally promising, CQ HealthBeat reports (Reichard, CQ HealthBeat, 1/19). Federal funding for embryonic stem cell research is allowed only for research using embryonic stem cell lines created on or before Aug. 9, 2001, under a policy announced by President Bush on that date (Kaiser Daily Women's Health Policy Report, 1/12). The hearing on Friday was sponsored by the Senate Health, Education, Labor and Pensions Committee and the Senate Appropriations-HHS-Education Subcommittee. Story Landis, director of the National Institute of Neurological Disorders and Stroke, said, "We are missing out on possible breakthroughs. The ability to work on newly derived stem cell colonies ... would be incredibly important." Landis added that "science works best when scientists can pursue all avenues of research. If the cure for Parkinson's disease or juvenile diabetes lay behind one of four doors, wouldn't you want the option to open all four doors at once instead of one door?" (Weiss, Washington Post, 1/20). George Daley of Harvard University, who testified on behalf of the American Society for Cell Biology, said embryonic cells "will not be replaced" by other types of stem cells, such as adult and amniotic fluid-derived stem cells. He also said that embryonic stem cells already "have saved lives, not directly through cell replacement, but indirectly through insights into disease and the development of drugs." Daley said, "I believe there are no credible scientific arguments which say that we should be studying adult stem cells at the exclusion of embryonic stem cells." John Wagner, a stem cell researcher at the University of Minnesota, said that "it is now clear that the most primitive adult stem cells, even those directly from the patient, are susceptible to immune attack." According to CQ HealthBeat, researchers also disputed a claim that adult stem cells could treat 71 diseases. Landis said adult stem cells could treat nine diseases (Reichard, CQ HealthBeat, 1/19).
Senate To Consider Own Version of Stem Cell Bill, Reaction
Senate Democrats are expected to pass a measure (S 5) identical to a House-approved bill (HR 3) that would expand federal funding for embryonic stem cell research rather than consider the House version, House and Senate aides said Friday, CQ HealthBeat reports (Wayne, CQ HealthBeat, 1/19). The House on Thursday voted 253-174 to approve the measure -- called the Stem Cell Research Enhancement Act of 2007 -- which would expand the number of stem cell lines that are eligible for federal funding by allowing funding for research using stem cells derived from embryos originally created for fertility treatments and willingly donated by patients (Kaiser Daily Women's Health Policy Report, 1/12). According to CQ HealthBeat, Democrats plan to have the Senate approve its own measure, possibly with amendments, and send it to the House for approval. The Senate has more support for the legislation than the House, and the strategy would allow the Senate to vote first on a potential veto override, CQ HealthBeat reports. Sen. Tom Harkin (D-Iowa), has said that if Bush vetoes the measure, then he will try to attach it to any "must-do" legislation. It is uncertain when the Senate will begin debate on the Stem Cell Research Enhancement Act, but it will not consider the measure this week (Wayne, CQ HealthBeat, 1/19). Sen. Orrin Hatch (R-Utah) on Friday at the hearing said to the researchers, "We've just got to wake up on this and untie your hands." Sen. Arlen Specter (R-Pa.) said the Senate is "in close range of overturning a presidential veto." Sen. Tom Coburn (R-Okla.) said, "Let's make sure we understand the dividing line" (Dunham, Reuters, 1/19). He added, "Some of us very earnestly believe life begins at conception. That position has to be respected." Specter has called on embryonic stem cell supporters to "organize a million person march" in Washington, D.C., "loudly enough to be heard on the second floor of the living quarters of the White House" (Reichard, CQ HealthBeat, 1/19).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Gynecologist who raped patients faces stiff prison sentence
Dr. Charles Momah, 49, has been found guilty on two counts of rape and two of indecent assault. The trial, in Seattle, USA, lasted four weeks. He was accused of targeting vulnerable women, many of them drug addicts - women he thought least likely to complain.
There are also some civil lawsuits against C Momah. He is accused of carrying out unnecessary examinations and operations, fondling his patients and touching them for no reason. His twin brother allegedly swapped places with him and indecently fondled patients as well. His brother, Dennis Momah, is a GP (general practitioner).
Over 50 patients and former staff members have filed complaints against Charles Momah.
His defence team said the witnesses were not credible.
A date for sentencing has not yet been set. C Momah could be locked up for up to 16 years. His licence to practise medicine was suspended in 2003.
: Christian
There are also some civil lawsuits against C Momah. He is accused of carrying out unnecessary examinations and operations, fondling his patients and touching them for no reason. His twin brother allegedly swapped places with him and indecently fondled patients as well. His brother, Dennis Momah, is a GP (general practitioner).
Over 50 patients and former staff members have filed complaints against Charles Momah.
His defence team said the witnesses were not credible.
A date for sentencing has not yet been set. C Momah could be locked up for up to 16 years. His licence to practise medicine was suspended in 2003.
: Christian
Ortho-McNeil Reduces Prices Of Its Contraceptive Pills To $3.20 For A 30-Day Supply
Ortho-McNeil -- which supplies contraceptives to the majority of family planning clinics nationwide -- on Tuesday said it will charge $3.20 for a 30-day supply of each of the five contraceptive pills that it offers to public health programs -- a more than 90% reduction in price -- the Charleston Gazette reports (Kelly, Charleston Gazette, 8/30). According to WV Family Planning Program Director Denise Smith, the cost of a 30-day supply of one type of contraceptive pill made by Ortho last month increased in West Virginia from one cent to $21.01, and the cost of the company's Ortho Evra patch increased from $12.15 to $22.46 in the store. "The organization has decided to further lower pricing to meet the needs of women and ensure access to contraceptive choices and work with underfunded public health services," an Ortho statement said (Kaiser Daily Women's Health Policy Report, 8/29). Ortho earlier this month also reduced the price for Ortho Evra to $15 per month, according to the Gazette. West Virginia acting Pharmaceutical Advocate Shana Phares said that Sen. Jay Rockefeller (D-W.Va.) asked the company to reassess its price increases. Even with Ortho's price reduction, family planning clinics nationwide face funding challenges as prices of contraceptives have risen from "pennies to dollars," Judith DeSarno, president of the National Family Planning and Reproductive Health Association, said.
West Virginia
WVFPP on Thursday ordered a three-month supply of generic contraceptive pills that cost between $1.72 and $14.21 for a 30-day supply. Smith said she ordered 7,000 Ortho Evra patches, but added that clinics cannot give the patches to new patients and that the state will not order more if the price stays at $15. She also said Ortho's price reduction for its pills is "good news overall, but it's a little late for us," adding that she will take into account the company's new prices when WVFPP considers ordering new pills in six weeks (Charleston Gazette, 8/30). Ortho-Evra provided more than 75% of contraceptive pills to the state program, which contracts with private health clinics statewide, and it is the only provider to the state of the birth control patch (Kaiser Daily Women's Health Policy Report, 8/29).
"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.
Volunteer Program Provides Health Benefits To Older Women
A new article in The Journal of Gerontology: Social Sciences reveals that African American women aged 60 and older who volunteer in elementary schools are not only more physically active than their non-volunteering counterparts, but seem to sustain this physical activity over time. Specifically, those who volunteered burned twice as many calories as those who did not.
This study, led by Erwin Tan, PhD, of the Johns Hopkins University, suggests that the country's investment in national and community service programs can simultaneously be an investment in public health.
"For our volunteers," Tan said, "volunteering with children may be as good for their health as a gym membership. For our children, the wisdom that our older adults have is priceless." He added that, due to their enjoyment of working with children, the volunteers may be more willing to keep up with this approach in the long term, compared with traditional exercise programs.
Tan also explained that the focus on African American women was due to their prevalence in the two community groups from which the study participants were recruited, but he said the results are likely the same for all older people.
The data was gathered from participants in the Experience Corps (EC) program, a community-based initiative that places older adults as volunteers in public elementary schools. This information was then compared to surveys of non-volunteers enrolled in the Baltimore Women's Health and Aging Studies.
Tan's research builds on the results of a 2006 study of the EC program, which showed that 15 hours of volunteer work per week at an elementary school nearly doubled a sedentary older adult's activity level. The new study demonstrates that the increased activity can remain high for at least three years.
Another Johns Hopkins-based investigation of the EC program was published in the December 2008 issue of The Gerontologist. A research team led by Michelle Carlson, PhD, reported similar findings about EC's potential cognitive benefits for participants.
She and her colleagues found that EC volunteers showed greater improvements in memory and executive function than those who did not participate in the program. In fact, the older adults with the lowest baseline performance in these areas - those most at risk for health disparities - demonstrated the most significant gains.
Both studies highlighted above show that everyday activity interventions (e.g., EC) can appeal to older adults' desires to remain socially engaged and productive in their post-retirement years. Simultaneously, these activities provide measurable physical and cognitive health benefits.
Notes:
The Journal of Gerontology: Social Sciences and The Gerontologist are refereed publications of The Gerontological Society of America (GSA), the nation's oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society - and its 5,000+ members - is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA's structure also includes a policy institute, the National Academy on an Aging Society, and an educational branch, the Association of Gerontology in Higher Education.
Source: Todd Kluss
The Gerontological Society of America
This study, led by Erwin Tan, PhD, of the Johns Hopkins University, suggests that the country's investment in national and community service programs can simultaneously be an investment in public health.
"For our volunteers," Tan said, "volunteering with children may be as good for their health as a gym membership. For our children, the wisdom that our older adults have is priceless." He added that, due to their enjoyment of working with children, the volunteers may be more willing to keep up with this approach in the long term, compared with traditional exercise programs.
Tan also explained that the focus on African American women was due to their prevalence in the two community groups from which the study participants were recruited, but he said the results are likely the same for all older people.
The data was gathered from participants in the Experience Corps (EC) program, a community-based initiative that places older adults as volunteers in public elementary schools. This information was then compared to surveys of non-volunteers enrolled in the Baltimore Women's Health and Aging Studies.
