Uterine Artery Embolisation May Adversely Affect Future Pregnancies

A paper to be published in The Obstetrician & Gynaecologist (TOG) examines the evidence on pregnancy outcomes following uterine artery embolisation (UAE), a treatment for fibroids.1 The authors underline the potential reproductive risks of UAE, and urge caution in recommending this treatment to women who wish to become pregnant in the future.


Uterine artery embolisation is a relatively new method for treating uterine fibroids.2 With the prevalence of fibroids being as high as 20-40% among women of reproductive age, this is a pressing issue as many women in the treatment population may not have completed their families.


The authors reviewed retrospective data and two small prospective trials of UAE versus surgical intervention (laparoscopic myomectomy). The results showed an increased risk of miscarriage, preterm birth, caesarean section, malpresentation and postpartum haemorrhage in pregnancies following UAE. Furthermore, the review found significantly higher miscarriage rates following UAE treatment for fibroids, than for women with untreated fibroids.


The authors note that the available data on pregnancy following UAE is limited. Nevertheless, in the absence of more robust evidence, they call for caution in recommending UAE to women still planning to become pregnant.


Co-author, Ertan Saridogan, consultant in reproductive medicine and minimal access surgery at Elizabeth Garrett Anderson Hospital, said "Uterine artery embolisation is a relatively new treatment option for uterine fibroids. Although a large number of women have already undergone this procedure, there is relatively limited information on its impact on a woman's future reproductive function.


"Our review on the outcome of pregnancies arising following uterine artery embolisation showed that they could be at increased risk for complications, especially miscarriage. Caution should be exercised when considering this treatment modality among women desirous of future pregnancies, particularly if alternative therapeutic options exist."


Jason Waugh, editor-in-chief of TOG, said "Studies have suggested that UAE is a safe and effective alternative to hysterectomy for alleviating fibroid-related disorders such as menorrhagia (heavy menstrual bleeding) and pressure symptoms. However, this study underlines the need for caution among women who still want to become pregnant.


"Patients with fibroids may experience painful symptoms and heavy, prolonged periods. Further research is needed in order to provide women with comprehensive information about the risks and benefits of available treatment options."


Notes


The Obstetrician & Gynaecologist (TOG) is published quarterly and is the Royal College of Obstetricans and Gynaecologists' (RCOG) medical journal for continuing professional development. TOG is an editorially independent, peer-reviewed journal aimed at providing health professions with updated information about scientific, medical and clinical developments in the specialty of obstetrics and gynaecology. TOG is hosted online by Stanford University's HighWire Press at: onlinetog.


1 Uterine fibroids are benign tumours of the uterus. Symptoms caused by fibroids include abnormal bleeding, pelvic pressure and pain, and reproductive problems. Fibroids are common and are the most frequent reason for a woman to have a hysterectomy.


2 Uterine artery embolisation (UAE) is an alternative to hysterectomy for fibroids. It is a relatively new, nonsurgical treatment option. The procedure is performed under conscious sedation, and both uterine arteries are blocked with particles injected via the femoral and uterine arteries. This causes the fibroids to shrink.


Reference


Homer H, Saridogan E. Pregnancy outcomes after uterine artery embolisation for fibroids. The Obstetrician & Gynaecologist 2009;11: 265-270.

Source
The Obstetrician & Gynaecologist

With A Doctor's Help Obese Women With PCOS Can Lose Weight

Simple weight-loss advice from a physician and regular follow-up helped obese women with polycystic ovary syndrome lose a substantial amount of weight, a new study found. The results were presented at The Endocrine Society's 91st Annual Meeting in Washington, D.C.



Polycystic ovary syndrome, or PCOS, is a common hormone imbalance in young women that raises the risk of infertility, obesity, type 2 diabetes and heart disease. Past research shows that modest weight loss - at least 5 percent of body weight - can significantly improve PCOS symptoms and reduce the risk of diabetes and heart disease.



However, medical management of obesity tends to be neglected, said study co-author Jean-Patrice Baillargeon, MD, MSc, an endocrinologist with the University of Sherbrooke Faculty of Medicine, Sherbrooke, Quebec, Canada.



