Nipple Piercing And Breastfeeding - Are They Compatible?

Until recently, the option to breastfeed after birth was not offered to women with nipple piercings. While there may have been assumed implications to breastfeeding when pierced, limited documentation exists.


Now, there exist organizations that promote breast-feeding for those women and teach nurses how to deal with them on an individual basis. "The challenge for perinatal nurses becomes how to intervene to maximize opportunities for breastfeeding success in women with nipple piercings," says Dr. Armstrong. While nurses are now encouraged to offer breastfeeding as an option, there are still reservations regarding the results.


In the past, breastfeeding supporters have said it is safe for pierced women to breastfeed, but noted there could be serious risks involved in doing so. Infants can aspirate on the jewelry and the metal of the jewelry can cause trauma to an infant's lips, palate, tongue and gums, according to an article in the June/July issue of AWHONN Lifelines presenting findings from research about women's breastfeeding success when the nipple is pierced.


"Careful history taking and physical assessment of the breasts at (prenatal) time affords the opportunity for nurses to provide pierced women with factual information about nipple piercing and breastfeeding," says lead author Myrna L. Armstrong. By considering the piercing as an integral part of the breastfeeding decision process, prenatal nurses can help foster breastfeeding success.


Dr. Myrna L. Armstrong, EdD, RN, FAAN, is a professor in the Health Sciences Center School of Nursing at Texas Tech University in Lubbock, TX. She has been involved in a program of research with patient education examining various elements of body art since 1990.


About AWHONN Lifelines


AWHONN Lifelines is the official clinical practice management magazine of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN). Lifelines presents the practical application of evidence and innovation within the most important women's health, obstetric and neonatal topics, such as cardiovascular, reproductive and perimenopausal health, cancers in women, nutrition, aging well, normal and high-risk labor and birth, and newborn care. Lifelines is read by more than 23,000 clinical and advanced practice nurses and other health care professionals involved in providing optimum nursing care for women and their newborns.



For more information, please visit:

blackwellpublishing/jognn

awhonn

ACOG Statement On Revised US Preventive Services Task Force RecommendationsOn Breast Cancer Screening

In response to today's US Preventive Services Task Force (USPSTF) statement that recommends against routine mammography screening for women in their 40s and recommends screening only once every two years for women ages 50 to 74, The American College of Obstetricians and Gynecologists (ACOG) maintains its current advice that women in their 40s continue mammography screening every one to two years and women age 50 or older continue annual screening. The USPSTF revised recommendations are published in the November 17, 2009, issue of Annals of Internal Medicine. (Read more.)


As the organization representing the nation's ob-gyns who provide health care exclusively for women, ACOG welcomes these new review data on breast cancer screening. However, the implications of the USPSTF's recommendations for both women and physicians are not insignificant and require that ACOG evaluate both the data and the USPSTF's interpretations in greater detail. All women, along with their physicians, should individually assess the benefits and as well as the risks of mammography screening.


The USPSTF also recommends against clinicians teaching women how to perform breast self-exams (BSE). At this time, ACOG's position is that ob-gyns should continue to counsel women that BSE has the potential to detect palpable breast cancer and can be performed.


ACOG strongly supports shared decision making between doctor and patient, and in the case of screening for breast cancer, it is essential.


Source

American College of Obstetricians and Gynecologists (ACOG)

Don't take HRT just to ward off cardiovascular disease

Doctors should not recommend that post-menopausal women start hormone replacement therapy (HRT) just to prevent
cardiovascular events. Also, women at particular risk of blood clots should be discouraged from using HRT to prevent
cardiovascular events.


Post-menopausal women are at higher risk of cardiovascular disease (CVD) than younger women. There are sound biological
arguments why giving post-menopausal women extra oestrogen might protect them from CVD, and various uncontrolled studies
appear to confirm this idea. However, the question of whether HRT has a long-term benefit for women at risk of CVD is
unresolved.


To answer this, Cochrane Review Authors drew on data from 10 large, well run studies. Pooling the results they were able to
compare the effects of giving HRT to 12,353 women, with giving placebos to 11,930 other women.


They concluded that giving HRT does not protect post-menopausal women from CVD. In addition, women who have specific risks
that may make them prone to suffer from blood clots should be discouraged from taking HRT at all.


Review title: Gabriel S?nchez et al: Hormone replacement therapy for preventing cardiovascular disease in post-menopausal
women. The Cochrane Database of Systematic Reviews 2005 Issue 2.


The Cochrane Library newsletter, 2005, issue 2

The best single source of reliable evidence about the effects of health care


John Wiley & Sons, Inc.

interscience.wiley

New Research Findings May Enable Earlier Diagnosis Of Uterine Cancer

Cancer is a genetic disease. It occurs when changes take place in the genes that regulate cell division, cell growth, cell death, cell signalling and blood vessel formation - either due to mutations caused by external factors such as smoking or radiation - or due to inherited changes. This interaction between defective genes and environmental factors means that cancer is an extremely complex disease. Cancer of the uterus, or endometrial carcinoma, is no exception.



Cancer of the uterus is the commonest gynaecological malignancy in the West and accounts for between five and six per cent of all cancers in Swedish women. However, the symptoms are often vague, and we know little about the genetic factors that lead to the appearance and development of this form of cancer. It is therefore vital that these genes are identified, as this could enable doctors to make the diagnosis much more quickly and easily, allowing the development of more effective cancer treatment.



In her study, Sandra Karlsson, a researcher at the Department of Cell and Molecular Biology, has used inbred rats to locate the defective genes that cause uterine cancer. Like monozygotic (identical) twins, these inbred rats are genetically almost identical, which makes it much easier to study the influence of the environment in which they live.



"More than 90 per cent of the female rats in the study spontaneously developed uterine cancer. By using advanced techniques to analyse gene expression in the tumours, we succeeded in identifying a gene signature that could be used as a future diagnostic test for human uterine cancer," says Sandra Karlsson.



The signature is made up of three genes. One of them protects the cell against oxygen free radicals. These free radicals are naturally and continuously produced in the cell, but excess amounts, which can damage the cell and the body's DNA, are associated with over 200 diseases, from arteriosclerosis and dementia to rheumatism, cerebral haemorrhage and cancer. The studies carried out by Sandra Karlsson on human malignant tumours have confirmed that changes in this gene are present in early as well as late stage cancer.



"This shows that the identified gene has an important role in the origin and development of uterine cancer," says Sandra Karlsson.







The thesis Gene Expression Patterns in a Rat Model of Human Endometrial Adenocarcinoma was publicly defended on the December 19th. Supervisor - Professor Karin Klinga Levan.



Source: Sandra Karlsson


University of Gothenburg

New York Times Editorials React To Reproductive Health-Related Issues In Health Reform Law

The New York Times recently published two editorials pertaining to the federal health reform law (PL 111-148).

~ Abortion: "In the fierce debate over health care reform, the United States Conference of Catholic Bishops charged that the legislation didn't do enough to restrict insurance coverage of abortions," while several "Catholic nuns and the Catholic Health Association of the United States, which represents hundreds of Catholic hospitals, looked at the same bill and concluded that it would have no effect on abortion financing," the Times writes. Bishop Lawrence Brandt of Greensburg, Pa., is now "punishing" nuns who signed a letter in support of the reform bill, the editorials states, adding that Brandt "has decreed that 'any religious community' that signed the letter would be forbidden to use the diocese's offices, parishes or newspaper to promote programs that encourage young people to consider the religious life." Brandt alleges that the nuns took "a public stance in opposition to the church's teaching on human life," according to the editorial. The nuns "saw the bill as a powerfully positive step, because it provided health insurance to millions of people without it, and hundreds of millions of dollars for the care of pregnant women," the editorial states. It concludes that the nuns who signed the letter "showed courage and compassion when they spoke out for reform. It makes no sense at all to try to punish them or thwart their efforts to find new sisters who would care for the sick and dying and lead exemplary Catholic lives" (New York Times, 5/1).

~ Rescissions: "Americans are already starting to see benefits of health care reform," a Times editorial states. Although the "new law requires health insurance companies -- starting in September -- to end their most indefensible practice: rescinding coverage after a policyholder gets sick," several insurers and their trade associations in recent days "have rushed to announce that they will end rescissions immediately," according to the editorial. Those announcements follow the release of an "investigative report by Reuters" that found that WellPoint, one of the nation's largest insurers, targeted women with breast cancer "for fraud investigations that could lead to rescissions," the editorial states. "WellPoint fiercely denied singling out breast cancer patients for scrutiny" but "acknowledged using computer algorithms to search for a range of conditions that applicants would likely have known about at the time they applied," according to the Times. This is "very good news for the thousands of people who each year pay their premiums but lose their coverage just when they are likely to run up big medical bills," the Times writes (New York Times, 5/3).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2010 The Advisory Board Company. All rights reserved.