Tan's research builds on the results of a 2006 study of the EC program, which showed that 15 hours of volunteer work per week at an elementary school nearly doubled a sedentary older adult's activity level. The new study demonstrates that the increased activity can remain high for at least three years.
Another Johns Hopkins-based investigation of the EC program was published in the December 2008 issue of The Gerontologist. A research team led by Michelle Carlson, PhD, reported similar findings about EC's potential cognitive benefits for participants.
She and her colleagues found that EC volunteers showed greater improvements in memory and executive function than those who did not participate in the program. In fact, the older adults with the lowest baseline performance in these areas - those most at risk for health disparities - demonstrated the most significant gains.
Both studies highlighted above show that everyday activity interventions (e.g., EC) can appeal to older adults' desires to remain socially engaged and productive in their post-retirement years. Simultaneously, these activities provide measurable physical and cognitive health benefits.
Notes:
The Journal of Gerontology: Social Sciences and The Gerontologist are refereed publications of The Gerontological Society of America (GSA), the nation's oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society - and its 5,000+ members - is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA's structure also includes a policy institute, the National Academy on an Aging Society, and an educational branch, the Association of Gerontology in Higher Education.
Source: Todd Kluss
The Gerontological Society of America
Exposure To Family Violence Compromises Physical And Mental Health Of Older Women
Older African American women exposed to high levels of family violence during their lifetimes are at significantly greater risk of poor health status, according to a report in the current issue of Journal of Women's Health, a peer-reviewed journal published by Mary Ann Liebert, Inc. This report is available free online at liebertpub/jwh
Higher lifetime exposure among older African American women to family violence, which may include intimate partner violence and elder maltreatment, is linked to worse physical and mental health, regardless of when the exposure occurred. Anuradha Paranjape, MD, MPH, Nancy Sprauve-Holmes, MPH, John Gaughan, PhD, and Nadine Kaslow, PhD, from Temple University School of Medicine (Philadelphia, PA) and Emory University School of Medicine (Atlanta, GA), used a survey to assess lifetime family violence levels, including physical violence, emotional, financial, and sexual abuse, neglect, and coercion, among 158 African American women 50 years of age or older attending ambulatory medicine clinics at a large inner-city public hospital in the southeastern U.S. The authors also gathered measures of the women's physical and mental health status.
In the article entitled, "Lifetime Exposure to Family Violence: Implications for the Health Status of Older African American Women," the authors conclude that a holistic approach to caring for older African American women should include greater awareness by clinicians of current and past violence exposure and the negative effects it may have on the health status of these women.
"This study provides further evidence of the enduring harmful effects that family violence can have on both mental and physical health, and in particular it highlights the association between such exposure and the health of older African American women," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, and Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA.
Notes:
Journal of Women's Health, published monthly, is a core multidisciplinary journal dedicated to the diseases and conditions that hold greater risk for or are more prevalent among women, as well as diseases that present differently in women. Under the leadership of Editor-in-Chief Susan G. Kornstein, MD, and Deputy Editor Wendy S. Klein, MD, of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, the Journal covers the latest advances and clinical applications of new diagnostic procedures and therapeutic protocols for the prevention and management of women's healthcare issues. Journal of Women's Health is the Official Journal of the American Medical Women's Association (AMWA).
Mary Ann Liebert, Inc., is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Obesity Management, Breastfeeding Medicine, Thyroid, Metabolic Syndrome and Related Disorders, and Diabetes Technology and Therapeutics. Its biotechnology trade magazine, Genetic Engineering & Biotechnology News (GEN), was the first in its field and is today the industry's most widely read publication worldwide. A complete list of the firm's 60 journals, books, and newsmagazines is available at liebertpub
Source:
Amy Gleason Quarshie
Mary Ann Liebert, Inc./Genetic Engineering News
Higher lifetime exposure among older African American women to family violence, which may include intimate partner violence and elder maltreatment, is linked to worse physical and mental health, regardless of when the exposure occurred. Anuradha Paranjape, MD, MPH, Nancy Sprauve-Holmes, MPH, John Gaughan, PhD, and Nadine Kaslow, PhD, from Temple University School of Medicine (Philadelphia, PA) and Emory University School of Medicine (Atlanta, GA), used a survey to assess lifetime family violence levels, including physical violence, emotional, financial, and sexual abuse, neglect, and coercion, among 158 African American women 50 years of age or older attending ambulatory medicine clinics at a large inner-city public hospital in the southeastern U.S. The authors also gathered measures of the women's physical and mental health status.
In the article entitled, "Lifetime Exposure to Family Violence: Implications for the Health Status of Older African American Women," the authors conclude that a holistic approach to caring for older African American women should include greater awareness by clinicians of current and past violence exposure and the negative effects it may have on the health status of these women.
"This study provides further evidence of the enduring harmful effects that family violence can have on both mental and physical health, and in particular it highlights the association between such exposure and the health of older African American women," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, and Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA.
Notes:
Journal of Women's Health, published monthly, is a core multidisciplinary journal dedicated to the diseases and conditions that hold greater risk for or are more prevalent among women, as well as diseases that present differently in women. Under the leadership of Editor-in-Chief Susan G. Kornstein, MD, and Deputy Editor Wendy S. Klein, MD, of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, the Journal covers the latest advances and clinical applications of new diagnostic procedures and therapeutic protocols for the prevention and management of women's healthcare issues. Journal of Women's Health is the Official Journal of the American Medical Women's Association (AMWA).
Mary Ann Liebert, Inc., is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Obesity Management, Breastfeeding Medicine, Thyroid, Metabolic Syndrome and Related Disorders, and Diabetes Technology and Therapeutics. Its biotechnology trade magazine, Genetic Engineering & Biotechnology News (GEN), was the first in its field and is today the industry's most widely read publication worldwide. A complete list of the firm's 60 journals, books, and newsmagazines is available at liebertpub
Source:
Amy Gleason Quarshie
Mary Ann Liebert, Inc./Genetic Engineering News
Fecal Incontinence Is Prevalent In US Women
It's a topic that is discussed so infrequently - for reasons that are easy to understand - that it may seem it isn't much of a problem. But new research shows that fecal incontinence is prevalent among U.S. women, especially those in older age groups, those who have had numerous babies, women whose deliveries were assisted by forceps or vacuum devices, and those who have had a hysterectomy.
Many women in the study who had fecal incontinence also had another medical condition, such as major depression or diabetes, and often experienced urinary incontinence in addition to FI. The findings are reported in the American Journal of Obstetrics and Gynecology.
"Increased attention should be paid to this debilitating condition, especially considering the aging of our population and the available treatments for FI," says senior author Dee E. Fenner, M.D., associate professor of obstetrics and gynecology, and director of gynecology, at the University of Michigan Medical School. "It is very important to the health of women that clinicians are aware of the prevalence of FI and can treat their patients accordingly."
The study, led by the University of Washington, was a postal survey of 6,000 women ages 30-90 who were enrolled in a large HMO in Washington state (the condition also affects men, but only women were involved in the study). Of the 64 percent who responded, the prevalence of FI was found to be 7.2 percent, with the occurrence increasing notably with age. FI was defined as loss of liquid or solid stool at least monthly.
The study was the first, to the authors' knowledge, to examine major depression as a potential risk factor for FI. They say FI could be a contributing factor to major depression in some cases, and major depression could be a contributing factor to FI in other cases.
FI can occur after damage to the anal sphincter muscles or scarring to the rectum, causing it to be unable to hold stool. Ulcerative colitis, Crohn's disease and some other conditions can cause this scarring to occur. Another contributing factor can be the stretching of the nerves that supply the sphincters, called the pudendal nerves, which can occur with childbirth, old age, trauma, or with medical diseases that affect the nerves, such as diabetes. Without intact nerves to stimulate the sphincters, the sphincters may undergo atrophy.
Because of the nature of the condition, people who have FI often do not discuss it with their doctors, experts say. That is why the study's authors encourage clinicians to take a more active role in finding out if their patients are experiencing FI, especially among patients age 50 or older. They note that while FI is present in many elderly women, it should not be considered merely a normal part of aging. They also encourage women to discuss the issue with their doctors.
It also is important for women and their doctors to be aware of the conditions that often go along with FI. Researchers found that women in the study with FI were more likely to have:
-- A higher number of deliveries
-- Urinary incontinence
-- A previous hysterectomy
-- Another medical condition as well, such as major depression or diabetes
-- A history of operative vaginal delivery, such as those using forceps or a vacuum-assisted device.
The impact of incontinence on the quality of life of the respondents was "significant," says Fenner, who is one of the founders of the Michigan Bowel Control Program at the University of Michigan Health System. "We found that half of the subjects with FI reported that their bowel symptoms had a large impact on their quality of life," she notes.
Treatments that can help people manage FI can range from changes in diet and exercise, to medications that improve the formation of stools, to surgery that repairs the sphincter muscles. In some cases, an artificial bowel sphincter can be implanted under the skin to mimic the natural function of the anal sphincter. Biofeedback - which involves daily exercises to improve the strength of muscles used to hold back a bowel movement - also is an option for some patients.
The lead author of the study was Jennifer L. Melville, M.D., M.P.H., of the Department of Obstetrics and Gynecology and the Department of Psychiatry & Behavioral Sciences at the University of Washington. In addition to Melville and Fenner, other authors were Ming-Yu Fan, Ph.D., of the Department of Psychiatry & Behavioral Sciences at the University of Washington and Katherine Newton, Ph.D., of the Center for Health Studies at the Group Health Cooperative of Puget Sound of Seattle.
The research was supported by grants from the National Institute of Child Health and Human Development and the National Institute of Mental Health, and a project-specific grant from Pharmacia Corporation.
Citation: American Journal of Obstetrics and Gynecology, Dec. 2005, vol. 193, 2071-6.
For more information about fecal incontinence:
med.umich.edu/1libr/aha/umfecal.htm
For more information about the Michigan Bowel Control Program:
med.umich.edu/bowelcontrol/about/fecal_incont.htm
Katie Gazella
kgazellaumich.edu
University of Michigan Health System
www.umich.edu
Many women in the study who had fecal incontinence also had another medical condition, such as major depression or diabetes, and often experienced urinary incontinence in addition to FI. The findings are reported in the American Journal of Obstetrics and Gynecology.