"Research shows that primary care physicians are usually reluctant to manage their patients' obesity because they feel poorly equipped to do so and their success is limited," Baillargeon said. "But our study demonstrates that it is possible, with a doctor's weight-loss advice and follow-up, for obese women with PCOS to achieve clinically significant and sustained weight loss."



Baillargeon stressed that this study did not involve multidisciplinary care from a team of different health care specialists, which many doctors view as the most effective approach to weight loss but which is costly. Instead, as is usually the case in real life, study patients saw only a doctor. The physician gave them general advice on losing weight and on diet and exercise.



The investigators reviewed the medical records of 117 obese women with PCOS who had an initial doctor's visit and follow-up care for at least 2 months at the medical center's reproductive endocrinology clinic between May 2002 and September 2008. These women had an average weight of 231 pounds (104 kilograms) and an average body mass index, or BMI, of 38.7, which is close to morbidly obese. Follow-up visits, usually every 6 months, consisted of PCOS management as well as a weigh-in and discussion of weight loss, which Baillargeon said helped maintain patients' motivation.



Of the 74 women who had 6 to 12 months of follow-up, 32 patients (43.2 percent) lost 5 percent or more of their body weight, which is considered clinically significant, the authors reported. Among 35 women with 3 years of follow-up or longer, 16 (nearly 46 percent) lost that much weight, and seven (20 percent) lost at least 10 percent of their body weight.



If needed, women received the diabetes drug metformin, which is often used to treat problems related to PCOS. Although past studies of whether metformin affects weight loss have shown mixed results, women in this study who took metformin lost more weight than those who did not.



"Medical management of these women is an opportunity to improve their future metabolic health," Baillargeon said. "Any physician who sees obese women with PCOS should at least discuss the importance of weight loss and lifestyle modifications."



This study was presented by Lysanne Pelletier, MD, a trainee at the University of Sherbrooke.



Source:
Aaron Lohr


The Endocrine Society

Beyond The Abstract - The Effect Of Age On Outcomes Of Sling Surgery For Urinary Incontinence

UroToday - This study demonstrates the need for caution when performing slings on older women with stress incontinence. We found that older women were not only more likely to fail surgery and require another procedure for stress incontinence, but also were more likely to experience emptying difficulty and new urge incontinence after a sling. These findings suggest a need for thorough pre-operative counseling of older women undergoing sling surgery, as their risk of surgical morbidity is higher than for younger women.





Jennifer Anger, MD, MPH, as part of Beyond the Abstract on UroToday. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.


Link to Full Abstract


UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.


To access the latest urology news releases from UroToday, go to:
www.urotoday


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Copyright © 2007 - UroToday
Reproduced for blog with permission of UroToday.
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Catholic Bishops Should Stop 'Harassing' Giuliani, Other Catholic Politicians, Letter To Editor Says

Former New York City Mayor Rudy Giuliani (R) and other Roman Catholic politicians who have said they "oppose abortion but do not wish to impose that view on the entire polity have support in Catholic teaching," and Catholic bishops should "cease harassing" them, Daniel Maguire, a professor of moral theology at Marquette University, writes in a New York Times letter to the editor (Maguire, New York Times, 6/29).

Some church leaders have said they are disturbed by Catholic politicians such as Giuliani, who is running for the Republican presidential nomination. Bishop Thomas Tobin, head of the Roman Catholic Diocese of Providence, R.I., in a recent column for the diocese's newspaper, the Rhode Island Catholic, said Giuliani's "public proclamations on abortion are pathetic and confusing," adding, "Even worse, they're hypocritical." Tobin also said that he never would support a candidate who supports abortion rights.

According to Tobin, Catholics are "required to be pro-life, to cherish and protect human life as a precious gift of God from the moment of conception until the time of natural death." Tobin is the first bishop to challenge Giuliani on his abortion-rights position. At a recent debate, Giuliani was prompted by moderator Wolf Blitzer of CNN to respond to Tobin's comments. He said, "My view on abortion is that it's wrong but that ultimately government should not be enforcing that decision on a woman" (Kaiser Daily Women's Health Policy Report, 6/25).

According to Maguire, Sts. Augustine and Thomas Aquinas both favored legalization of commercial sex work because they thought "greater evils" would occur if it were banned. Legislators who "truly think abortion immoral could vote to keep it legal since greater evils" -- including "multiple deaths of women" from "botched abortions as seen before Roe v. Wade," the 1973 U.S. Supreme Court case that effectively barred state abortion bans -- "would follow," Maguire writes (New York Times, 6/29).