China's Henan Province Bans Sale Of Drugs For Medical Abortion

China's Henan province on Monday banned the sale of drugs for medical abortions in coordination with the province's efforts to maintain gender balance among infants, Xinhua/China Daily reports. People who violate the law could receive fines of between $385 and $2,564 and risk having their illegal profits seized by the state, and a pregnant woman who undergoes an abortion illegally could face a fine of $256. According to Xinhua/China Daily, local government sources said the ban could be seen as a measure to support regulations prohibiting sex-selective abortion in the province. Under those regulations, which took effect on Monday, abortion is permitted only if the fetus has a serious hereditary disease or severe birth defect, if continuation of gestation will damage the health or life of the pregnant woman, or if the pregnant woman is divorced or widowed (Xinhua/China Daily, 1/3). A 2000 census found that the ratio of infant boys to infant girls in Henan was about 118 boys for every 100 girls. The worldwide ratio is about 107 boys to 100 girls (BBC News, 1/3). According to the Henan Population and Family Planning Commission, the direct cause of the imbalance was gender identification with "advanced technology" and abortions of female fetuses (Xinhua/China Daily, 1/3). Sex-selective abortion is banned nationwide, but physicians who help people determine a fetus' sex for nonmedical reasons generally face only administrative penalties (Kaiser Daily Women's Health Policy Report, 8/3/06).

"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.

Pre-eclampsia Kidney Disease Link

Pre-eclampsia is a complication in pregnancy occurring in approximately eight percent of all pregnancies. It is characterised by elevated blood pressure and protein in the urine. It generally develops after 20 weeks of pregnancy.


Medical doctor and researcher Bjoern Egil Vikse from the Department of Medicine at University of Bergeb is the first author of an upcoming article in the March issue of the Journal of the American Society of Nephrology.


Vikse explains that there were two reasons for becoming involved in this work. The first was that a collegaue had previously found a strong correlation between pre-eclampsia and a later incidence of cardiovascular disease. The second is that UiB researchers have a unique research tool. They have access to two large databases: one is a birth registry; the other is a kidney biopsy registry. This enables them to use large, well-documented data pools in their work.


The Birth Registry provided Vikse with data from 1967 and the Kidney Biopsy Registry dates from 1988.


Unexpectedly strong correlation


Vikse and his colleagues first compared data from the two registries to see if there was a correlation between the children of mothers who had experienced pre-eclampsia and incidence of kidney disease in these children. They found no correlation.


They then compared the two databases for a possible correlation between the incidence of pre-eclampsia and later incidence of kidney disease in the mothers and found an unexpectedly strong result.


"We were amazed that the correlation was so strong," says Vikse. The data showed that pre-eclampsia alone was responsible for the mothers having a 3.3% increased risk of developing kidney disease later. If, in addition, the child had a low birth weight, the risk increased to a 4.8% increased risk with low birth-weight and a dramatic17% increased risk with very low birth-weight.


Another unexpected finding was that the increased risk was not associated with any particular kidney disease: all kidney diseases had a similar increased risk.


"You would expect the risk increase to be linked to a particular disease," explains Vikse. "It was most unusual to find that this was not the case."


Future directions


Vikse explains that the researchers will now try to characterise the correlation further as well as checking for correlations with other medical conditions such as kidney failure. Studies into the development of both pre-eclampsia and kidney disease are also needed to see if there are any similarities between the mechanisms by which both medical conditions develop.


According to Vikse, there are also more far-reaching consequences as well. This result suggests that information about having experienced a pregnancy with pre-eclampsia should be included in a woman's medical history record. Such women need to be followed up for the rest of their lives because of their increased risk of cardiovascular and kidney disease.


www.uib.no/info/english


RESEARCH COUNCIL OF NORWAY

P.O Box 2700,

St.Hanshaugen,

N-0131,

Oslo,

forskningsradet.no


About the RESEARCH COUNCIL OF NORWAY>/b>


The Research Council of Norway plays a vital role in developing and implementing the country''s national research strategy. It acts as: * a government adviser, identifying present and future needs for knowledge and research; * a funding agency for independent research programmes and projects, strategic programmes at research institutes, and Norwegian participation in international research programmes; * a co-ordinator, initiating networks and promoting co-operation between R&D institutions, ministries, business and industry, public agencies and enterprises, other sources of funding, and users of research. The Executive Board of the Research Council of Norway is responsible for the Council''s policy at the national level. Six research boards, one for each research division, submit annual strategic plans and budgets to the main Executive Board for final approval. Important research priorities according to the Research Council are: * basic research * marine research * information and communication technology * health research * energy and climate research * biotechnology * petroleum research * material science Approximately one third of Norway''s public sector research investment is channelled through the Research Council. The remainder is transferred directly from the ministries to the relevant research institutions. In 1999, Norway spent a total of NOK 20 billion on R&D, of which public sector allocations accounted for roughly NOK 8.5 billion. In 2003 the Research Council of Norway has a budget of NOK 4,4 billion.

Early Detection Of Second Breast Cancers Halves Women's Risk Of Death

A group of international researchers has found the first reliable evidence that early detection of subsequent breast tumours in women who have already had the disease can halve the women's chances of death from breast cancer.



According to the research published online in the cancer journal, Annals of Oncology [1], if the second breast cancer was picked up at its early, asymptomatic stage, then the women's chances of survival were improved by between 27-47% compared to women whose second breast cancer was detected at a later stage when symptoms had started to appear.



Until now, the impact of early detection of second breast cancers was unclear. Attempts to investigate it have been complicated by the fact that it is not possible to run randomised controlled trials because women who have already had one breast cancer are at higher risk of a relapse or a second breast cancer and, therefore, are generally advised to have regular breast checks as part of their follow-up care. What studies there have been have not made adjustments for the main factors that could bias the findings from a non-randomised study and often have looked at breast cancers occurring in either the same breast (ipsilateral relapse) or the other breast (contralateral) but not either breast.



The current study looked at 1,044 women who had attended one clinical centre in Florence (Italy) between 1980-2005 and who had developed a second breast cancer. In that time 455 women had ipsilateral breast cancers (IBC) diagnosed and 589 women had contralateral breast cancers (CBC) diagnosed. Of these second cancers, 699 (67%) were asymptomatic and 345 (33%) were symptomatic.



The researchers found that mammography was more sensitive than clinical examination for detecting second cancers (86% versus 57%). However, 13.8% of cases were only detected by clinical examination. Asymptomatic cancers were smaller than symptomatic for both IBC and CBC; early stage cancers were more frequent in asymptomatic (58.1%) than in symptomatic (22.6%) women; and fewer women with asymptomatic than symptomatic CBC had node metastases (an indicator that the cancer may have spread).



In the analysis of the results, the researchers (from Italy, Australia and the UK) adjusted to allow for lead-time bias (bias caused by an earlier detection of the cancer) and length-time bias (bias caused by the fact that some breast cancers develop more slowly than others and, therefore, are more likely to be detected at the asymptomatic stage and are less likely to cause death).



Associate Professor Nehmat Houssami, a breast physician and principle research fellow at the University of Sydney's School of Public Health, Australia, who led the study, said: "Intuitively, it makes sense to consider that early detection of second breast cancers will improve prognosis, since breast cancer survivors have a long-term risk of developing further disease or relapse in either breast. However, due to a paucity of evidence about this until now, current recommendations on surveillance of breast cancer survivors vary substantially between countries and organisations.
















"Our study provides new evidence on several aspects of early detection of second breast cancers. We set out to estimate the effect of early, asymptomatic detection while adjusting for the two main biases known to be associated with non-randomised studies of the impact of early detection - lead time and length bias - so we believe that the estimates we report are more valid than previously reported estimates, while acknowledging the limitation that the evidence is not from a randomised controlled trial.



"In addition, we have estimated this for early detection of either ipsilateral or contralateral breast cancer, while other studies have focused on one or the other. So our estimates may be more useful for clinicians discussing this aspect of breast cancer follow-up with their patients."



She continued: "To our knowledge, this is the only study to have taken length-time bias into account when quantifying the impact of early, asymptomatic detection of breast cancer. This is important because slow-growing or indolent cancers have a much smaller probability of proving fatal, and this group of women will tend to be over-represented in the early-detected cancers, biasing the effect of screening to make it appear more beneficial."



In their paper, the researchers write: "Recommendations on follow-up after treatment of early breast cancer should consider our findings, which suggest that early detection of second breast cancer events improves prognosis in this ever-increasing group of women."



Prof Houssami said: "Periodic surveillance of women with BC is currently under scrutiny in some countries and questions have been raised as to the value of sustained follow-up of breast cancer survivors in some health settings. So I think this work provides a timely reminder of the potential benefit of early detection of second breast cancers and supports ongoing surveillance in this group of women."



She said that their finding that nearly 14% of second breast cancers were only detected by clinical examination and that mammograms had a sensitivity of 86% was also important. "There are health settings where new imaging (ultrasound or MRI) is advocated for screening because of the belief that mammography is not sufficient and misses too many cancers in breast cancer survivors. Our data suggest that mammography, with clinical examination, is sensitive and effective (with the caveat that the Florence centre where the study originated has established experience in mammography of at least 40 years). We feel that additional screening imaging should only be used selectively, for example, in women with extremely dense breasts, or when investigating questionable findings from the mammogram or clinical examination."