"Increased attention should be paid to this debilitating condition, especially considering the aging of our population and the available treatments for FI," says senior author Dee E. Fenner, M.D., associate professor of obstetrics and gynecology, and director of gynecology, at the University of Michigan Medical School. "It is very important to the health of women that clinicians are aware of the prevalence of FI and can treat their patients accordingly."
The study, led by the University of Washington, was a postal survey of 6,000 women ages 30-90 who were enrolled in a large HMO in Washington state (the condition also affects men, but only women were involved in the study). Of the 64 percent who responded, the prevalence of FI was found to be 7.2 percent, with the occurrence increasing notably with age. FI was defined as loss of liquid or solid stool at least monthly.
The study was the first, to the authors' knowledge, to examine major depression as a potential risk factor for FI. They say FI could be a contributing factor to major depression in some cases, and major depression could be a contributing factor to FI in other cases.
FI can occur after damage to the anal sphincter muscles or scarring to the rectum, causing it to be unable to hold stool. Ulcerative colitis, Crohn's disease and some other conditions can cause this scarring to occur. Another contributing factor can be the stretching of the nerves that supply the sphincters, called the pudendal nerves, which can occur with childbirth, old age, trauma, or with medical diseases that affect the nerves, such as diabetes. Without intact nerves to stimulate the sphincters, the sphincters may undergo atrophy.
Because of the nature of the condition, people who have FI often do not discuss it with their doctors, experts say. That is why the study's authors encourage clinicians to take a more active role in finding out if their patients are experiencing FI, especially among patients age 50 or older. They note that while FI is present in many elderly women, it should not be considered merely a normal part of aging. They also encourage women to discuss the issue with their doctors.
It also is important for women and their doctors to be aware of the conditions that often go along with FI. Researchers found that women in the study with FI were more likely to have:
-- A higher number of deliveries
-- Urinary incontinence
-- A previous hysterectomy
-- Another medical condition as well, such as major depression or diabetes
-- A history of operative vaginal delivery, such as those using forceps or a vacuum-assisted device.
The impact of incontinence on the quality of life of the respondents was "significant," says Fenner, who is one of the founders of the Michigan Bowel Control Program at the University of Michigan Health System. "We found that half of the subjects with FI reported that their bowel symptoms had a large impact on their quality of life," she notes.
Treatments that can help people manage FI can range from changes in diet and exercise, to medications that improve the formation of stools, to surgery that repairs the sphincter muscles. In some cases, an artificial bowel sphincter can be implanted under the skin to mimic the natural function of the anal sphincter. Biofeedback - which involves daily exercises to improve the strength of muscles used to hold back a bowel movement - also is an option for some patients.
The lead author of the study was Jennifer L. Melville, M.D., M.P.H., of the Department of Obstetrics and Gynecology and the Department of Psychiatry & Behavioral Sciences at the University of Washington. In addition to Melville and Fenner, other authors were Ming-Yu Fan, Ph.D., of the Department of Psychiatry & Behavioral Sciences at the University of Washington and Katherine Newton, Ph.D., of the Center for Health Studies at the Group Health Cooperative of Puget Sound of Seattle.
The research was supported by grants from the National Institute of Child Health and Human Development and the National Institute of Mental Health, and a project-specific grant from Pharmacia Corporation.
Citation: American Journal of Obstetrics and Gynecology, Dec. 2005, vol. 193, 2071-6.
For more information about fecal incontinence:
med.umich.edu/1libr/aha/umfecal.htm
For more information about the Michigan Bowel Control Program:
med.umich.edu/bowelcontrol/about/fecal_incont.htm
Katie Gazella
kgazellaumich.edu
University of Michigan Health System
www.umich.edu
Estonia's Total Fertility Rate Increasing In Part Because Of Government Program Encouraging Women To Give Birth
Estonia's total fertility rate has increased to an average of 1.5 children per woman from an average of 1.3 children per woman in the late 1990s, which could be the result of a government initiative aimed at sustaining the nation's population by providing women who have children with monthly stipends, the Wall Street Journal reports. The initiative, launched in 2004, was pushed after a 2001 world population report by the United Nations showed that Estonia was "one of the fastest-shrinking nations on earth," according to the Journal. Under the program, Estonia provides employed women who have children with their monthly salary, up to $1,560 monthly, over a 15-month period and unemployed women with $200 monthly. According to the Journal, the average monthly salary in Estonia is $650. The program has helped raise the total fertility rate because many employed women in the country could not afford to take time off from work to have children and because taking time off could have a negative impact on job security, according to the Journal. Some other factors that contributed to the lower total fertility rate include advances in birth control and ideas about personal freedom and happiness, the Journal reports. Estonia's program could serve as a model for other countries with low total fertility rates, according to the Journal. The Estonian government plans to continue formulating strategies -- such as expanding preabortion counseling and subsidizing child-care providers and private day care -- to help improve the total fertility rate, the Journal reports. According to the Journal, Estonia needs a total fertility rate of 2.1 children per woman to maintain its current population (Walker, Wall Street Journal, 10/20).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Blogs Comment On Reproductive Health Legislation, Research, Other Topics
The following summarizes selected women's health-related blog entries.
~ "Electronic Mnemonics and the Pill," Laura Lloyd, National Campaign To Prevent Teen and Unplanned Pregnancy's "Pregnant Pause": Although oral contraceptives are the most popular birth control method among U.S. teens and young adults, the pill "tends to be less effective than it could be thanks to user error," Lloyd writes. The pill, when taken perfectly, is 99.7% effective, but "when it's taken the way women typically take it -- forgetting a pill (or two) here, forgetting a pill (or three) there -- the level of effectiveness drops to 92%," she continues. Two recent studies examining whether text message reminders increased pill adherence indicate that "there's definite promise and a number of issues that warrant further study," Lloyd writes. One study found no difference in pill adherence between women who received text message reminders, while the other study showed the opposite, according to Lloyd. "I'd say it's too early in the game to know exactly how well the reminder worked (or didn't, as the case may be)," she continues, adding that "at least there are researchers in our field that have taken the first step in exploring how digital devices can help women get a little closer to perfect when using their less-than-perfect methods" (Lloyd, "Pregnant Pause," National Campaign To Prevent Teen and Unplanned Pregnancy, 9/4).
~ "Planned Parenthood is Protecting Choice Right in the Heart of Utah," Feminists for Choice: "When most people think of Utah, the first image they conjure up usually isn't a Planned Parenthood clinic," according to the blog. However, the organization operates nine clinics in the state, including a new site in Orem, "which is home to Utah Valley University and the next door neighbor of Provo, home to Brigham Young University." The Orem clinic is the fastest growing in Utah, "experiencing an 18% increase in its patient load since the clinic opened in 2009," the blog adds. Planned Parenthood of Utah CEO Karrie Galloway said the growth can be attributed to several factors, including Utah's young population and high demand for family planning services and sexually transmitted infection testing. Galloway said that the "traditional model for pro-choice organizing doesn't fit here in Utah," but that "[m]any people ... express incredibly pro-choice views and show their support of Planned Parenthood when they are surveyed." She added that "people support us financially," but "[t]hey're just not very visible or vocal" (Feminists for Choice, 9/1).
~ "Access to Abortion: Red State, Blue State, Interstate," Amanda Marcotte, RH Reality Check: A recent study that "found people in areas with more restrictive abortion policies search [the Internet] for the word 'abortion' more than in liberal areas" is "one with big implications for how we understand the relationship between policy, culture and reproductive rights," Marcotte writes. The study's authors "assumed women in these areas are more likely to look to the Internet for help in finding abortion providers because they feared asking their primary care doctors," Marcotte continues. She adds adding that "antiabortion policies tend to coincide ... with general cultural and legal obstacles to contraception access," which "raises the unintended pregnancy rate, thus the more frequent searching for abortion services." Marcotte argues that the lesson to be learned from the study "is that many women are drastically underserved in the reproductive health department," with inadequate access to contraception, family planning services and comprehensive sex education. "The other thing we can learn from this is that women who have poor access to abortion services are turning to the Internet, so the Internet is where the information they need should be," Marcotte states. She writes that the Internet "can be a great place to find information and service, but sadly it's also a place where emboldened right-wing demagogues can spread lies and misinformation" (Marcotte, RH Reality Check, 9/2).
~ "How Did We Strip Away Women's Reproductive Rights This Year?" Alex DiBranco, Change's "Women's Rights": DiBranco discusses the Center for Reproductive Rights' recent review of federal and state policy changes that affect reproductive rights. On the federal level, during the health reform debate, "[a]nti-choicers won a victory with the Nelson amendment, which imposed mandatory restrictions on abortion coverage while giving states the green light to make life even harder for women, should the mood take them." According to DiBranco, "Arizona, Louisiana, Mississippi, Missouri and Tennessee took them up on that offer" by banning health plans operating in their health insurance exchanges from offering abortion coverage. Florida and Oklahoma "would have followed if it weren't for the woman-friendly pen of their governors," she continues. "Attempts at personhood ballot initiatives that declare against both science and many people's personal beliefs that life begins at conception have also been popular, but luckily these unconstitutional attempts to define all abortion as murder have failed to win over the voters," DiBranco writes. State legislatures also passed "laws requiring doctors to counsel women with scientifically unfounded information, ... mandatory ultrasounds even for rape victims ... and parental notification laws that endanger abused girls," she adds (DiBranco, "Women's Rights," Change, 8/31).
~ "Women's Health Care Under Attack at UNC," NARAL Pro-Choice America's "Blog for Choice": Last month, the "anti-choice blogosphere initiated an e-mail campaign against the [University of North Carolina] system's new required health insurance plan to be implemented this fall" because "it includes the option of abortion care, a standard coverage included in more than 87% of private health insurance plans," the blog states. "Fortunately, NARAL Pro-Choice North Carolina has been fighting to save women's health coverage at the UNC system," the blog continues. According to the blog, the "UNC system responded to the protests by offering an alternative plan where students can opt out of abortion coverage," ensuring that they will still have access to comprehensive health care." In addition, "[s]tudents who don't opt out won't pay a higher rate because abortion coverage doesn't affect health plan costs," the blog notes ("Blog for Choice," NARAL Pro-Choice American, 8/27).