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

Applying Internal Stitches To Support Vagina, Other Internal Organs Reduces Incontinence In Women After Surgery, Study Says

A procedure that applies two permanent, internal stitches from each side of the vagina to ligaments in the pelvis can help reduce incontinence by 80% in women who have had surgery to correct pelvic prolapse -- a condition that occurs when the pelvic organs weaken and drop into or through the vaginal opening -- according to a study published in the April 13 issue of the New England Journal of Medicine, the Chicago Tribune reports. About 200,000 women in the U.S. annually undergo surgery to correct pelvic prolapse, after which up to 60% of the women experience "urinary stress incontinence," which can be caused by laughing, coughing, exercising or other actions, according to the Tribune (Kotulak, Chicago Tribune, 4/13). Linda Brubaker, an OB/GYN professor at Loyola University, and colleagues enrolled 322 women in the study, which was funded by NIH (Marchione, AP/Houston Chronicle, 4/12). Physicians on half of the participants performed the routine surgery for pelvic prolapse, which repositions the vagina and other internal organs, in conjunction with the Burch colposuspension procedure, which applies four internal stitches to support the bladder. The other half of participants underwent only the routine surgery, the Tribune reports. The study finds that performing the additional surgery helped to alleviate the pressure on the bladder's urinary opening and decreased the risk of urinary leakage (Chicago Tribune, 4/13). According to the study, 6% of women who underwent the Burch procedure in conjunction with the routine surgery reported urinary control problems three months later, compared with 25% of the participants who did not have the additional procedure (AP/Houston Chronicle, 4/12).

Reaction
Pelvic prolapse is a "very common problem in women, and this is the first time we've been able to demonstrate that an operation can actually prevent urinary incontinence,' Brubaker said (AP/Houston Chronicle, 4/12). Despite some "limitations" in the study, including a short follow-up period, it demonstrates that performing the Burch procedure along with the routine prolapse surgery results in improved urinary control, Rebecca Rogers, an OB/GYN at the University of New Mexico, writes in a related editorial in the journal (Rogers, NEJM, 4/13).


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

Campaigns Supporting, Opposing South Dakota Abortion Ban Report $4M In Contributions

VoteYesforLife, which supports a South Dakota law (HB 1215) banning abortions except to save a woman's life, on Wednesday said it filed a report showing it received nearly $2.2 million in cash donations to its campaign from June 28 through Oct. 28, while the South Dakota Campaign for Healthy Families, a coalition of opponents of the law, said it has raised about $1.8 million during the time period, the AP/Aberdeen American News reports (Lammers, AP/Aberdeen American News, 11/2). The Campaign for Healthy Families blocked the July 1 enactment of the law by gathering enough signatures to put the issue on the November ballot (Kaiser Daily Women's Health Policy Report, 11/1). Detailed campaign finance reports were due on Tuesday to the South Dakota Office of the Secretary of State, but the reports were not posted on the office's Web site on Wednesday, according to the AP/American News. The Campaign for Healthy Families said about $160,000 of the $1.8 million it raised came from state residents and the rest came from donors outside the state (AP/Aberdeen American News, 11/2). VoteYesforLife said about 65% of its campaign contributions of more than $100 came from people and groups in South Dakota (Myers, Sioux Falls Argus Leader, 11/2). The group also reported $39,000 worth of contributions in goods and services, while the Campaign for Healthy Families said it has received less than $50,000 in in-kind contributions, the New York Times reports (Davey, New York Times, 11/2). In addition, the Campaign for Healthy Families in two supplemental finance reports lists more than $200,000 in additional contributions, while VoteYesforLife in a supplemental reported more than $155,000 in further donations (AP/Aberdeen American News, 11/2).

ABCNews' "World News Tonight" on Wednesday reported on campaigns supporting and opposing the ballot initiative. The segment includes comments from Maria Bell, a Sioux Falls ob-gyn who is co-chair of the Campaign for Healthy Families; state Rep. Roger Hunt (R), the ban's sponsor; David Kranz, columnist for the Sioux Falls Argus Leader; Leslee Unruh, campaign manager for VoteYesForLife; and South Dakota residents (Reynolds, "World News Tonight," ABCNews, 11/1). A transcript of the segment 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.