Prof Houssami concluded: "The next step is to determine how to maximise early detection in this specific setting while ensuring feasibility and efficiency. One possibility currently under exploration would be to estimate the risk of a symptomatic tumour and the stage of the symptomatic tumour by time since the last mammogram. There are many questions about the optimal process and model of surveillance, such as frequency for surveillance and who should be performing longer-term surveillance in breast cancer patients, that we have not addressed in this study. These issues require further research."



[1] Early detection of second breast cancers improves prognosis in breast cancer survivors. Annals of Oncology. doi:10.1093/annonc/mdp037



Annals of Oncology is a monthly journal published on behalf of the European Society for Medical Oncology (ESMO) by Oxford Journals.

Source
Annals of Oncology

Long Haul Flights Double Risk Of Blood Clots, Says WHO Report

The results from phase I of a group of studies by the World Health Organization (WHO) on the hazards of travel suggest that travellers who sit immobile
for four hours or more, for example in a plane, train, bus or car, are doubling their risk of getting a blood clot (venous thromboembolism or VTE).


The absolute risk of developing a blood clot is still quite small however: double a very small number and you still have a relatively small number. The
absolute risk of developing VTE from being seated immobile for four hours or more is about 1 in 6,000 the study concluded.
This is the main finding of Phase I of the WHO Research Into Global Hazards of Travel (WRIGHT) project, which was released today.
The VTE occurs when the blood stagnates in the veins after being seated for a long time. VTE usually leads to a deep vein thrombosis (DVT) and pulmonary
embolism.
A deep vein thrombosis (DVT) is where a blood clot or thrombus occurs in a deep vein, usually in the lower part of the leg.

Symptoms of DVT include localized pain, tenderness and swelling. It is life-threatening when it happens together with thromboembolism, where part or all of
the blood clot breaks off and travels to the lungs where it lodges in a blood vessel and becomes a pulmonary embolism that blocks the flow of essential
blood. Symptoms of pulmonary embolism include pains in the chest and difficulty breathing.
DVT can be detected and treated, and so can VTE, but if it is not, it can be fatal.
One of the studies in the WRIGHT project looked at flying in particular. It showed that taking several flights over a short period of time also put
travellers at higher risk of developing VTEs. This is because the elevated risk of a VTE from one flight stays high for about four weeks, and if more flights are
made in those four weeks, the risk accumulates.
The WRIGHT report showed that other factors that can elevate a traveller's risk of getting a VTE include:

Being obese.
Being very tall or very short (taller than 1.9 metres or 6 ft 3 in, or shorter than 1.6 metres or 5 ft 3 in).
Using oral contraceptives.
Inherited blood disorders that lead to increased clotting tendency.

The study did not investigate how to prevent DVT or VTE but experts do say that travellers should move their feet up and down at the ankle to exercise their
calf muscles and get the blood circulating in their lower legs.
Also, travellers should not wear tight clothes during travel because they encourage blood stagnation.
The authors suggest that transport authorities, airlines and doctors should inform travellers about the risk of getting VTE while travelling.
They said further studies should be done to determine the most effective ways to prevent VTEs. This is the goal of Phase II of the WRIGHT project, which is
awaiting further funding.
In the meantime the WHO advises passengers to consult their doctors about the risks of VTE before they travel.
The WRIGHT project was set up following the report in 2000 of a young female English traveller who died from a pulmonary embolism after a long haul flight
from Australia. Later in that year, the Select Committee on Science and Technology of the United Kingdom House of Lords recommded research be done on DVT
and associated risks and an expert group was convened by the WHO the following Spring, six years ago.
Phase I of the WRIGHT project was funded by the UK Government's Department for Transport and Department of Health and the European Commission.
The purpose of Phase I was to confirm whether air travel increased the risk of VTE and if so by how much.
There were five studies altogether, conducted by researchers from the Universities of Leiden, Amsterdam, Leicester, Newcastle, Aberdeen and Lausanne. The
studies were:

A case controlled population study on the risk factors of VTE.
Two retrospective cohort studies on employees of international organizations and Dutch commercial pilots that investigated risk of VTE due to air
travel.
Two pathophysiological studies that investigated the impact of immobility on travel-related VTE, and the influence, if any, of low oxygen and low
pressure in the aircraft cabin on travel-related VTE.


Click here to see
the full WRIGHT report (PDF reader required).

: Catharine Paddock

Writer: blog

Blogs Comment On Health Reform, Maternal Mortality, Breast Cancer, Other Topics

The following summarizes selected women's health-related blog entries.

White House To Meet With Antiabortion Activists Next Week," Jake Tapper, ABC News' "Political Punch": Melody Barnes, domestic policy adviser to President Obama and director of the Domestic Policy Council, and White House Director of Public Liaison Tina Tchen on Thursday will meet with Charmaine Yoest of Americans United for Life Action to discuss reproductive rights-related issues in health reform proposals, the blog entry says. According to Yoest, the meetings' participants will discuss abortion, provider "conscience" clauses and care for the elderly. The meeting comes after Yoest wrote a letter to Obama in June. In the letter, Yoest said that health reform legislation "would delegate to bureaucratic committees the role of determining the minimum benefits that any private or public health care plan must offer," including family planning and abortion services. Yoest wrote that she is concerned that the bills do not include language that explicitly excludes coverage for abortion services, adding, "We're a non-partisan group so I felt like we in good faith needed to make the effort" to reach out to the White House (Tapper, "Political Punch," ABC News, 9/11).
"When Planning a Pregnancy Can Save a Woman's Life," Ana Langer, Huffington Post blogs: A recent UNICEF report "is the latest in a series of drumbeats for a concerted, large-scale campaign to save the lives of mothers and newborns worldwide, far too many of whom are dying from entirely preventable causes," Langer, president of EngenderHealth, writes. She adds that Congress should approve a spending increase for family planning and maternal health in the fiscal year 2010 Foreign Operations Bill (S 1434). According to Langer, 99% of the more than half million maternal deaths per year occur in developing countries, "where maternal care is scarce." The U.S. "can do our part" to reduce maternal mortality "by doing more to fund lifesaving efforts" like family planning services, Langer continues. "Education about, and access to, contraception is also critical for saving lives ... because when women and their partners are empowered to decide if and when to have children, it can significantly reduce the likelihood that mothers will die in childbirth," Langer writes. She adds, "In this day and age, no woman should die giving life," and "no woman should die because she was unable to plan her pregnancy." The health of women and their children "is the currency that stabilizes communities and allows for economic development," Langer continues, concluding, "That's what family planning is about, and it's why [it] should be included in any global effort to protect the lives of women and newborns" (Langer, Huffington Post blogs, 9/14).
"Stoking Fire: Anti-Choicers Target Komen Foundation," Eleanor Bader, RH Reality Check: The well-documented fact that an abortion or miscarriage does not increase a woman's risk of developing breast cancer "has failed to quiet" antiabortion groups and endocrinologist Joel Brind of Baruch College, who first claimed a link between abortion and breast cancer in the early 1980s, Bader writes. She adds that "apparently, preaching to their own hasn't gotten the antis adequate play, so they are now targeting Susan G. Komen for the Cure," a group that advocates for breast cancer treatment and research. The organization, which has raised more than $60 million for research, has been "dubbed ... a menace to women" by Roman Catholic dioceses across the U.S. and organizations like STOPP, an affiliate of the American Life League, Bader writes. She continues, "The naysayers have two objections," including "advis[ing] women to begin reproducing when they are young and warn[ing] them about the abortion/breast cancer connection." Bader adds, "Not surprisingly, this contention has gained little traction, even among right-wingers, so the anti-Komen posse has trucked out a reliable antiabortion bugaboo," the Planned Parenthood Federation of America, which receives grants for breast cancer screening and education programs from Komen. "Although it's far too soon to predict the upshot of the federal health care battle, by all accounts the anti-Komen campaign has fallen flat, doing little to hamper the group's ongoing efforts," Bader says (Bader, RH Reality Check, 9/15).
"Rights Group Calls Obama's Comments on Abortion in Health Reform 'Lamentable,'" Jodi Jacobson, RH Reality Check: Jacobson writes, "For women's rights groups, who saw health reform as a chance to advance reproductive justice -- including equity access for low-income women to all legal reproductive and sexual health services including abortion care -- the past few months have been a serious disappointment." According to Jacobson, "Disorganization and lack of clear leadership from the White House and Congress [have] left the Democrats once again ceding the conversation and the political territory to the far right." She adds, "Now, even in a compromise in which no federal funding for legal abortion services for women will be allowed, the president has been persistently reinforcing, if only rhetorically, the barriers low-income women face to care, and to exercising their basic human rights to whether, when and with whom to have children." She reports that the Center for Reproductive Rights has "openly expressed disappointment in the process and in the president's comments on abortion funding in his speech" last Wednesday to Congress. Jacobson includes a statement from CRR President Nancy Northup. She concludes, "There is as yet no guarantee that the Capps Amendment -- which protects the rights of women to access to abortion care under private insurance even where federal funding subsidies exist for some enrollees -- will survive the legislative process, and far right groups and legislators continue to mislead on the issue of abortion care in health reform" (Jacobson, RH Reality Check, 9/11).
"Did Sebelius Back More Steps for Banning Abortion Funding in Health Care?" Dan Gilgoff, U.S. News & World Report's "God & Country": Gilgoff writes that comments from HHS Secretary Kathleen Sebelius during an appearance Sunday on ABC's "This Week" "seemed to suggest that President Obama would go further than the current House health care bill (HR 3200) does in preventing public financing of abortions." However, Gilgoff says, a "second reading of her remarks makes it pretty clear that she's merely seconding Obama's previous commitment to preventing government money from funding abortion." He concludes, "Religious conservatives disagree, but I don't think Sebelius' comments mean that Obama's coming around to their side" (Gilgoff, "God & Country," U.S. News & World Report, 9/14).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2009 The Advisory Board Company. All rights reserved.