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.
Women Who Suffer Domestic Violence Experience Long-Lasting Health Problems, Report Says
Women who suffer physical abuse from intimate partners - the most common form of violence perpetrated against women worldwide - experience serious health consequences, according to a report released on Thursday by the World Health Organization, the AP/Boston Globe reports. The survey of 24,000 women in 10 countries found that women who suffer domestic abuse were twice as likely as other women to suffer health problems, including pain, dizziness, gynecological and mental health problems, which persist after the abuse has stopped, the report says. They also were more likely to have had a miscarriage or an induced abortion (Ross, AP/Boston Globe, 11/24). The report says 4% to 12% of respondents who had been pregnant said they were beaten during pregnancy (Nebehay/Reaney, Reuters UK, 11/24). The survey, which was conducted in collaboration with the London School of Hygiene and Tropical Medicine and the nongovernmental organization PATH, was the first global report on domestic violence (AP/Boston Globe, 11/24). Researchers surveyed women in Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia and Montenegro, Tanzania and Thailand (WHO release, 11/24). Rates of domestic abuse varied between 15% of women in Japan to 71% in Ethiopia (AP/Boston Globe, 11/24). Fewer than half of the women who had been abused said they sought help from law enforcement authorities. In roughly half of the sites surveyed, women said it was acceptable for a man to beat his wife in certain situations (Vergano, USA Today, 11/26). To combat the violence, WHO recommends bolstering support services for women and training medical workers to recognize the signs of domestic abuse (Schlein, VOA News, 11/24). The report was released ahead of the International Day for the Elimination of Violence Against Women, which was marked on Friday. The U.N. Development Fund for Women also called for more awareness about the link between violence and the spread of HIV/AIDS (U.N. News Service, 11/25).
New York Times Examines Practice in Africa of Forced Marriages
The New York Times on Sunday examined the practice in some remote villages in Africa in which young girls are married off -- "sometimes to husbands as much as half a century older" -- in transactions with other families. In some communities, girls often "must leap straight from childhood to marriage at a word from their fathers," sometimes "years before they reach puberty," according to the Times. Such forced marriages can lead to "staggering" consequences, including the spread of HIV, a lack of education, early pregnancies and high-risk births, and a life of subservience, the Times reports (LaFraniere, New York Times, 11/27).
"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.
Many Vaccines In Pipeline Including Warts Vaccine
A clinical trial treating the papillomaviruses responsible for genital warts was on target at the halfway mark, according to Australian of the Year 2006 Professor Ian Frazer and trial manager, sexual health specialist Dr David Jardine
More than 200 patients in China and Australia have taken part in the trial so far run from the Princess Alexandra (PA) Hospital.
"The new treatment has so far proven safe, and we want to know if it improves the outcome after conventional therapy, which all patients also receive," Dr Jardine said.
Trial researchers aim to use a tweaked version of Professor Frazer's cervical cancer vaccine to treat genital warts.
Professor Frazer said this vaccine could be one of the first made locally at the biopharmaceutical production centre, which received $100 million in last night's Federal Budget.
The centre, called the Translational Research Institute, is planned to be a one-stop shop at the PA Hospital for medical research and health care, catering for medical discoveries, clinical trials and drug manufacture.
"Conducting trials in Australia gives Australians the chance to help develop new treatments," Professor Frazer said.
"Should the product under trial be effective, it also gives them the chance to be amongst the first to benefit."
A vaccine would complement both the pap smear program and currently available vaccines to prevent infections.
Genital warts are transmitted by skin contact and the 2003 Australian Study of Sex and Relationships of 20,000 adults revealed four percent of people had had visible genital warts.
Dr Jardine said men and women with genital warts who would like to take part in the trial could call 3240 5881 to learn more. All calls are handled in confidence.
Contact: Miguel Holland
Research Australia
More than 200 patients in China and Australia have taken part in the trial so far run from the Princess Alexandra (PA) Hospital.
"The new treatment has so far proven safe, and we want to know if it improves the outcome after conventional therapy, which all patients also receive," Dr Jardine said.
Trial researchers aim to use a tweaked version of Professor Frazer's cervical cancer vaccine to treat genital warts.
Professor Frazer said this vaccine could be one of the first made locally at the biopharmaceutical production centre, which received $100 million in last night's Federal Budget.
The centre, called the Translational Research Institute, is planned to be a one-stop shop at the PA Hospital for medical research and health care, catering for medical discoveries, clinical trials and drug manufacture.
"Conducting trials in Australia gives Australians the chance to help develop new treatments," Professor Frazer said.
"Should the product under trial be effective, it also gives them the chance to be amongst the first to benefit."
A vaccine would complement both the pap smear program and currently available vaccines to prevent infections.
Genital warts are transmitted by skin contact and the 2003 Australian Study of Sex and Relationships of 20,000 adults revealed four percent of people had had visible genital warts.
Dr Jardine said men and women with genital warts who would like to take part in the trial could call 3240 5881 to learn more. All calls are handled in confidence.
Contact: Miguel Holland
Research Australia
Hormone Therapy In Early Post-Menopause Has No Effect On Memory
Hormone therapy taken in the first few years after menopause does not appear to affect a woman's memory, but may lead to increased sexual interest, according to a study published in the September 25, 2007, issue of Neurology, the medical journal of the American Academy of Neurology.
The study, the largest to date examining the effects of hormone therapy in early post-menopausal women, involved 180 women between the ages of 45 and 55 who had finished their last menstrual cycle in the past one to three years. The women were randomly given placebo or hormone therapy consisting of daily estrogen and progesterone for four months. The women also underwent tests on memory, attention, cognitive function, emotional status, sexuality, and sleep.
The study found no significant difference in cognition among women taking hormone therapy compared to women taking placebo.
"These results are similar to previous studies suggesting hormone therapy has minimal effect on a woman's memory when taken many years after menopause," said study author Pauline Maki, PhD, with the University of Illinois in Chicago. "While our results are inconsistent with smaller studies that found improvement in verbal memory for women who only used estrogen, it may be that progesterone modifies the protective effects of estrogen on verbal memory."
The study also found an increase in sexual interest and thoughts in the women taking hormone therapy. "The level of sexual interest reported by women on hormone therapy increased 44 percent and their number of sexual thoughts increased 32 percent compared to the placebo group," said Maki.
In addition, women with vasomotor symptoms, such as hot flashes and night sweats, showed a decrease in such symptoms and an improvement in general quality of life, but no cognitive benefits over placebo. Maki says the study is limited since it was terminated before it reached its desired sample size of 275 women due to a drop in participation over concerns about the safety of hormone therapy following publication of the Women's Health Initiative, which suggested long-term use of hormone therapy increases a women's risk for breast cancer and does not protect against cardiovascular disease.
Wyeth Pharmaceuticals supported the study.
The American Academy of Neurology, an association of more than 20,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis.
aan
The study, the largest to date examining the effects of hormone therapy in early post-menopausal women, involved 180 women between the ages of 45 and 55 who had finished their last menstrual cycle in the past one to three years. The women were randomly given placebo or hormone therapy consisting of daily estrogen and progesterone for four months. The women also underwent tests on memory, attention, cognitive function, emotional status, sexuality, and sleep.
The study found no significant difference in cognition among women taking hormone therapy compared to women taking placebo.
"These results are similar to previous studies suggesting hormone therapy has minimal effect on a woman's memory when taken many years after menopause," said study author Pauline Maki, PhD, with the University of Illinois in Chicago. "While our results are inconsistent with smaller studies that found improvement in verbal memory for women who only used estrogen, it may be that progesterone modifies the protective effects of estrogen on verbal memory."
The study also found an increase in sexual interest and thoughts in the women taking hormone therapy. "The level of sexual interest reported by women on hormone therapy increased 44 percent and their number of sexual thoughts increased 32 percent compared to the placebo group," said Maki.
In addition, women with vasomotor symptoms, such as hot flashes and night sweats, showed a decrease in such symptoms and an improvement in general quality of life, but no cognitive benefits over placebo. Maki says the study is limited since it was terminated before it reached its desired sample size of 275 women due to a drop in participation over concerns about the safety of hormone therapy following publication of the Women's Health Initiative, which suggested long-term use of hormone therapy increases a women's risk for breast cancer and does not protect against cardiovascular disease.
Wyeth Pharmaceuticals supported the study.
The American Academy of Neurology, an association of more than 20,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis.
aan
Depression In Females Linked To Sense Of Smell
Can't smell the roses? Maybe you're depressed. Smell too much like a rose yourself? Maybe you've got the same problem. Scientists from Tel Aviv University recently linked depression to a biological mechanism that affects the olfactory glands. It might explain why some women, without realizing it, wear too much perfume.
Scientific research that supports this theory was published this year in the journal Arthritis and Rheumatism. "Our scientific findings suggest that women who are depressed are also losing their sense of smell, and may overcompensate by using more perfume," explains researcher Prof. Yehuda Shoenfeld, a member of the Sackler Faculty of Medicine at Tel Aviv University. "We also believe that depression has biological roots and may be an immune system response to certain physiological cues."
Women who are depressed are also more likely to lose weight. With a reduced sense of smell, they are less likely to have a healthy appetite, he says.
Prof. Shoenfeld draws his conclusions from lifetime research on autoimmune diseases, focusing on conditions such as lupus, arthritis and rheumatism.
More Than a Feeling
Affecting about 1.5 million Americans, depression accompanying lupus, Prof. Shoenfeld has found, is much more than an emotional reaction to being ill. It appears to have a biological cause.