Endometriosis Raises Risk Of Ovarian, Kidney And Thyroid Cancer

Women with endometriosis have an increased risk of developing either ovarian, kidney or thyroid cancer, say French researchers at the 23rd Annual Meeting of the European Society of Human Reproduction and Embryology, Lyon, France.


The researchers, led by Dr. Anna-Sofia Melin, Karolinska Institute, Stockholm, Sweden, examined data on 63,630 women who had endometriosis. They found that endometriosis was linked to a higher risk of developing certain types of tumor. They also found that the number of children a woman has had does not seem to influence her cancer risk, even if she has had no children.


Dr Melin said "It could be that defects in the immune system allow the endometriosis to grow and also might allow cancer cells to grow in different parts of the body. Maybe the treatment of endometriosis can influence cancer development. We do not know yet."


Dr. Melin and team doubt that the fertility problems brought on by endometriosis raise cancer risk.


The scientists found endometriosis raised the risk of developing the following types of tumors:


-- Ovarian tumors - 37% greater risk

-- Endocrine tumors - 38% greater risk

-- Kidney tumors - 36% greater risk

-- Thyroid tumors - 33% greater risk

-- Brain tumors - 27% greater risk

-- Malignant melanoma - 23% greater risk

-- Breast cancer - 9% greater risk

Surprisingly, women with endometriosis seem to have a 29% lower risk of developing cervical cancer.


Dr. Melin said "Our hope is that doctors in general start to view the endometriosis disease as a serious disease that causes a lot of suffering to the patient and also may lead to cancer."


What is Endometriosis?


It is a medical condition caused by the lining of the womb growing elsewhere in the body, such as the ovaries, fallopian tubes and abdominal cavity - other areas can be affected, such as the bladder, bowel, vagina, cervix and vulva. It affects about 15% of women of reproductive age - in advanced cases it can leave women infertile.


The misplaced tissue develops into lesions or growths which respond to the menstrual cycle, as does the tissue of the uterine lining - on a monthly basis the tissue builds up, breaks down and sheds. The blood from the misplaced tissue, however, has no way of leaving the body. The patient experiences internal bleeding, inflammation, bowel problems, infertility and scar tissue formation.


It is a painful, chronic disease which affects 5.5 million women/girls in Canada/USA.


Symptoms of Endometriosis?


-- Painful period

-- Pain before period

-- Painful sex

-- Infertility

-- Fatigue

-- During periods urination is painful

-- During periods bowel movements are painful

-- Nausea, diarrhea, constipation

-- Yeast infection


23rd Annual Meeting of the European Society of Human Reproduction and Embryology

Experts Available: National Day Of Remembrance And Action On Violence Against Women

Sexual assault is one of the most under-reported crimes. According to Statistics Canada, fewer than 10% of sexual assaults are reported to the police. Canadian Institutes of Health Research (CIHR) experts are available to discuss the health implications of violence in light of the National Day of Remembrance and Action on Violence against Women on December 6.


The CIHR Institute of Gender and Health currently supports more than 100 researchers and graduate students on the topic of violence.


"Their studies identify groups at risk of violence and the factors that influence this behaviour. The studies also analyze the effects on the victims," said Dr. Miriam Stewart, Scientific Director for CIHR Institute of Gender and Health. "The research helps better inform strategies for prevention and intervention."


Here are a few examples of CIHR-funded research:


-- Computer-assisted program to detect victims of abuse: Dr. Farah Ahmad from St-Michael's Hospital in Toronto is leading the development of a computer-assisted intimate partner violence screening that may offer an effective and timely way to detect victims of abuse.


-- Mothers and children exposed to partner violence: Dr. Nicole Letourneau from the University of New Brunswick has launched a first-of-its-kind study into the relationship between mothers and children who have been exposed to partner violence. The study involves 90 mothers and their children, and 90 service providers. Dr. Letourneau was named Canada's Premier Young Researcher by CIHR this November 22 in Ottawa.


-- Abuse in same-sex relationships: Dr. Janice Ristock from the University of Manitoba worked with local community organizations in 6 Canadian cities to bring together the experiences of women who had been abused in their same-sex relationships. She is the author of the book No more secrets: Violence in lesbian relationships.