Pope Condemns Sexual Violence Against Women, Criticizes African Countries' Move To Legalize Some Abortions

Speaking in Angola during a weeklong tour of Africa, Pope Benedict XVI on Friday condemned sexual violence against women and criticized moves by some African countries to legalize some abortions, the AP/Google reports. In a speech in Luanda, Angola, Benedict said, "Particularly disturbing is the crushing yoke of discrimination that women and girls so often endure, not to mention the unspeakable practice of sexual violence and exploitation, which causes such humiliation and trauma." He also condemned the "irony of those who promote abortion as a form of 'maternal' health care," adding, "How disconcerting the claim that the termination of life is a matter of reproductive health." According to the AP/Google, the pope's comments referred to an African Union agreement signed by Angola and 44 other countries stating that abortion should be legal in cases of rape, incest or when the woman's life is in danger. Angola, a former Portuguese colony, is predominantly Catholic, with about 8.6 million residents, more than 60% of the population, who are members of the faith. Traditionally, Angolans have had large families, but in recent years many have cited the country's high cost of living as a reason for wanting to curtail family growth, according to the AP/Google (Simpson, AP/Google, 3/20).

Vatican Official Speaks Out Against Excommunication Over Abortion for Brazilian Girl

In related news, Archbishop Rino Fisichella, the top bioethics official for the Vatican, said that excommunication was unwarranted in the case of two Brazilian doctors who performed an abortion on a nine-year-old girl who was allegedly raped by her stepfather, the Religion News Service/Washington Post reports. Fisichella's statement on the abortion case was the lead article in a recent issue of the official Vatican newspaper, L'Osservatore Romano. The abortion case stirred controversy when the local archbishop, Josa Cardoso Sobrinho, excommunicated the doctors and the mother of the girl for allowing the abortion, which was performed when the girl was about 15 weeks pregnant. The doctors said carrying the pregnancy to term would have been life-threatening for the girl, who weighed 80 pounds. Fisichella, who did not address the excommunication of the girl's mother, said that although abortion is an "intrinsically wicked act," it might have been the lesser evil under the circumstances. He stressed that a degree of moral discretion is required for doctors, a position that is in contrast to the church's usual stance on abortion, the Religion News Service/Post reports. "The life was in serious danger because of the pregnancy in progress," he wrote, adding, "How to act in these cases? An arduous decision for the physician and for the moral law itself."

According to the Religion News Service/Post, Fisichella's article included a "frank rebuke" of Archbishop Sobrinho, accusing the archbishop of rushing to declare excommunication. Fisichella wrote that Sobrinho's action affected the "credibility" of the church's teaching, adding that now the church "appears in the eyes of so many as insensitive, incomprehensible and lacking in mercy." The Religion News Service/Post reports that Vatican journalist Sandro Magister said it is likely that Fisichella's statement was approved by Cardinal Tarcisio Bertone, who as secretary of state is considered to be the Vatican's second highest official after the Pope. Fisichella's statement contradicts Cardinal Giovanni Battista Re, head of the Vatican's Congregation for Bishops, who publicly defended the action of Archbishop Sobrinho (Rocca, Religion News Service/Washington Post, 3/21).


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.

Blogs Comment On Levi Johnston, Obama's Budget Proposal, Other Topics

The following summarizes selected women's health-related blog entries.

~ "Why We Need Bristol (And Levi)," Cristina Page, Birth Control Watch: Bristol Palin and the Candie's Foundation's "shared message to teens is: you don't want to become a teen parent," something that "traditional pregnancy prevention messages have often missed" because they "assumed that teens don't need convincing on that issue," Page writes. The Candie's Foundation recently made Palin, the daughter of Alaska Gov. Sarah Palin (R), an ambassador to promote teen pregnancy prevention. However, "there is one thing very important missing from the Candie's campaign," Page says. The national conversation on teen pregnancy "desperately needs" the involvement of teenage boys like Levi Johnston, the father of Palin's four-month-old son, Page writes. Johnston "brings with him a great chance to make boys the stakeholders they inevitably are" and "offers a unique perspective on the difficulties of being a teen father, one that will resonate with boys in a way [Palin's] point of view will not," she continues. In making Palin a teen pregnancy prevention ambassador, the Candie's Foundation is "taking a big risk," and it "would extend that risk further by giving [Johnston] an equal voice in the discussion," Page writes. She continues, "But with big risk comes the possibility for great gains, too." Palin and Johnston are "bravely offering their intensely personal misstep up for others to learn from. The may be at odds with each other, ... but they are united in their message about the not-so-glamorous life of teen parents," she says (Page, Birth Control Watch, 5/8).

~ "The Next Justice: What Obama Wants," Geoffrey Stone, Huffington Post blogs: Four factors "will be especially important" to President Obama when he is deciding on his Supreme Court nominee to replace retiring Justice David Souter, according to Stone, a law professor at the University of Chicago. Stone says that the factors include: high intellectual ability; moderately liberal stances on issues; a "strong voice" on the role of the Supreme Court; and the ability to "[b]uild a consensus within the Court." The "essence," for Obama, of the terms "moderate liberal" and "conservative" is "his continuing reference to 'empathy,'" Stone writes. He continues that Obama "wants to appoint a justice who understands that a unique role in our system of government is to be especially attentive to the interests of the unrepresented, the oppressed, political and religious dissenters, those accused of crime and minorities who have traditionally lost out in the political process." The U.S. and the Supreme Court "badly need a justice who can articulate a progressive view of constitutional interpretation, both to counter the conservatives on the Court and to change the terms of the national debate," he writes. Obama will also "want to appoint a justice who adds a measure of diversity of experience and perspective within the court," such as a woman or racial minority, Stone concludes (Stone, Huffington Post blogs, 5/11).














~ Blog Posts Examine Sex Education, Other Provisions in Obama's Budget Proposal, Jodi Jacobson/Sharon Camp/AmplifyYourVoice: Obama's fiscal 2010 budget proposal that was released last week "puts us on the road to evidence-based public health policy," Jacobson writes in a RH Reality Check blog entry. However, it "does not, unfortunately, really advance the journey towards comprehensive sex education, and is therefore a missed opportunity," she writes (Jacobson, RH Reality Check, 5/9). Camp writes in a Huffington Post blog entry that although the "most welcome development" of the budget proposal is "the abolition of 'abstinence-only-until-marriage' programs," it is important to remember that the proposal "is just a starting point" and that "Congress gets a crack at whether to accept, reject or modify the president's recommendations." Camp in the blog post assesses several areas of the budget related to women's health, including sex education, access to abortion, family planning and global health issues, among others (Camp, Huffington Post blogs, 5/8). AmplifyYourVoice writes in a Daily Kos blog entry that the Obama proposal "struck a blow to the abstinence-only community" but that "these people are not giving up." The blog post continues, "And considering that our fight to end funding for abstinence-only programs is long from over, considering that Congress must pass this budget without sneaking funding for ab-only back in, neither should we." The blog post includes links to videos of comments from abstinence-only supporters (AmplifyYourVoice, Daily Kos, 5/8).

~ "For the Culture War, a Hail Mary," Chris Korzen, Huffington Post blogs: Attempts by "culture warriors" on the right to "sabotage" President Obama's plan to give the commencement speech at the University of Notre Dame later this month "is ostensibly an effort to reassert the Church's position on abortion," Korzen writes. "In reality, the Notre Dame 'scandal' is little more than a manufactured controversy, and a predictable product of the Republican coalition's current sorry state of affairs," he continues. Korzen writes that Obama's "genuine commitment to prevention has ruffled the feathers of absolutists on both sides of the aisle. But for abortion 'grays' -- those Americans who remain conflicted about abortion, many of them moderate swing voters -- the president's willingness to acknowledge the moral dimension of the issue is a breath of fresh air." He notes that the opposition to the Notre Dame speech isn't coming from the "pious masses" but from "Catholic Republican front groups" like Fidelis, the Catholic League and the Cardinal Newman Society. He concludes that even "if the party faithful can be convinced that the culture war's benefits outweigh its costs, the radical voice will continue to dominate the Republican agenda" (Korzen, Huffington Post blogs, 5/8).