In lupus patients and those with other autoimmune diseases, a particle known as an "autoantibody" attacks the person's own immune system, appearing in the human body as an aberrant reaction to autoimmune diseases. This particle "is a real novelty," says Prof. Shoenfeld. "We have found that, when generated, it weakens a person's sense of smell and can induce the feeling of depression."
Scientists today widely accept the fact that people with Alzheimer's disease lose their sense of smell. Prof. Shoenfeld's research is the first that links depression to smell in lupus patients, however.
The implications are wide and can be applied to the general population, says Prof. Shoenfeld. "People who are depressed seem to respond well to aromatherapy. Certain smells seem to help them overcome the effects of the biological factors, suggesting that depression may have a biological cause."
This research also raises questions about the cause of psychotic disorders such as schizophrenia. "There may be an organic cause to these disorders, and if this is the case, clinicians might have to change their attitude about current therapies they use," Prof. Shoenfeld says. "I think that science is able to show that aromatherapy might not be just for quacks. After all, some of these remedies have been used since the time of the Egyptians to treat organic diseases."
Prof. Shoenfeld also suggests that a standardized "smell test" could be used by doctors to help diagnose depression as well as autoimmune diseases.
Retail Therapy and Aromatherapy
He adds that the association between one's sense of smell and depression has interesting implications for "smell marketing," used by retailers to encourage shoppers to buy, especially around holiday time. "These tactics are already being used by retailers and banks all over the world," says Prof. Shoenfeld.
"The retail industry has learned that if it splashes good smells around, it can convince clients to buy more and invest more money. It certainly has an effect on one's mood."
Prof. Shoenfeld is an internationally recognized expert in autoimmune diseases and a medical doctor. He is the head of the Department of Medicine "B" at the Sheba Medical Center in Israel and edits four medical journals, including Harefua (in Hebrew), The Journal of Autoimmunity, Autoimmunity Reviews and the Israel Medical Association Journal. Work on this recent study was done in close collaboration with Prof. Joab Chapman, the head of the Neurology Department at Sheba Medical Center, and a professor at Tel Aviv University.
American Friends of Tel Aviv University supports Israel's largest and most comprehensive center of higher learning. It is ranked among the world's top 100 universities in science, biomedical studies, and social science, and rated one of the world's top 200 universities overall. Internationally recognized for the scope and groundbreaking nature of its research programs, Tel Aviv University consistently produces work with profound implications for the future.
Source: George Hunka
American Friends of Tel Aviv University
Scientific research that supports this theory was published this year in the journal Arthritis and Rheumatism. "Our scientific findings suggest that women who are depressed are also losing their sense of smell, and may overcompensate by using more perfume," explains researcher Prof. Yehuda Shoenfeld, a member of the Sackler Faculty of Medicine at Tel Aviv University. "We also believe that depression has biological roots and may be an immune system response to certain physiological cues."
Women who are depressed are also more likely to lose weight. With a reduced sense of smell, they are less likely to have a healthy appetite, he says.
Prof. Shoenfeld draws his conclusions from lifetime research on autoimmune diseases, focusing on conditions such as lupus, arthritis and rheumatism.
More Than a Feeling
Affecting about 1.5 million Americans, depression accompanying lupus, Prof. Shoenfeld has found, is much more than an emotional reaction to being ill. It appears to have a biological cause.
In lupus patients and those with other autoimmune diseases, a particle known as an "autoantibody" attacks the person's own immune system, appearing in the human body as an aberrant reaction to autoimmune diseases. This particle "is a real novelty," says Prof. Shoenfeld. "We have found that, when generated, it weakens a person's sense of smell and can induce the feeling of depression."
Scientists today widely accept the fact that people with Alzheimer's disease lose their sense of smell. Prof. Shoenfeld's research is the first that links depression to smell in lupus patients, however.
The implications are wide and can be applied to the general population, says Prof. Shoenfeld. "People who are depressed seem to respond well to aromatherapy. Certain smells seem to help them overcome the effects of the biological factors, suggesting that depression may have a biological cause."
This research also raises questions about the cause of psychotic disorders such as schizophrenia. "There may be an organic cause to these disorders, and if this is the case, clinicians might have to change their attitude about current therapies they use," Prof. Shoenfeld says. "I think that science is able to show that aromatherapy might not be just for quacks. After all, some of these remedies have been used since the time of the Egyptians to treat organic diseases."
Prof. Shoenfeld also suggests that a standardized "smell test" could be used by doctors to help diagnose depression as well as autoimmune diseases.
Retail Therapy and Aromatherapy
He adds that the association between one's sense of smell and depression has interesting implications for "smell marketing," used by retailers to encourage shoppers to buy, especially around holiday time. "These tactics are already being used by retailers and banks all over the world," says Prof. Shoenfeld.
"The retail industry has learned that if it splashes good smells around, it can convince clients to buy more and invest more money. It certainly has an effect on one's mood."
Prof. Shoenfeld is an internationally recognized expert in autoimmune diseases and a medical doctor. He is the head of the Department of Medicine "B" at the Sheba Medical Center in Israel and edits four medical journals, including Harefua (in Hebrew), The Journal of Autoimmunity, Autoimmunity Reviews and the Israel Medical Association Journal. Work on this recent study was done in close collaboration with Prof. Joab Chapman, the head of the Neurology Department at Sheba Medical Center, and a professor at Tel Aviv University.
American Friends of Tel Aviv University supports Israel's largest and most comprehensive center of higher learning. It is ranked among the world's top 100 universities in science, biomedical studies, and social science, and rated one of the world's top 200 universities overall. Internationally recognized for the scope and groundbreaking nature of its research programs, Tel Aviv University consistently produces work with profound implications for the future.
Source: George Hunka
American Friends of Tel Aviv University
Experimental Vaginal Test Could Help Ob-Gyns Choose Best Induction Date
The AP/Seattle Post-Intelligencer on Monday examined a vaginal test under review by FDA that could help ob-gyns choose the best date at which to induce labor and reduce the health risks involved in performing the procedure too early. According to the AP/Post-Intelligencer, one in five pregnant women annually in the U.S. elects or finds it medically necessary to induce labor, which can cause prolonged labor ending in caesarean section if the pregnant woman's body is not ready to deliver. The experimental test, which is manufactured by Adeza, looks for fetal fibronectin, a protein that is described as a "uterine glue" substance. If the protein appears in the vagina from mid-pregnancy onward, it is believed to signal that the body is preparing for labor, the AP/Post-Intelligencer reports. In a recent Adeza-sponsored study of 875 first-time pregnant women in 22 hospitals, those who tested positive for fetal fibronectin were 38% more likely to deliver vaginally within one day of the induction's start than women who tested negative for the protein. In addition, women who tested negative for fetal fibronectin were 29% more likely to undergo a c-section delivery than women who tested positive for the protein. Michael Randell, an Atlanta ob-gyn, said the test could offer an objective, rather than subjective, confirmation of a manual cervical exam. However, other ob-gyns say the test could lead to questionable inductions. "I don't feel this trend for elective inductions is a good thing," Peter Bernstein of Montefiore Medical Center in New York said (Neergaard, AP/Seattle Post-Intelligencer, 6/5).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Lung Cancer Risk Reduced In Female Textile Workers Exposed To Endotoxin
Long-term, high-level exposure to bacterial endotoxin-- a contaminant found in raw cotton fiber and cotton dust -- is associated with a 40 percent decrease in lung cancer risk among female Chinese textile workers, according to a new study in the March 7 Journal of the National Cancer Institute.
Since the 1970s, studies in the U.S. and abroad have reported a lower than average risk of lung cancer for textile workers. Additionally, studies have shown that workers in other occupations with high endotoxin exposure, such as dairy farmers, have reduced lung cancer risks as well. Although many researchers thought endotoxin might be associated with reduced risk of lung cancer, no previous studies had quantified the relationship between endotoxin exposure and lung cancer risk.
George Astrakianakis, Ph.D., of the University of Washington in Seattle, and his colleagues compared the endotoxin exposure of 628 female cotton textile workers in Shanghai who were diagnosed with lung cancer with a group of 3,184 female workers without lung cancer who were matched by age to the cancer patients. They estimated the workers' total endotoxin exposure in textile factories based on their measurements of cotton dust exposure, which varied depending on the workers' jobs and length of employment.
The risk of developing lung cancer decreased as workers were exposed to greater amounts of endotoxin over many years. Twenty years of exposure to endotoxin reduced the incidence of lung cancer to approximately 7.6 per 100,000, compared with 19.1 per 100,000 for the average Shanghai woman. The risk was lowest for women whose endotoxin exposure occurred early in their career.
How endotoxins could reduced lung cancer risk is unclear. "Potential anticarcinogenic effects of endotoxin are probably mediated by the innate and acquired immune systems, although the specific mechanisms have yet to be elucidated," the authors write.
The researchers considered several other factors that could have influenced their results. The protective effect of endotoxin could not be explained by differences in smoking habits, but the authors could not exclude a potential bias in the study's design, which they call the healthy worker survivor effect. The authors also acknowledge that uncertainties exist in estimating endotoxin exposures in past years, but the findings remained virtually unchanged when different exposure scenarios were applied.
In an accompanying editorial, Paolo Boffetta, M.D., of the International Agency for Research on Cancer in France, discusses the importance of this finding for lung cancer research, but warns that the study's limitations make it too early to consider using endotoxins for lung cancer prevention. "Results of the study by Astrakianakis [and colleagues] are strongly suggestive that endotoxin exposure is associated with a reduced risk of lung cancer, but potential confounding [variables] and lack of strong supportive mechanistic evidence prevent stronger conclusions," Boffetta writes. "Great caution should be exercised by all when moving from the results of observational studies of the effects of complex mixtures to interventions aimed at cancer prevention."
Contact:
* Article: Clare Hagerty, press office, University of Washington
* Editorial: Paolo Boffetta, International Agency for Research on Cancer
Citation:
* Article: Astrakianakis G, Seixas NS, Ray R, Camp JE, Gao DL, Feng Z, et al. Lung Cancer Risk Among Female Textile Workers Exposed to Endotoxin. J Natl Cancer Inst 2007; 99: 357-364
* Editorial: Boffetta P. Endotoxins in Lung Cancer Prevention. J Natl Cancer Inst 2007 99: 339
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at jnci.oxfordjournals/.