Dr. Miriam Stewart, Scientific Director for CIHR Institute of Gender and Health, is available to comment on the health risks of abused women. The CIHR-funded researchers are also available for interviews.


CIHR's Institute of Gender and Health is the first research institute in the world to examine the health of women and girls, men and boys. It champions efforts to better understand how sex and gender influence access to the health system, chronic conditions, disabilities, health across the lifespan, health behaviour, addictions and environmental determinants of health. cihr-irsc.gc.


Canadian Institutes of Health Research (CIHR)

160 Elgin St., 9th Fl.

Ottawa, Ontario K1A 0W9

Canada

cihr-irsc.gc/e/193.html

Utah Should Include Both Abstinence, Contraception Education In Schools, Editorial Says

"Facts are sometimes the first casualty in the abortion debate," a Salt Lake Tribune editorial says. An example of this came during a January committee hearing in the Utah Legislature over a bill (H.B. 90) that would raise criminal penalties for performing illegal abortions and change the definition of viability, according to the editorial. The state Legislature approved the bill, which now is before Gov. Jon Huntsman (R). During the January hearing, state Rep. Stephen Sandstrom (R) said that nationwide statistics show that "'the vast majority of abortions happen to middle-age women,'" who "'know about birth control,'" the editorial states. Sandstrom also said that abortion "'doesn't have anything to do with teaching abstinence in the schools,'" the editorial says.

According to the editorial, "Sandstrom was flat wrong, not least about the age of the 'vast majority' of women who obtain abortions performed in Utah." The editorial notes that 2007 data from the state Department of Health's Center for Health Data show that of the 3,516 abortions in Utah that year, the largest number was among teens, while the next highest number was among women ages 20 to 24. "Together, these two youngest cohorts accounted for 65% of the abortions" in 2007, the most recent year for which data are available, the editorial says, adding, "So much for middle-age women."

It continues, "Because most women who have abortions are young, we continue to believe that one of the surest ways to reduce the number of abortions is through comprehensive sex education in the public schools that includes instruction about contraception." However, a bill proposing such curriculum "went nowhere in this year's legislative session," the editorial says. Although "Utah's abstinence-only sex education is correct when it teaches that not having sex before marriage is the certain way to prevent pregnancy, it also is clear that that message is not persuading many young people," according to the editorial. It adds that leaving young people "ignorant of the knowledge to protect against conception and disease from sex outside of marriage is both cruel and unrealistic," as well as "bad public health policy." It concludes, "Abstinence is one way to prevent abortion. Contraception is another. Utah should teach both" (Salt Lake Tribune, 3/19).


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.

Health Reform Proposals Include Several Changes To Improve Women's Coverage

Health care reform legislation under consideration in Congress "would dramatically change the rules" on how health insurance covers women, McClatchy/Contra Costa Times reports. In the current insurance market, women typically are charged more for coverage because they tend to use more preventive care. In many states, women can be denied coverage from insurers that consider pregnancy or previous caesarean sections pre-existing conditions.

McClatchy/Times reports that reform would affect women in three main areas: gender-based pricing, preventive care and financial assistance for lower-income parents. The bills in Congress would make the practice of gender-based pricing illegal; eliminate copayments and deductibles for preventive care, such as mammograms and Pap tests; require reasonable rates for maternity coverage; and provide financial assistance to people who are unable to afford health insurance, according to McClatchy/Times.

According to the National Women's Law Center, women ages 15 to 44 spend 68% more on health care than their male peers. An NWLC survey found that insurers in 47 states and Washington, D.C., that permit gender rating charged 40-year-old women between 4% and 48% more than their male counterparts. A 2009 Commonwealth Fund study found that 45% of women ages 18 to 64 were uninsured or underinsured, compared with 39% of men, based on 2007 data.

Rep. Jan Schakowsky (D-Ill.) said women "are in double jeopardy" because they are "usually charged more" and also "earn less than men." She added that "even if [women] were charged the same premiums, they would pay a bigger percentage of their income" (Lightman, McClatchy/Contra Costa Times, 10/6).


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.