~ "'Conscience Rules' Ignore Patient," Sally Steenland, Washington Post's On Faith: President Obama's proposed rescission of the Bush administration's HHS provider "conscience" rule "should set a fairer balance between the rights, needs and responsibilities of providers and patients," Steenland, a senior policy adviser at the Center for American Progress, writes. Steenland adds that the Obama administration's final version is expected to be released soon. The public debate surrounding the current rule "is usually framed as one of provider conscience vs. patient access," she says, adding, "The problem is that this frame ignores the conscience of the patient." For example, she writes, a woman might be taking birth control because of a decision from her conscience, and when a pharmacist refuses to fill that woman's prescription, the pharmacist is "defying the patient's conscience in favor of his or her own." Steenland continues, "One conscience should never trump all others." She writes that "we must find ways to negotiate conflicting consciences so that religious liberty is respected and health care is safeguarded" (Steenland, Washington Post's On Faith, 5/11).

~ "In Choosing Souter's Replacement, Obama Should Follow the Lead of ... George W. Bush?," Mitchell Bard, Huffington Post blogs: Bard writes that the "single most important thing" he learned in law school was that "U.S. Supreme Court justices are far more powerful in shaping American society than the average person realizes," adding that "the selection of a justice to the Court is one of the most important decisions a president will make during his time in office." He continues, "I have full confidence that President Obama understands the immense importance of selecting the right replacement for David Souter. My hope is that as he goes through the process, he uses as his guide" former President George W. Bush -- "the most unlikely of mentors" -- in three areas. Bard notes Obama should "influence the court for the next 20 years" as Bush did in selecting younger judges or "go Bush one better and appoint a justice in his or her early to middle 40s, giving the candidate the opportunity to shape American policy for 30 to 40 years." Obama also should put in place "progressives to balance out Bush's conservative picks," Bard says. Furthermore, "Obama needs to select someone with an unassailably qualified resume," as "a lack of qualification is the only lifeline to the Republicans in bringing the choice down." Bard concludes that if Obama follows Bush's lead when selecting a replacement for Souter -- "a young progressive with a traditionally impressive resume -- he will have done a good job in carrying out his responsibilities" (Bard, Huffington Post blogs, 5/11).

~ "Houston Pulls a Palin," Abigail Kramer, Salon's Broadsheet: Kramer criticizes the city of Houston's recent decision to bill a woman for forensic evidence collection at a local hospital after she was raped. "A big thank you to the criminal justice establishment of Houston for giving victims one more reason not to report rape," Kramer writes. According to Kramer, Texas has a Crime Victims' Compensation Fund that automatically pays up to $700 of the cost of an investigation of sexual assault, but state law requires that victims exhaust all other potential sources before the fund pays more. Kramer writes, "This isn't the first time we've seen such dangerous nonsense." She recalls when Alaska Gov. Sarah Palin (R), who at the time was mayor of Wasilla, Alaska, allowed the city to charge victims for their own rape test kits, as well as other examples. Kramer concludes that it is difficult to know how common this practice is in other states because there is no federal law regulating who pays for what, which "would be treating rape like any other prosecutable, punishable violent crime" (Kramer, Salon's Broadsheet, 5/11).


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.

Blogs Comment On Sotomayor Confirmation Hearings, Health Reform, Other Topics

The following summarizes selected women's health-related blog entries.

~ "Judge Sotomayor Provides Important Testimony on the Constitutional Right to Privacy and Its Application to Reproductive Rights," Marcia Greenberger, Womenstake: "One major line of questions, asked repeatedly throughout the hearings" for President Obama's Supreme Court nominee Sonia Sotomayor was her "views on the constitutional right to privacy," Greenberger writes, adding, "Given that this right is central to women's lives, protecting" such "decisions involving whether to bear children ... and having consensual adult sexual relations, it is important to analyze Judge Sotomayor's answers carefully." According to Greenberger, because Sotomayor "had not ruled directly on the right to privacy as a federal judge, her testimony in this area warrants particular attention." Following questions from senators such as Herb Kohl (D-Wis.), Orrin Hatch (R-Utah) and Dianne Feinstein (D-Calif.), Sotomayor portrayed a "clear agreement with the right to privacy and strong description of the court's current precedents regarding Roe and women's health," which "lend[s] further support to the view from her legal record that she would not undermine Roe v. Wade if confirmed to the Supreme Court" (Greenberger, Womenstake, 7/16).

~ "Major Steps Forward for Health Care Reform," Thao Nguyen, Womenstake: Nguyen, outreach manager for the National Women's Law Center, reports that the health care reform legislation passed by the Senate Health, Education, Labor and Pensions Committee is "particularly important for women because of the critical headway it makes towards women's ability to secure access to quality, affordable health care throughout their lives." The bill "works towards confronting many of the particular obstacles faced by women in our current health care system," such as banning the "discriminatory" practice of basing insurance premiums on gender, even when maternity benefits are excluded, Nguyen writes. The bill also bans insurance companies from rejecting patients based on medical history, which has prevented many domestic violence survivors and women who have had caesarean sections from obtaining coverage. Nguyen concludes that "the momentum for health care reform could not have come at a more needed time" because women and their families "need quality, affordable and comprehensive health more than ever" (Nguyen, Womenstake, 7/15).

~ "Democrats for Life of America Ousts Member Who Supports Contraception," Feministing: Feministing reports that Democrats for Life of America removed Rep. Tim Ryan (D-Ohio) from its advisory board because he supports efforts to improve access to contraception. According to Ryan, he was dismissed from the board after four years after attempting to persuade the group to support contraceptive use as a way to avoid unintended pregnancies. According to the blog, "This is why we call anti-choicers 'anti-choice': because they're not just about making abortion illegal." It adds, "They don't want women to have access to contraception either -- something that 98% of American women will use at some point in their lives" (Feministing, 7/15).















~ "Umpires, Perspective and the Supreme Court," Jim Wallis, Sojourners' "God's Politics": "During his opening remarks for his own confirmation hearing in 2005, Chief Justice [John] Roberts made" an analogy between judges and umpires "that has gotten a lot of play in the media and has already been used quite a few times during" Sotomayor's confirmation hearing, Wallis writes. He adds that "nothing in the world would frustrate me more than an umpire who would call the game differently based upon the color of the jersey that" players were wearing. "But I haven't seen that happen," Wallis writes, adding, "In fact, the biggest problem we face isn't an umpire that has favored one team over the other, but umpires who make mistakes in their rulings and judgment because of their lack of perspective." He adds that Sen. Jeff Sessions (R-Ala.) and "others who have picked up these talking points of criticism have mistaken a very particular view of the world. They have claimed an attribute that only belongs to God." According to Wallis, the "problem is that Sen. Sessions doesn't really want impartiality; he wants judges who will see things just like he would." He concludes that a senator who "wants only one perspective isn't really concerned with truth or justice, but with the maintenance of historic dominance and control" (Wallis, "God's Politics," Sojourners, 7/16).

~ "Are You a Condom Worshipper? (Or, When the Purity Pushers Lose Their Damn Minds)," Feministing: National Abstinence Clearinghouse President Leslee Uhruh's comment that supporters of comprehensive sex education are "condom worshippers" is a good example of "why folks in the virginity movement need to rebrand their image," a Feministing blog entry states. It notes that "the majority of the country ... want[s] their kids to learn medically accurate information about sex so they can make healthy decisions." The blog continues, "That's why more media-savvy abstinence-only leaders are now using more mainstream-friendly language" and rebranding themselves as "folks interested in 'holistic approaches' and 'healthy lifestyle choices.'" The post continues that "[w]hile I'm glad to see that these organizations are scrambling, I'm also a bit wary of writing them off completely," which is why "we have to continue to be vigilant on a state and community level." The blog recommends checking Advocates for Youth or SIECUS for updates on sex education policy (Feministing, 7/16).


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's Health Advocates Use Health Reform To Tackle Gender Biases In Coverage

Women's health organizations and advocates are drawing attention to several lesser-known provisions in health reform legislation that would improve insurance coverage and health care for women, USA Today reports. Although the congressional debate over abortion coverage has garnered the most media attention among women's health issues in the reform debate, advocates say that provisions such as prohibiting insurance companies from charging women more than men for the same policies or requiring companies to offer maternity coverage in basic plans would "affect far more women, who have received inadequate care and coverage for too long," USA Today reports. As health reform bills near the final stages, advocates are working to ensure that women's health provisions are preserved as lawmakers look to trim the legislation's cost.