Contact: Liz Savage
Journal of the National Cancer Institute
Since the 1970s, studies in the U.S. and abroad have reported a lower than average risk of lung cancer for textile workers. Additionally, studies have shown that workers in other occupations with high endotoxin exposure, such as dairy farmers, have reduced lung cancer risks as well. Although many researchers thought endotoxin might be associated with reduced risk of lung cancer, no previous studies had quantified the relationship between endotoxin exposure and lung cancer risk.
George Astrakianakis, Ph.D., of the University of Washington in Seattle, and his colleagues compared the endotoxin exposure of 628 female cotton textile workers in Shanghai who were diagnosed with lung cancer with a group of 3,184 female workers without lung cancer who were matched by age to the cancer patients. They estimated the workers' total endotoxin exposure in textile factories based on their measurements of cotton dust exposure, which varied depending on the workers' jobs and length of employment.
The risk of developing lung cancer decreased as workers were exposed to greater amounts of endotoxin over many years. Twenty years of exposure to endotoxin reduced the incidence of lung cancer to approximately 7.6 per 100,000, compared with 19.1 per 100,000 for the average Shanghai woman. The risk was lowest for women whose endotoxin exposure occurred early in their career.
How endotoxins could reduced lung cancer risk is unclear. "Potential anticarcinogenic effects of endotoxin are probably mediated by the innate and acquired immune systems, although the specific mechanisms have yet to be elucidated," the authors write.
The researchers considered several other factors that could have influenced their results. The protective effect of endotoxin could not be explained by differences in smoking habits, but the authors could not exclude a potential bias in the study's design, which they call the healthy worker survivor effect. The authors also acknowledge that uncertainties exist in estimating endotoxin exposures in past years, but the findings remained virtually unchanged when different exposure scenarios were applied.
In an accompanying editorial, Paolo Boffetta, M.D., of the International Agency for Research on Cancer in France, discusses the importance of this finding for lung cancer research, but warns that the study's limitations make it too early to consider using endotoxins for lung cancer prevention. "Results of the study by Astrakianakis [and colleagues] are strongly suggestive that endotoxin exposure is associated with a reduced risk of lung cancer, but potential confounding [variables] and lack of strong supportive mechanistic evidence prevent stronger conclusions," Boffetta writes. "Great caution should be exercised by all when moving from the results of observational studies of the effects of complex mixtures to interventions aimed at cancer prevention."
Contact:
* Article: Clare Hagerty, press office, University of Washington
* Editorial: Paolo Boffetta, International Agency for Research on Cancer
Citation:
* Article: Astrakianakis G, Seixas NS, Ray R, Camp JE, Gao DL, Feng Z, et al. Lung Cancer Risk Among Female Textile Workers Exposed to Endotoxin. J Natl Cancer Inst 2007; 99: 357-364
* Editorial: Boffetta P. Endotoxins in Lung Cancer Prevention. J Natl Cancer Inst 2007 99: 339
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at jnci.oxfordjournals/.
Contact: Liz Savage
Journal of the National Cancer Institute
Overeating, Alcohol Abuse And Depression Intertwined In Young Women
On TV, Sex and the City makes regular Cosmo-drinking sessions seem like a glamorous, harmless pastime. In reality, though, excessive alcohol use can relate to overeating and depression in young women, according to the results of a new study.
"Anyone who has been touched by depression, obesity or alcoholism knows that these disorders on their own can be devastating. When they're combined, these disorders become more costly, more difficult to treat and more impairing," said Carolyn McCarty, Ph.D., lead study author and a research associate professor at the University of Washington and Seattle Children's Research Institute.
In the study in the September/October issue of the journal General Hospital Psychiatry, the researchers surveyed 393 men and 383 women at ages 24, 27 and 30 about their weight, alcohol use and depression symptoms within the last year.
"When you look across time, alcohol use and obesity predicted later depression. The big picture here is that these disorders, though they're different in manifestation and symptoms, appear to be related for some groups of women." McCarty said.
The researchers found that women who had alcohol use disorders at age 24 were more than three times as likely to be obese at age 27, compared to women who did not.
In addition, women who were obese at age 27 were more than twice as likely to be depressed at age 30, and women who were depressed at age 27 had an increased risk of alcohol disorders at age 30. For young men, the disorders did not appear to have similar connections over time.
"From a clinical or health care provider perspective, when you think about what to do about one of these problems, you have to think about what to do about the other," said Gregory Simon, M.D., a psychiatrist and researcher at the Group Health Center for Health Studies in Seattle. "Being overweight is the norm among people who are depressed, so when helping people with depression, you've got to think about how their weight is related." Simon had no affiliation with the study.
Although she noted more research is necessary to understand why these disorders are more related in women, McCarty suggested that women might be more likely to ruminate, or "chew" on problems in response to stress, which could increase the likelihood of developing depression, eating problems and substance abuse. Different biological pathways in the brain might also play a role.
General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. For information about the journal, contact Wayne Katon, M.D., at (206) 543-7177.
McCarty CA, et al. Longitudinal associations among depression, obesity and alcohol use disorders in young adulthood. Gen Hosp Psychiatry, 31(5), 2009.
Source
General Hospital Psychiatry
"Anyone who has been touched by depression, obesity or alcoholism knows that these disorders on their own can be devastating. When they're combined, these disorders become more costly, more difficult to treat and more impairing," said Carolyn McCarty, Ph.D., lead study author and a research associate professor at the University of Washington and Seattle Children's Research Institute.
In the study in the September/October issue of the journal General Hospital Psychiatry, the researchers surveyed 393 men and 383 women at ages 24, 27 and 30 about their weight, alcohol use and depression symptoms within the last year.
"When you look across time, alcohol use and obesity predicted later depression. The big picture here is that these disorders, though they're different in manifestation and symptoms, appear to be related for some groups of women." McCarty said.
The researchers found that women who had alcohol use disorders at age 24 were more than three times as likely to be obese at age 27, compared to women who did not.
In addition, women who were obese at age 27 were more than twice as likely to be depressed at age 30, and women who were depressed at age 27 had an increased risk of alcohol disorders at age 30. For young men, the disorders did not appear to have similar connections over time.
"From a clinical or health care provider perspective, when you think about what to do about one of these problems, you have to think about what to do about the other," said Gregory Simon, M.D., a psychiatrist and researcher at the Group Health Center for Health Studies in Seattle. "Being overweight is the norm among people who are depressed, so when helping people with depression, you've got to think about how their weight is related." Simon had no affiliation with the study.
Although she noted more research is necessary to understand why these disorders are more related in women, McCarty suggested that women might be more likely to ruminate, or "chew" on problems in response to stress, which could increase the likelihood of developing depression, eating problems and substance abuse. Different biological pathways in the brain might also play a role.
General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. For information about the journal, contact Wayne Katon, M.D., at (206) 543-7177.
McCarty CA, et al. Longitudinal associations among depression, obesity and alcohol use disorders in young adulthood. Gen Hosp Psychiatry, 31(5), 2009.
Source
General Hospital Psychiatry
Kagan Could Be Confirmed Thursday Afternoon
With a Senate vote expected this afternoon, Elena Kagan's confirmation to become the fourth woman to serve on the Supreme Court is essentially "assured," the AP/Atlanta Journal-Constitution reports. Nearly every Senate Democrat, the chamber's two independents and a number of Republican senators have said they will support Kagan, ensuring more than enough votes to secure the confirmation (Hirschfeld Davis, AP/Atlanta Journal-Constitution, 8/5).
As of Thursday morning, only three Republicans had not announced how they will vote on Kagan, according to CQ Today. Among this group, Sens. Scott Brown (Mass.) and Christopher Bond (Mo.) are considered "possible 'yes' votes," CQ Today reports. Bond -- who opposed Kagan's nomination to become solicitor general but supported President Obama's first Supreme Court nominee, Justice Sonia Sotomayor, last year -- said Wednesday that he still hopes to meet with Kagan before the vote. Republican Sen. Mike Enzi (Wyo.) also has not said how he will vote.
So far, five Republicans have pledged to support Kagan and only one Democrat -- Sen. Ben Nelson (Neb.) -- plans to vote against her. Thirty-three Republican senators have said they plan to oppose Kagan. Even if Bond and Brown both support Kagan, she is likely to receive fewer "yes" votes than the 68 -- including nine Republicans -- that Sotomayor garnered last year (Stern, CQ Today, 8/4). Republicans are not expected to mount a filibuster against Kagan's confirmation (Oliphant, Los Angeles Times, 8/5).
Ginsburg Considers Possibility of Three Female Justices 'Exhilarating'
If confirmed, Kagan would become the third female justice on the current court, joining Justices Sotomayor and Ruth Bader Ginsburg. Ginsburg, the second woman ever to serve on the Supreme Court, said the prospect of three women serving simultaneously is "one of the most exhilarating developments."
According to the AP/San Diego Union-Tribune, there has been "persistent speculation that Ginsburg could retire next year and give Obama his third vacancy to fill." However, Ginsburg -- who is 77 years old and has undergone treatment for pancreatic cancer -- said she hopes to serve until age 82, the age at which former Justice Louis Brandeis retired (Sherman, AP/San Diego Union-Tribune, 8/4).
U.S. News & World Report Columnist Considers Kagan's Influence on Court
The "conventional wisdom" is that Kagan would "not change much on the court" because "she's a liberal justice replacing her fellow liberal, retir[ed] Justice John Paul Stevens," U.S. News & World Report columnist Mary Kate Cary writes. However, Kagan's confirmation would create "a critical mass" of women on the bench "that will change the way the group once called the 'brethren' will approach its work," Cary says, adding, "A lot of the difference has to do with the kind of questions women ask." Cary notes that the presence of women in newsroom and boardrooms changed the face of journalism and corporate culture because women see the world differently than men and tend to ask different types of questions (Cary, U.S. News & World Report, 8/4).