Most Arguments Over Sex Education 'Miss The Point,' Time Opinion Piece Says

Congress this spring "will dive once more into the war over sex education" as it debates whether to eliminate $176 million in federal funding for abstinence-only education programs, Amy Sullivan-Anderson writes in a Time opinion piece that will be published in the magazine's March 30 issue. Although advocates "will debate at top volume the merits of abstinence-only efforts vs. more comprehensive education programs that also teach about birth control and sexually transmitted infections, ... [t]hese arguments miss the point," Sullivan-Anderson writes. "We now have a pretty good sense of which sex-education approaches work," she says. A "[s]ubstaintial" body of research, including a 2007 Bush administration report, has shown that comprehensive sex education programs are "most effective at changing teen sexual behaviors," according to Sullivan-Anderson. She notes that comprehensive sex education programs are "largely uncontroversial outside Washington" and that "[v]ast majorities of parents favor" such programs.

What is missing from the sex education debate is "the political will and community investment necessary to educate kids about sexuality and healthy relationships in a truly responsible and honest way," Sullivan-Anderson writes. Students need programs that do not "end after two weeks" and that give them "a safe space to return to for answers and advice," she says. According to Sullivan-Anderson, an "innovative relationship and sex education curriculum" in an Anderson County, S.C., school district is an example of "what can happen when a community decides that it's crazy to spend more time teaching kids about decimals and fractions than about dating and sex." The program, which the school district runs in conjunction with a local teen pregnancy prevention organization, extends through three years of middle school and into high school, in addition to an after-school program for at-risk teens. Sullivan-Anderson writes that there is "growing evidence" that such programs "can be more effective than abstinence-only curriculums at persuading teens to behave more responsibly" and can reduce sexual risk in three areas: delaying the age at which teens first have sex, decreasing the number of sexual partners and increasing condom use among sexually active teens. The "crucial difference" between the newer comprehensive curriculums and their older counterparts is the "new emphasis on behavior," she says, adding that schools and parents are "increasingly putting their support behind the comprehensive approach."

South Carolina's 1988 Comprehensive Sex Education Act requires sex education from elementary school through high school, including a minimum of 12.5 hours of "reproductive health and pregnancy prevention education" during high school. The state law allows each school district "to make its own decisions about what sex education should involve," but "with federal funding limited to abstinence-only programs, local districts have a powerful incentive to restrict their sex education curriculums," Sullivan-Anderson writes. The program in Anderson County's District 3, called Impact, "is sometimes referred to as 'abstinence first' or 'abstinence plus' because it combines factual information about birth control and STIs with a strong message that kids should wait to have sex," according to Sullivan-Anderson. Other school districts in Anderson County are interested in replicating the program in their schools, but the "only thing stopping them is money," she says. Sullivan-Anderson writes that since District 3's program began, teen birth rates in the school district were stable for three years and then dropped the last two years.














However, "even if every community in America woke up tomorrow and decided to put an end to the sex-education wars -- laying aside the chastity belts and condom bananas and embracing comprehensive, abstinence-first education -- it's not clear that much would change," according to Sullivan-Anderson. Despite "all the battles over funding and policies, no one really knows how sex education is taught inside most classrooms," she continues. She writes that "very few" states and local school districts "set standards on how to give students factual information about sex or teach them to develop healthy relationships. Even fewer attempt to evaluate what is covered in the classroom, and 17 states don't even require sex education to be taught in public schools." She notes that the National Center for Health Statistics recently reported that teen birth rates in 2007 increased for the second year, reversing a decline that began in the early 1990s. "Taking sex education seriously isn't easy," Sullivan-Anderson writes, "But we can't afford to keep failing our children."

Sullivan-Anderson also profiles a 16-year-old student participating in the Impact program (Sullivan-Anderson, Time, 3/19).


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 Who Suffer Migraine With Aura Have Better Outcomes After Stroke

Women with a history of migraine headache with aura (transient neurological symptoms, mostly visual impairments) are at increased risk of stroke. However, according to new research reported in Circulation: Journal of the American Heart Association stroke events in women with migraine with aura are more likely to have mild or no disability compared to those without migraine.



In a new analysis of the Women's Health Study involving 27,852 women over 13.5 years, researchers found those who have migraine with aura and who experience an ischemic stroke were twice as likely to have no significant disability from stroke.