According to USA Today, the National Women's Law Center reports that 40 states and Washington, D.C., allow so-called "gender rating," in which insurance companies charge women more than men for the same individual policies or charge businesses with mostly female workers higher group rates. About 4.7 million women purchased individual insurance in states with this pricing practice in 2008, according to the Kaiser Family Foundation. In addition, insurance companies currently can offer policies that exclude coverage for pre-existing conditions, including past caesarean sections, or deny maternity coverage if a woman is pregnant when she applies for a policy. Insurance companies can deny coverage to survivors of domestic violence in eight states and Washington, D.C.

Sen. Barbara Mikulski (D-Md.) said she would like the final health reform bill to include provisions requiring minimum benefits packages offered by health plans to include coverage for preventive cancer screenings for women, including mammograms and Pap tests. "When it comes to health insurance, women are discriminated against," Mikulski said, adding, "We pay more and we get less, and often we are denied care." Robert Zirkelbach of America's Health Insurance Plans said the insurance industry supports eliminating gender rating and the practice of denying coverage to domestic violence survivors. According to Zirkelbach, most plans already cover maternity care, and there is a "good chance" that basic benefits packages will include such coverage.

Some Republicans, including Sen. Jon Kyl (Ariz.), have been fighting the inclusion of maternity coverage in a basic benefits package. Kyl drew attention for his position on the issue last week in an exchange with Sen. Debbie Stabenow (D-Mich.), who supports the coverage. Kyl said in a hearing, "I don't need maternity care and so requiring that to be in my insurance policy is something that I don't need and will make the policy more expensive." Stabenow replied, "I think your mom probably did." According to USA Today, an online video of the senators' comments has drawn about 150,000 views on YouTube (Hall, USA Today, 10/5).


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.

Illinois Pharmacists, Walgreen Reach Settlement On EC Distribution Rule

Illinois pharmacists who object to dispensing emergency contraception on moral grounds would be allowed to let another person on staff fill the prescription under a settlement filed last week between Deerfield, Ill.-based Walgreen and the state, the AP/Yahoo! News reports. According to the settlement, trained technicians or store owners would be able to contact a pharmacist at another location and then follow his or her directions for dispensing EC, which can prevent pregnancy if taken within 72 hours of sexual intercourse (Wills, AP/Yahoo! News, 10/11).

The Washington, D.C.-based American Center for Law and Justice in January 2006 filed a state lawsuit against Walgreen on behalf of four Illinois pharmacists who were suspended without pay in November 2005 for declining to dispense EC based on moral or religious beliefs. The lawsuit -- which was filed in Madison County, Ill., Circuit Court -- says the company violated the Illinois Health Care Right of Conscience Act, which allows health care providers to refuse to perform procedures that conflict with their moral or religious beliefs.

Under an Illinois rule -- which was proposed by Gov. Rod Blagojevich (D) and approved in August 2005 by the Illinois Joint Committee on Administrative Rules -- state pharmacies are required to dispense EC if they stock any FDA-approved contraceptive or risk losing their licenses. If any prescribed contraceptive is out of stock, pharmacies must provide an alternative, order the drug, make arrangements for another local pharmacy to fill the order or return the prescription to the customer. The rule allows pharmacies to opt not to sell any contraceptives (Kaiser Daily Women's Health Policy Report, 1/13).

Reaction
Francis Manion, an attorney for the pharmacists who filed the lawsuit, said the settlement is between Walgreen and the state, adding that his clients generally support it and will not continue with the litigation. "We think it's fair for us as well as our pharmacists," Walgreen spokesperson Tiffani Bruce said, adding that the deal "allows us to continue to care for patients." Attorneys said the settlement does not include any exchange of money.

"It seems to be a thoughtful settlement," Pam Sutherland, president of Illinois Planned Parenthood, said Wednesday, adding that the settlement gives pharmacists "an out, and it still makes sure the woman gets her prescription." The settlement must be reviewed by a legislative panel before it can take effect because it requires a change in state rules (AP/Yahoo! News, 10/11).

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.

Low-Income Women Less Likely To Receive Mammograms, CDC Report Finds, USA

Women without a high school diploma or with an annual household income lower than $15,000 are less likely to receive mammograms than women with more education and a higher income, according to a CDC report published on Thursday in the Morbidity and Mortality Weekly Report, the South Florida Sun-Sentinel reports. The report, which focused on 35 metropolitan areas nationwide, examined 2000 census data and records from a national health survey conducted by telephone in 2002. According to the report, 78.5% of women ages 40 and older said that they had received a mammogram within the previous two years. Among those women, 68.4% with an annual household income of less than $15,000 underwent mammograms, compared with 82.5% with an annual household income of more than $50,000, the report found. The report said that more research is required to determine the reasons for the disparity, although the difference might result from factors such as access to health care, cost, availability of public transportation or availability of public heath clinics (McVicar, South Florida Sun-Sentinel, 10/7). The complete report is available online.


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Preventive Surgeries Linked To Lower Risk Of Breast And Ovarian Cancer

Women with the inherited mutations of the BRCA1 or BRCA2 genes who had preventive (prophylactic) breast removal (mastectomy) or the removal of the fallopian tubes and ovaries (salpingo-oophorectomy) were found to have a significantly lower risk of developing ovarian and breast cancers, says a study published in JAMA (Journal of the American Medical Association), September 1st issue.


The authors wrote that females who carry the inherited mutations of the BRCA1 or BRCA2 genes have a considerably higher chance of developing breast or ovarian cancer - there is a 56% lifetime risk of breast cancer and 84% lifetime risk of ovarian cancer.


The authors added:


Women who are mutation carriers have cancer risk-management options that include risk-reducing salpingo-oophorectomy, risk-reducing mastectomy, annual cancer screening, and chemoprevention.


Susan M. Domchek, M.D., of the University of Pennsylvania School of Medicine, Philadelphia, and team carried out a study involving 2,482 women who had the BRCA 1 and BRCA 2 mutations to find out what their cancer risk reduction was following a prophylactic salpingo-oophorectomy and mastectomy, incorporating mutation type (BRCA1 vs. BRCA2), and cancer history (prior history of breast cancer vs. none). The women's gene mutations were determined between 1974 and 2008.


The study was performed at 22 clinical and research genetics centers in North America and Europe. The participants were monitored through to the end of 2009.


Breast Cancer Risk: The investigators found that:

None of the women with the mutated genes who had a prophylactic mastectomy developed cancer during the 3-year follow-up period.
7% of the women with the mutated genes who did not have a prophylactic mastectomy developed cancer during the 3-year follow-up period.

Ovarian Cancer Risk: The investigators found that:

Risk-reducing salpingo-oophorectomy was associated with a decreased risk of ovarian cancer, with no ovarian cancer events seen during the 6 years of prospective follow-up in BRCA2 mutation carriers without prior breast cancer who underwent the procedure.
Three percent of women without salpingo-oophorectomy over a similar follow-up period were diagnosed with ovarian cancer.

The researchers found no cases of ovarian cancer among women with the BRCA 1 mutation after salpingo-oophorectomy, which was also linked to a lower risk of breast cancer in BRCA1 and BRCA2 mutation carriers without prior diagnosis of breast cancer.


The authors wrote:


Compared with women who did not undergo risk-reducing salpingo-oophorectomy, undergoing salpingo-oophorectomy was associated with lower all-cause mortality (10 percent vs. 3 percent), breast cancer-specific mortality (6 percent vs. 2 percent), and ovarian cancer-specific mortality (3 percent vs. 0.4 percent).





"Association of Risk-Reducing Surgery in BRCA1 or BRCA2 Mutation Carriers With Cancer Risk and Mortality"

Susan M. Domchek, MD; Tara M. Friebel, MPH; Christian F. Singer, MD, MPH; D. Gareth Evans, MD; Henry T. Lynch, MD; Claudine Isaacs, MD; Judy E. Garber, MD, MPH; Susan L. Neuhausen, PhD; Ellen Matloff, MS; Rosalind Eeles, PhD; Gabriella Pichert, MD; Laura Van t'veer, PhD; Nadine Tung, MD; Jeffrey N. Weitzel, MD; Fergus J. Couch, PhD; Wendy S. Rubinstein, MD, PhD; Patricia A. Ganz, MD; Mary B. Daly, MD, PhD; Olufunmilayo I. Olopade, MD; Gail Tomlinson, MD, PhD; Joellen Schildkraut, PhD; Joanne L. Blum, MD, PhD; Timothy R. Rebbeck, PhD

JAMA. 2010;304(9):967-975. doi:10.1001/jama.2010.1237

Missouri's Constitutional Amendment Protecting Stem Cell Research Encounters 'Political, Financial Roadblocks,' New York Times Reports

A constitutional amendment approved by Missouri voters in November 2006 that was expected to expand and protect human embryonic stem cell research in the state has "run into political and financial roadblocks, putting the future of the research in doubt," the New York Times reports. According to the Times, the debate over the amendment has become a "fight over what constitutes 'cloning.'"