Washington Times Editorial Advocates Filibuster
A Washington Times editorial argues that opponents of Kagan's confirmation "should use every parliamentary tool available," including the filibuster, "to delay a final confirmation vote until after the August recess." Because the "new Supreme Court term doesn't start until October, ... [a] delay doesn't hurt anything," the editorial continues, concluding that a fight against Kagan is "a battle that needs to be waged" (Washington Times, 8/4).
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.
HPV DNA Testing Detects Lesions Earlier, Allowing Screening Interval To Be Longer
The DNA testing of HPV (human papillomavirus) identifies lesions which can lead to cervical cancer earlier than conventional cytological techniques do. This earlier identification may make it such that the screening interval be longer, according to an article published in The Lancet.
Professor Chris Meijer, VU University Medical Centre, Amsterdam, Holland, and team looked at 17,155 women who had been taking part in the regular screening program in The Netherlands; they were aged 29-56 years. 8,575 of them underwent HPV DNA testing to identify the high-risk types of HPV which cause cervical cancer. The Other 8,580 received conventional cytological testing. After a period of five years, both groups underwent cytological testing as well as DNA testing.
The researchers already know that genetic HPV testing detects more CIN lesions. What they did not know, and wanted to find out, was whether these lesions were non-regressive cancer precursors. They found that CIN3+ lesions (cervical cancer and its most serious precursor lesions) were identified in 68 women who underwent HPV DNA testing, compared to 40 in the cytological testing group. After five years, 24 women were detected with CIN3+ lesions in the HPV DNA group, versus 56 in the cytological testing group.
Even though the number of women with CIN3+ lesions detected during the two rounds of tests did not differ between the two groups, those in the HPV DNA testing group had their lesions detected earlier, the authors explained.
"Our results show that implementation of HPV DNA testing in cervical screening leads to earlier detection of clinically relevant cervical lesions. On the basis of this data, we suggest that the current screening interval of five years could be extended by at least one year. The extension will be advantageous to women because of a reduction in the lifetime number of screening tests and referrals," the authors wrote.
"A full cost-effectiveness analysis will help to determine whether primary HPV testing alone is the preferred strategy for primary cervical screening," they concluded.
thelancet
Professor Chris Meijer, VU University Medical Centre, Amsterdam, Holland, and team looked at 17,155 women who had been taking part in the regular screening program in The Netherlands; they were aged 29-56 years. 8,575 of them underwent HPV DNA testing to identify the high-risk types of HPV which cause cervical cancer. The Other 8,580 received conventional cytological testing. After a period of five years, both groups underwent cytological testing as well as DNA testing.
The researchers already know that genetic HPV testing detects more CIN lesions. What they did not know, and wanted to find out, was whether these lesions were non-regressive cancer precursors. They found that CIN3+ lesions (cervical cancer and its most serious precursor lesions) were identified in 68 women who underwent HPV DNA testing, compared to 40 in the cytological testing group. After five years, 24 women were detected with CIN3+ lesions in the HPV DNA group, versus 56 in the cytological testing group.
Even though the number of women with CIN3+ lesions detected during the two rounds of tests did not differ between the two groups, those in the HPV DNA testing group had their lesions detected earlier, the authors explained.
"Our results show that implementation of HPV DNA testing in cervical screening leads to earlier detection of clinically relevant cervical lesions. On the basis of this data, we suggest that the current screening interval of five years could be extended by at least one year. The extension will be advantageous to women because of a reduction in the lifetime number of screening tests and referrals," the authors wrote.
"A full cost-effectiveness analysis will help to determine whether primary HPV testing alone is the preferred strategy for primary cervical screening," they concluded.
thelancet
National Organization for Women Establishes Kansas Abortion-Rights PAC To Fill Void After Death Of Abortion Provider Tiller
The Kansas chapter of the National Organization for Women has formed its own political action committee to replace ProKanDo, a PAC founded in 2002 by abortion provider George Tiller that was closed after his murder in May, the AP/Hays Daily News reports. ProKanDo spent more than $1 million over the last four years to advocate for abortion rights, assist candidates who support abortion rights and oppose antiabortion-rights candidates. The organization had more than 6,400 contributors but received between one-third and one-half of its annual funding from Tiller, according to former Director Julie Burkhart.
NOW has scheduled a conference in Wichita on July 25 to discuss legislative strategy and Kansas elections. Marla Patrick, coordinator of NOW's Kansas chapter,? said that although the new PAC will not have the same financial support from Tiller that ProKanDo received, his death has invigorated grassroots support. She added, "I think that can be every bit as effective, if not more so, especially in light of all the recent events" (Hegeman, AP/Hays Daily News, 7/18).
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.
NOW has scheduled a conference in Wichita on July 25 to discuss legislative strategy and Kansas elections. Marla Patrick, coordinator of NOW's Kansas chapter,? said that although the new PAC will not have the same financial support from Tiller that ProKanDo received, his death has invigorated grassroots support. She added, "I think that can be every bit as effective, if not more so, especially in light of all the recent events" (Hegeman, AP/Hays Daily News, 7/18).
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.
Women In Namibia Call For Efforts To Improve Sexual Rights, Curb Spread Of HIV
A group of women in Namibia recently called for efforts to improve their sexual rights in an effort to curb the spread of HIV in the country, the New Era reports. "Women should know about their sexual rights; it is very important, especially for women in rural areas where men, more often than not, abuse women," advocate Vicky Schimming said at a recent workshop on sexual rights, culture and HIV/AIDS. The workshop is part of a nationwide campaign, organized by the group Sister Namibia, that was launched in 2000 to examine the sexual and cultural practices that violate women's rights and contribute to the spread of HIV. According to Sister Namibia Director Liz Frank, the campaign also aims to collect case studies for a handbook on sexuality in Namibia and bolster local capacity to hold workshops on the connections between HIV/AIDS, poverty, some cultural practices and sexual violence.
"Everyone talks about the need to change behavior to stop the spread of HIV/AIDS, but there is hardly any discussion on the need to change harmful sexual cultural practices that are often the drivers of the disease," Frank said. According to workshop participant Ngondi Ngatjiheue, women in some parts of the country are not able to make choices about sex. "Sex is difficult," she said, adding that a woman "cannot ask to have sex with [her] husband, and [she] cannot refuse him when he wants sex." Ngatjiheue also said that women do not have the power to negotiate condom use. "If you insist, your husband or partner will accuse you of infidelity," she said, adding, "It is only a small percentage of men who will accept the use of condoms."
According to Namibia's 2007 National HIV/AIDS Policy, traditional leaders should be provided with education about the risks of some customs and practices. In addition, the policy says that people involved with traditional initiations are required to use accurate and appropriate sex and reproductive health education and that unsafe practices should be stopped, modified or replaced with alternative practices (Sasman, New Era, 10/3).
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.
© 2008 Advisory Board Company and Kaiser Family Foundation.? All rights reserved.
"Everyone talks about the need to change behavior to stop the spread of HIV/AIDS, but there is hardly any discussion on the need to change harmful sexual cultural practices that are often the drivers of the disease," Frank said. According to workshop participant Ngondi Ngatjiheue, women in some parts of the country are not able to make choices about sex. "Sex is difficult," she said, adding that a woman "cannot ask to have sex with [her] husband, and [she] cannot refuse him when he wants sex." Ngatjiheue also said that women do not have the power to negotiate condom use. "If you insist, your husband or partner will accuse you of infidelity," she said, adding, "It is only a small percentage of men who will accept the use of condoms."
According to Namibia's 2007 National HIV/AIDS Policy, traditional leaders should be provided with education about the risks of some customs and practices. In addition, the policy says that people involved with traditional initiations are required to use accurate and appropriate sex and reproductive health education and that unsafe practices should be stopped, modified or replaced with alternative practices (Sasman, New Era, 10/3).
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.
© 2008 Advisory Board Company and Kaiser Family Foundation.? All rights reserved.
Mothers Of Women With An Endocrine Disorder Have Increased Risk Of Cardiovascular Disease
Mothers of women with a
common endocrine disorder -- polycystic ovary syndrome (PCOS) -- provide
evidence that menstrual irregularity and unhealthy metabolic traits
associated with PCOS are inherited and persist with age, according to a new
study published today in the Proceedings of the National Academy of
Sciences (www.pnas).
"There have been few studies looking at the long-term consequences of
PCOS," said senior author Andrea Dunaif, M.D., President of The Endocrine
Society and Chief of Endocrinology, Metabolism and Molecular Medicine of
the Feinberg School of Medicine at Northwestern University in Chicago. "The
results of our study strongly suggest that metabolic problems will continue
as women with PCOS age, putting them at a high risk for cardiovascular
disease and type 2 diabetes."
PCOS is a common problem affecting about 7% young adult women. Women
with this disorder have irregular menstrual cycles and elevated levels of
male hormones, or androgens, which may result in excessive facial hair
growth and acne. PCOS is frequently also associated with insulin resistance
and the syndrome is a leading cause of type 2 diabetes in adolescent and
young adult women. Women with PCOS also have elevations of low-density
lipoprotein (LDL, or "bad") cholesterol and a markedly increased prevalence
of a condition called metabolic syndrome. Another negative health feature
of PCOS is abnormal lipid levels, but the reasons are controversial.
Insulin resistance, type 2 diabetes, increased LDL levels and metabolic
syndrome all increase risk for cardiovascular disease.
Studies of women with PCOS, by definition, have been limited to women
in their reproductive years; therefore, little is known about their health
as they age. The long-term health consequences of PCOS are of considerable
importance because many of these women have risk factors that confer
substantially increased risk for developing cardiovascular disease and
other problems. It is well documented that PCOS runs in families. Though
limited, past studies of mothers of women with PCOS have shown increased
androgen levels, insulin resistance, and glucose intolerance, suggesting
that these traits are inherited.