Supporters of the amendment say that it bans human cloning, which is defined in the amendment as an act that could result in a pregnancy and the creation of a human fetus inside a woman's uterus. Opponents say that cloning is the replication of cells, regardless of implantation in the uterus. Some state lawmakers who oppose the amendment said they will continue to fight it by introducing new bills that would ban some types of stem cell research.

"We think it's a false distinction to say that a clone exists only based on geography," Pam Fichter, president of Missouri Right to Life, said, adding that the group supports "ethical stem cell research, and we think cloning was misrepresented to voters. We know that a majority of Missourians oppose cloning." Donn Rubin -- chair of the Missouri Coalition for Lifesaving Cures, which led efforts to pass the amendment -- said that reproductive cloning was a major concern among voters. "What we protect is a very promising form of medical research that involves cells in a lab dish, not something that involves pregnancy," Rubin said.

Jaci Winship, executive director of Missourians Against Human Cloning, said the group is considering the possibility of a new initiative against the amendment, perhaps as soon as next year. Members of MRTL have been gathering signatures and contributions for the effort, the Times reports. According to Rubin, MCLC has continued raising money to prepare for another fight over the amendment.

Future of Research
According to the Times, although legislative efforts have failed so far, the "uncertainty" of the research's future in the state has made it difficult for facilities to attract stem cell specialists (Davey, New York Times, 8/10).

Many scientists who considered moving to Missouri to conduct stem cell research will not come to the state because of the uncertainty over whether the legislation will be overturned. The Stowers Institute for Medical Research in late July canceled plans to expand in Kansas City, Mo., because it was unable to recruit top stem cell researchers. The institute also transferred a large portion of its $2 million endowment to Delaware because the political climate in Missouri was too hostile (Kaiser Daily Women's Health Policy Report, 8/1).














Kevin Eggan, an assistant professor of molecular and cellular biology at Harvard University, said he strongly considered moving to Stowers but delayed his plans. "Everybody hoped that Missouri was going to be a good test case," Eggan said, adding, "It was exciting to us that stem cell research was being voted in a state which has very restrictive abortion laws. But it has turned out to be a big disappointment."

Sen. Chuck Graham (D) said, "For a bright shining moment in time, we were moving ahead as a state to protect research." He added, "But now the other side wants to walk away, not only from stem cell research, but all research. Their attitude now is, if there's a beaker or a Petri dish involved, we're not going to fund it." Rep. Jim Lembke (R), who opposes embryonic stem cell research and proposed legislation outlawing elements of the research, said, "As people are educated about this issue, they come around" (New York Times, 8/10).

"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.

European Guidance For Osteoporosis Diagnosis And Management

The International Osteoporosis Foundation (IOF) has welcomed the recently published paper European guidance for the diagnosis and management of osteoporosis in postmenopausal women(1) from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).



This paper constitutes a roadmap for European countries to practically implement the new FRAX™ tool based on the WHO technical report, Assessment of osteoporosis at the primary health care level(2,3). The European guidance, published in Osteoporosis International, is a critical review of diagnostic methods, treatments and their monitoring options. It also shows case-finding strategies supported by health economic data.



IOF sees the ESCEO guidance as a positive move towards using the FRAX™ algorithm in daily practice. The WHO report and FRAX™ tool, released on February 21, 2008, help health practitioners to better understand the new paradigm for diagnosis and management of people at risk of developing fragility fractures.



In this regard, there will be a FRAX™ exhibition booth at the forthcoming ECCEO 8 Congress in Istanbul, Turkey, to be held at the Grand Cevahir Hotel & Convention Center. Participants will have the opportunity to have their 10-year fracture risk calculated, based on their geographic origin and individual risk factors. As a next step, the ESCEO paper can contribute with guidance on how to manage or monitor their condition, in the most rationale and cost-effective way.



Professor Jean-Yves Reginster, President of ESCEO, noted, "The ESCEO European guidance is convergent with the WHO report on how to assess and treat postmenopausal women with or at risk from osteoporosis. Moreover, cost-effectiveness analyses which illustrate scenarios based on a UK setting provide a starting point for health policy makers and health care providers to develop national guidelines on diagnosis and intervention thresholds."



The ESCEO guidance is very timely, as across Europe, osteoporosis is a major public health problem with serious medical and economic impact. In 2000, throughout the region, there were an estimated 620,000 new hip fractures, 574,000 forearm fractures, 250,000 shoulder fractures, and 620,000 spinal fractures in men and women aged 50 years or over, accounting for 34.8% of such fractures worldwide(4). There are more than 2.7 million osteoporotic fractures in men and women in Europe at a direct cost of 36 billion euros(5). It is estimated that by 2050, direct costs related to hip fractures will increase to 76.7 billion euros(6).







Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster, JY, Borgstr?¶m F, Rizzoli R, on behalf of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2008 Feb 12; [Epub ahead of print]
















Kanis JA on behalf of the World Health Organization Scientific Group (2008) Assessment of osteoporosis at the primary health care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases. University of Sheffield, UK.



World Health Organization. Assessment of osteoporosis at the primary health care level. Summary Report of a WHO Scientific Group. WHO, Geneva. who.int/chp/topics/rheumatic/en/index.html



Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726-1733



Kanis JA, Johnell O, on behalf of the Committee of Scientific Advisors of the International Osteoporosis Foundation (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:220-238



Kanis JA et al. Requirements for DXA for the management of Osteoporosis in Europe. Osteoporosis Int. 2005;16:229-38)



Osteoporosis, in which the bones become porous and break easily, is one of the world's most common and debilitating diseases. The result: pain, loss of movement, inability to perform daily chores, and in many cases, death. One out of three women over 50 will experience osteoporotic fractures, as will one out of five men (7,8,9).



Unfortunately, screening for people at risk is far from being a standard practice. Osteoporosis can, to a certain extent, be prevented, it can be easily diagnosed and effective treatments are available.



The International Osteoporosis Foundation (IOF) is the only worldwide organization dedicated to the fight against osteoporosis. It brings together scientists, physicians, patient societies and corporate partners.



Working with its 184 member societies in 89 locations, and other healthcare-related organizations around the world, IOF encourages awareness and prevention, early detection and improved treatment of osteoporosis.



Melton U, Chrischilles EA, Cooper C et al. How many women have osteoporosis" Journal of Bone Mineral Research, 1992; 7:1005-10



Kanis JA et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporosis International, 2000; 11:669-674



Melton LJ, et al. Bone density and fracture risk in men. JBMR. 1998; 13:No 12:1915



For more information on osteoporosis and IOF please visit: iofbonehealth/



Source: janice blondeau


International Osteoporosis Foundation

Bionovo Completes Enrollment Of MF101 Phase 2 Trial To Evaluate A Safer, New Therapy For Menopausal Symptoms

Bionovo, Inc.
(OTC Bulletin Board: BNVI) provided an update on its Phase 2 clinical trial
of MF101, a novel, oral treatment for hot flashes and other symptoms of
menopause. The Company has fully enrolled its FDA-approved trial with 184
women volunteers. Dr. Deborah Grady at the University of California, San
Francisco is serving as the Principal Investigator and the multi-center
trial is being conducted at six clinical sites across the country. The
trial will evaluate the efficacy of MF101 on actual and perceived relief
from menopausal symptoms. The women enrolled in the trial are aged 40-60
and experiencing greater than 7 moderate-to-severe hot flashes each day.



MF101 is an estrogen receptor beta (ER-beta) selective drug developed
as an alternative to those products currently on the market that have been
shown to increase the risk for breast and uterine cancers. Bionovo
recognized the opportunity to commercialize a product that would be equally
effective, with an improved safety profile to hormone therapy, and began
the clinical development of MF101. The drug candidate has been evaluated by
an independent Data and Safety Monitoring Board and has passed through a
standard two-round examination for safety. The Phase 2 study is expected to
run for an additional four months with results anticipated in early April
2007.



"For too long women had to face the choice between quality of life and
their long-term health," said Isaac Cohen, President and CEO, Bionovo. "The
market for menopausal products is enormous and growing, and we believe
there is great opportunity for a product that offers both efficacy and
safety."



The Phase 2 trial is a double-blind, randomized, placebo-controlled
trial. Women volunteers were randomized to groups of 60 receiving 2 doses
of MF101 or placebo. The trial is being conducted at the following sites:
University of California, San Francisco, University of Pittsburgh,
University of Minnesota, University of Tennessee, University of Alabama and
the San Diego Medical Center for Clinical Research.



About MF101



MF101, an ER-beta selective agonist, is designed for the treatment of
vasomotor symptoms such as hot flashes and night sweats in postmenopausal
women. In animal studies, MF101 has been shown to prevent tumor formation
in the breast and uterus, suggesting that Bionovo's lead drug will not
increase the risk of either breast or uterine cancer. In Phase 1 clinical
testing of MF101, the drug was found to be safe, well tolerated and taken
with high compliance. A multi-center, Phase 2, double-blind,
placebo-controlled, randomized clinical trial of MF101 has completed full
enrollment of 180 patients.