Armed with this information, Dr. Dunaif and colleagues, Susan Sam, M.D.
and Richard S. Legro, M.D., of Pennsylvania State University College of
Medicine, in Hershey, Pa., wanted to test their hypothesis that abnormal
lipid levels are an inherited trait in families of women with PCOS as well
as look at the impact of age on reproductive and metabolic characteristics.
They studied 215 non-Hispanic white mothers of women with PCOS and 62
control women of comparable age, weight, and ethnicity, drawn from the
National Health and Nutrition Examination Survey III (NHANES III). The
study group was limited to non-Hispanic white women because of the
potential confounding effects of ethnicity on insulin sensitivity and lipid
levels. All participants were asked to complete a questionnaire on their
reproductive history, exercise habits, tobacco use, and alcohol intake.
In investigating lipid levels, the researchers found that mothers of
women with PCOS had elevated total and LDL cholesterol but triglycerides
and high- density lipoprotein (HDL, or "good") cholesterol did not differ
between the groups. The mothers had markers of insulin resistance. They
also had an increased prevalence of metabolic syndrome compared to
nationwide prevalence in normal women of similar age. The strongest
predictor of LDL levels in mothers was their daughters' LDL levels. The
researchers had previously found that elevated LDL levels are the
predominant lipid abnormality in women with PCOS, a finding that was
mirrored in the mothers' group.
Thirty-one percent of mothers reported a history of irregular menses.
There were no differences in age or body mass index between these mothers
and those with a history of regular menses. Mothers with menstrual issues
also had higher levels of androgens, glucose, and LDL compared with mothers
with a history of regular menses, suggesting, say researchers, that these
mothers may have had PCOS. Total testosterone and unbound testosterone
levels were higher in mothers with a history of irregular menses than in
the controls. The prevalence of hyperandrogenemia was likely underestimated
in this study because of a general decline in ovarian function with age,
which leads to lower circulating androgen levels.
"Our study shows that menstrual history is an accurate marker for PCOS
in both epidemiologic and genetic studies," said Dr. Legro.
Forty-seven percent of mothers had metabolic syndrome compared with 32
percent of the control group. There was a significant increase in the
prevalence of metabolic syndrome in obese mothers compared with the general
population represented by the women in NHANES III. Moreover, the
researchers believe that the prevalence of metabolic syndrome in mothers is
underestimated because mothers receiving medications for hypertension,
diabetes, or hyperlipidemia were excluded. Overall, these findings suggest
that mothers of women with PCOS should be screened for cardiovascular
disease risk factors.
This study was supported by grants from the National Institutes of
Health National Institute of Child Health and Human Development and Office
of Research on Women's Health.
Founded in 1916, The Endocrine Society is the world's oldest, largest,
and most active organization devoted to research on hormones, and the
clinical practice of endocrinology. Endocrinologists are specially trained
doctors who diagnose, treat and conduct basic and clinical research on
complex hormonal disorders such as diabetes, thyroid disease, osteoporosis,
obesity, hypertension, cholesterol and reproductive disorders. Today, The
Endocrine Society's membership consists of over 13,000 scientists,
physicians, educators, nurses and students, in more than 80 countries.
Together, these members represent all basic, applied, and clinical
interests in endocrinology. The Endocrine Society is based in Chevy Chase,
Maryland. To learn more about the Society, and the field of endocrinology,
visit the Society's web site at www.endo-society
The Endocrine Society
www.endo-society
www.pnas
common endocrine disorder -- polycystic ovary syndrome (PCOS) -- provide
evidence that menstrual irregularity and unhealthy metabolic traits
associated with PCOS are inherited and persist with age, according to a new
study published today in the Proceedings of the National Academy of
Sciences (www.pnas).
"There have been few studies looking at the long-term consequences of
PCOS," said senior author Andrea Dunaif, M.D., President of The Endocrine
Society and Chief of Endocrinology, Metabolism and Molecular Medicine of
the Feinberg School of Medicine at Northwestern University in Chicago. "The
results of our study strongly suggest that metabolic problems will continue
as women with PCOS age, putting them at a high risk for cardiovascular
disease and type 2 diabetes."
PCOS is a common problem affecting about 7% young adult women. Women
with this disorder have irregular menstrual cycles and elevated levels of
male hormones, or androgens, which may result in excessive facial hair
growth and acne. PCOS is frequently also associated with insulin resistance
and the syndrome is a leading cause of type 2 diabetes in adolescent and
young adult women. Women with PCOS also have elevations of low-density
lipoprotein (LDL, or "bad") cholesterol and a markedly increased prevalence
of a condition called metabolic syndrome. Another negative health feature
of PCOS is abnormal lipid levels, but the reasons are controversial.
Insulin resistance, type 2 diabetes, increased LDL levels and metabolic
syndrome all increase risk for cardiovascular disease.
Studies of women with PCOS, by definition, have been limited to women
in their reproductive years; therefore, little is known about their health
as they age. The long-term health consequences of PCOS are of considerable
importance because many of these women have risk factors that confer
substantially increased risk for developing cardiovascular disease and
other problems. It is well documented that PCOS runs in families. Though
limited, past studies of mothers of women with PCOS have shown increased
androgen levels, insulin resistance, and glucose intolerance, suggesting
that these traits are inherited.
Armed with this information, Dr. Dunaif and colleagues, Susan Sam, M.D.
and Richard S. Legro, M.D., of Pennsylvania State University College of
Medicine, in Hershey, Pa., wanted to test their hypothesis that abnormal
lipid levels are an inherited trait in families of women with PCOS as well
as look at the impact of age on reproductive and metabolic characteristics.
They studied 215 non-Hispanic white mothers of women with PCOS and 62
control women of comparable age, weight, and ethnicity, drawn from the
National Health and Nutrition Examination Survey III (NHANES III). The
study group was limited to non-Hispanic white women because of the
potential confounding effects of ethnicity on insulin sensitivity and lipid
levels. All participants were asked to complete a questionnaire on their
reproductive history, exercise habits, tobacco use, and alcohol intake.
In investigating lipid levels, the researchers found that mothers of
women with PCOS had elevated total and LDL cholesterol but triglycerides
and high- density lipoprotein (HDL, or "good") cholesterol did not differ
between the groups. The mothers had markers of insulin resistance. They
also had an increased prevalence of metabolic syndrome compared to
nationwide prevalence in normal women of similar age. The strongest
predictor of LDL levels in mothers was their daughters' LDL levels. The
researchers had previously found that elevated LDL levels are the
predominant lipid abnormality in women with PCOS, a finding that was
mirrored in the mothers' group.
Thirty-one percent of mothers reported a history of irregular menses.
There were no differences in age or body mass index between these mothers
and those with a history of regular menses. Mothers with menstrual issues
also had higher levels of androgens, glucose, and LDL compared with mothers
with a history of regular menses, suggesting, say researchers, that these
mothers may have had PCOS. Total testosterone and unbound testosterone
levels were higher in mothers with a history of irregular menses than in
the controls. The prevalence of hyperandrogenemia was likely underestimated
in this study because of a general decline in ovarian function with age,
which leads to lower circulating androgen levels.
"Our study shows that menstrual history is an accurate marker for PCOS
in both epidemiologic and genetic studies," said Dr. Legro.
Forty-seven percent of mothers had metabolic syndrome compared with 32
percent of the control group. There was a significant increase in the
prevalence of metabolic syndrome in obese mothers compared with the general
population represented by the women in NHANES III. Moreover, the
researchers believe that the prevalence of metabolic syndrome in mothers is
underestimated because mothers receiving medications for hypertension,
diabetes, or hyperlipidemia were excluded. Overall, these findings suggest
that mothers of women with PCOS should be screened for cardiovascular
disease risk factors.
This study was supported by grants from the National Institutes of
Health National Institute of Child Health and Human Development and Office
of Research on Women's Health.
Founded in 1916, The Endocrine Society is the world's oldest, largest,
and most active organization devoted to research on hormones, and the
clinical practice of endocrinology. Endocrinologists are specially trained
doctors who diagnose, treat and conduct basic and clinical research on
complex hormonal disorders such as diabetes, thyroid disease, osteoporosis,
obesity, hypertension, cholesterol and reproductive disorders. Today, The
Endocrine Society's membership consists of over 13,000 scientists,
physicians, educators, nurses and students, in more than 80 countries.
Together, these members represent all basic, applied, and clinical
interests in endocrinology. The Endocrine Society is based in Chevy Chase,
Maryland. To learn more about the Society, and the field of endocrinology,
visit the Society's web site at www.endo-society
The Endocrine Society
www.endo-society
www.pnas
Marie Stopes Discusses Birth Control With Islamic Leaders In Afghanistan
Marie Stopes International is leading seminars in Afghanistan that explain the benefits of birth control to Islamic religious leaders known as mullahs, the New York Times reports. Afghanistan has a fertility rate of six children per woman, the highest in Asia. The country is second only to Sierra Leone in maternal mortality, with the rate as high as 8% in some areas of Afghanistan. According to the Times, although Islam does not necessarily forbid birth control, mullahs "consider children to be blessings from God" and "are usually the most determined opponents of having fewer of them."
The Times reports the mullahs were reluctant to participant in the seminars and were paid to attend. However, some emerged from a recent session with a positive outlook. The sessions are led by a mullah with the assistance of a doctor, and the messages are related to the Koran. Seminar leaders aim to convey that having children is good but that women shouldn't have too many of them and should wait two years between pregnancies to give their bodies time to recover.
Syed Masoom, a mullah and one of the trainers, said urban Afghans are looking for ways to have fewer children. He said the country is changing and mullahs are the best place to start to instigate further change. He explained, "This is an Islamic country," adding, "If the clerics support this, no one will oppose it."
Marie Stopes is also working with Afghan women to distribute birth control door to door in Kabul. In 2009, sales of birth control pills almost doubled from 6,000 packages in January to 11,000 in September, according to Marie Stopes figures. Although many women are receptive to the pills, Marie Stopes workers say that the most difficult houses at which to distribute birth control are those headed by mullahs, and some women choose to use contraception in secret (Tavernise, New York Times, 11/15).
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.
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