About Bionovo, Inc.



Bionovo is a drug development company focusing on the discovery of
novel pharmaceutical agents for cancer and women's health. The company has
one drug in Phase 2 clinical testing to treat conditions associated with
menopause and a second drug, BZL101, for breast cancer that will enter
Phase 2 clinical testing later this year. The company is developing its
products in close collaboration with leading U.S. academic research
centers, including the University of California, San Francisco, University
of Colorado Health Sciences Center, University of California, Berkeley, and
the University of Texas, Southwestern. For further information please
visit: bionovo/.


Bionovo, Inc

bionovo/

How Predictable Are Urinary Tract Infections?

It is expected that women will experience urinary tract infections (UTIs) at least twice during their lifetime. If a test existed that could predict UTIs, health care providers and patients would benefit. In the February 2008 issue of Urologic Nursing, Deborah Kuklinski and Sumana Koduri explore using urine dipsticks, an in-office test, to predict UTI.


Kuklinski and Koduri say a urine dipstick positive for nitrites (produced by bacteria in a UTI) implies UTI, but the urine culture, which takes longer and is more expensive, is the gold standard for a positive diagnosis. If the urine dipstick could be used to diagnose a UTI, say the authors, treatment could begin immediately. They found that despite associating urine dipsticks and urine cultures positive for nitrites, 40%-50% of the UTIs would have been missed without the urine culture due to the sensitivity of the bacteria.


Although Kuklinski and Koduri couldn't conclude the urine dipstick accurately diagnosed UTI, their study indicates the urine culture is still important for diagnosis and treatment. They recommend practitioners continue to use the urine culture and offer patient education on UTI symptoms.


Predicting Urinary Tract Infections in a Urogynecology Population

Deborah Kuklinski, MS, RNC, WHNP; Sumana Koduri, MD

Urologic Nursing; February 2008

suna


The Society of Urologic Nurses and Associates is a national, non-profit professional membership association with over 3,000 members and annual revenues of $1.5 million. SUNA derives its income from membership dues (only $60), conference registration fees, exhibits, advertising, grants, and the sale of educational products.


SUNA publishes a professional, peer-reviewed bi-monthly journal (Urologic Nursing Journal) and a bi-monthly newsletter (Uro-Gram). SUNA establishes the scope and standards of urologic nursing practice and the scope and standards of advanced urologic nursing practice. SUNA provides scholarships, grants and awards to deserving nurses and other health care professionals.


SUNA supports and promotes the certification of urologic nurses and associates by providing educational preparation for the examinations offered which lead to certification in three areas.


SUNA provides a variety of opportunities for participation including local chapters, task forces and Special Interest Groups (SIGS) in five major subspecialty areas.


suna

Family Lifespan Boosted By Late Motherhood

Women who have babies naturally in their 40s or 50s tend to live longer than other women. Now, a new study shows their brothers also live longer, but the brothers' wives do not, suggesting the same genes prolong lifespan and female fertility, and may be more important than social and environmental factors.



"If women in your family give birth at older ages, you may well have a chance of living longer than you would otherwise," says the study's lead author, demographer Ken R. Smith, a professor of family and consumer studies at the University of Utah. "If you have a female relative who had children after age 45, then there may be some genetic benefit in your family that will enhance your longevity."



For descendants of the Utah and Quebec pioneers studied, "you may be able to look at the ages when your female ancestors gave birth - rather than just their longevity - in estimating how long you may live," says Smith, whose study will be published online May 4 and in the June 10 print issue of the Journal of Gerontology: Biological Sciences.



The researchers examined high-quality genealogical records from the Utah Population Database at the University of Utah with its records of 1.6 million Utah Mormon pioneers and their descendants. They also used the University of Montreal's Program on Demographic History Research, which has records on 400,000 people who lived in heavily Catholic Quebec between 1608 and 1850.



Specifically, the study involved the records of 11,604 Utah men who were born between 1800 and 1869 and who had at least one sister who lived at least to age 50; and the records of 6,206 Quebec men who lived between 1670 and 1750, and had at least one sister who lived to 50 or older. The key findings:
Women who had "late fertility" - a birth at age 45 or older - were 14 percent to 17 percent less likely to die during any year after age 50 than women who did not deliver a child after age 40. That confirmed earlier studies. But those studies did not determine if the women gave birth later and lived longer because of genes or because of social and environmental factors such as good nutrition or healthy living.


Brothers who had at least three sisters, including at least one sister who gave birth at age 45 or later, were 20 percent to 22 percent less likely to die during any year after age 50 than brothers who had no "late fertile" sisters. That indicates what earlier studies did not, namely, the same genes may influence the lifespan of both sexes and women's ability to give birth at older ages.


The brothers' wives didn't have longer lives, suggesting any environmental or social factors that influence lifespan had only a weak influence, and that genes may explain why brothers lived longer when they had a sister who gave birth in her 40s.

The study didn't address how much longevity is due to genetics, but Smith says scientists believe genes account for up to 25 percent of differences in longevity.
















Smith conducted the study with two other University of Utah researchers: Richard Cawthon, a research associate professor of human genetics, and demographer Geraldine Mineau, a research professor and director of population sciences at the university's Huntsman Cancer Institute, where Smith also is an investigator. Other coauthors were demographer Alain Gagnon and sociologist Ryan Mazan of the University of Western Ontario, and demographer Bertrand Desjardins, of the University of Montreal.



Good Genes Versus a Good Environment



Smith says that during the last decade, "there have been several studies that show a number of species, including humans, are able to reproduce late without medical intervention - and those females live longer." Other studies found that late menopause also is associated with women having prolonged fertility and longevity.



"There is a genetic component to longevity, especially for living to very old ages," Smith says. "The new thing here is what most evolutionary biologists long have argued: that survival and reproduction are intrinsically linked to one another. So the novel finding in this paper is discovering this link in humans before modern contraception."



But he says the link between late motherhood and longevity "could be something that is not inherited. It could be good nutrition or really good living, suggesting that if you are a healthier mom you live longer."



That is why the researchers looked at the lifespan of the brothers of women who had babies late, and of those brothers' wives. The wives are not blood relatives, so genetic factors shared by sisters and brothers wouldn't be the same in the brothers' wives.



Smith says the study focused on the longevity of brothers rather than sisters of late-fertile women because "men's own reproductive history doesn't get in the way of assessing the role of their female relatives' fertility."



The study focused on the two pioneer groups not only because of the quality of the data but because of the absence of modern birth control and an unfavorable attitude toward natural family planning methods by Mormons and Catholics. Also, a link between late fertility and lifespan is easier to observe in large families with more sisters.



Since all of those studied are now dead, the researchers could look at the full length of their fertile periods and lives. "Not many data sets could do this," Smith says.



The researchers controlled for various factors that could skew the results. For example, they excluded any individuals who did not live to at least 50 because a husband's death at a younger age would influence his wife's child-bearing.



Late Babies Linked to Longer Life for Moms and Blood Uncles
The study confirmed earlier research showing that women who have babies late tend to live longer.



Compared with women who had their last baby before age 41, Utah pioneer women who had their last baby at age 41 to 44 were 6 percent less likely to die during any given year past age 50, and Utah pioneer women who had their final birth at age 45 or older were 14 percent less likely to die during any given year after age 50.



In other words, imagine woman A had her last baby at age 35, woman B had her last baby at 42 and woman C had her last baby at 46. Then at age 52 - or any other age past 50 - woman B would be 6 percent less likely to die than woman A, and woman C would be 14 percent less likely to die than woman A.



In Quebec, slightly different age groups were analyzed. Compared with younger mothers, women who had their last child between ages 42 and 44?? were 6 percent less likely to die during any given year past age 50, and women who had their last child at age 44?? or older were 17 percent less likely to die during any given year past age 50.


By looking at the brothers of women who had children late, the study suggests the same age-slowing genes may be responsible for both prolonged fertility in women and longer lifespan in both sexes. The effects of late fertility were strongest for brothers with at least three sisters because the larger the number of sisters, the more likely it is at least one will give birth in middle age.



So in the Utah group, brothers with three or more sisters - at least one of whom gave birth at age 45 or older - were 20 percent less likely to die during any given year after age 50 than men without late-fertile sisters.



In Quebec, brothers with three or more sisters - at least one of whom gave birth at age 44?? or older - were almost 23 percent less likely to die during any single year after age 50 than men without sisters who gave birth late.


It is possible social and environmental reasons - good water, good nutrition, a healthy environment - could explain why the brothers and their late-birthing sisters had longer lives. So the researchers also examined the longevity of the brothers' wives.

They found no increase in lifespan, indicating that heredity - far more than environmental factors - played a role in the prolonged fertility and longer lives of the women, and the longer lives of their brothers.



Smith says the new findings do not conflict with one of his earlier studies finding that having larger families reduced parents' lifespan. Both findings can operate together.



Source:
Lee Siegel


University of Utah