"The message from this study should be reassuring for migraineurs," said Tobias Kurth, M.D., Sc.D., the study's principal author and associate epidemiologist at Brigham and Women's Hospital in Boston, Mass.



"It is important for women who have migraine with aura to know that their risk of stroke is considerably low and there is high likelihood of a migraine-associated stroke being mild."



The reason for these results is unclear. But Kurth, who is also director of research at INSERM in Paris, France, speculated that mechanisms, perhaps involving smaller vessels - not the traditional mechanisms for stroke, lead to a smaller size stroke.



Compared to those without migraine history, women with migraine and aura were more likely to have a good to excellent functional outcome - defined as having no symptoms and no significant disability, researchers said.



Women participating in the study were divided into four groups: 22,723 who reported no migraine history; 5,129 who reported a migraine history; 3,612 who had active migraine; and of those who reported active migraine, 1,435 reported active migraine with aura.



Researchers evaluated functional ability after stroke at hospital discharge using the modified Rankin Scale, a seven-point scale that measures degree of impairment.



At the onset of the study, women completed a questionnaire about their headaches that allowed classification into the groups of migraine with and without aura, history of migraine or no history of migraine. Each following year, the women reported new medical conditions, including transient ischemic attack (TIA) or stroke, which were confirmed after medical record review.



During 13.5 years of follow-up, 398 TIAs and 345 ischemic strokes occurred.



Women in the study were primarily Caucasian, average age 55, healthy and working in the healthcare field.



There is currently little reason to believe that the association differs for women with other characteristics or men, Kurth said.



The first author is Pamela M. Rist, M.Sc., a doctoral student at the Harvard School of Public Health and research fellow at Brigham and Women's Hospital. Other co-authors are: Julie E. Buring, Sc.D.; Carlos S. Kase, M.D.; Markus Schurks, M.D., M.Sc. Author disclosures are on the manuscript.



The Women's Health Study is supported by grants from the National Heart, Lung, and Blood Institute and the National Cancer Institute. Grants from the Donald W. Reynolds, Leducq and Doris Duke Charitable foundations funded part of the study.



Source:

Karen Astle

American Heart Association

Non-Parental Care Of Infants Tied To Unfavorable Feeding Practices

With more new mothers in the workplace than ever before, there has been a corresponding increase in the number of child-care facilities in the United States.



At the same time, data from a variety of sources point to a growing prevalence of overweight infants and toddlers.



Is there a connection?



According to a new study co- University of Illinois community health professor Juhee Kim and Karen Peterson, a professor of nutrition and society at Harvard University's School of Public Health, child-care factors and feeding practices may indeed play a role.



"Our study is the first to report, to our knowledge ... the potential importance of infant child care on infant nutrition and growth," the researchers said in an article published in the July issue of the Archives of Pediatrics & Adolescent Medicine, a publication affiliated with the Journal of the American Medical Association. "The results of this study indicate that structural characteristics of child care, such as age at initiation, type and intensity, were all related to infant feeding practices and weight gain among a representative sample of U.S. infants."



Specifically, Kim and Peterson found that 9-month-old infants who routinely receive non-parental care - provided by relatives, licensed day-care centers or more informal child-care providers - may experience higher rates of unfavorable feeding practices. The babies also weigh more than those whose primary caregivers are their parents.



The researchers' findings could have significant public-health ramifications, as weight gain in infancy can ultimately be a predictor of obesity later in life.



Obesity, in turn, is linked to a number of chronic illnesses, such as diabetes and hypertension, as well as adulthood morbidity and mortality.



In their study, Kim and Peterson analyzed baseline data from a nationally representative sample of 8,150 9-month-old infants to determine whether infant-feeding practices and non-parental care might be a factor in the rise in weight of the infants. They used data collected for children enrolled in the Early Childhood Longitudinal Study, Birth Cohort, conducted by the U.S. Department of Education's National Center for Education Statistics.



Kim and Peterson found that 55.3 percent of the infants had received regular, non-parental child care, with half of those infants receiving full-time child care. Among babies in child care, 40 percent began receiving such care at age 3 months; 39 percent, between 3 and 5.9 months, and 21 percent at 6 months or older.



"Weight gain and the prevalence of overweight were lowest among infants who received care by parents," the researchers noted in the published article.
















The researchers also examined data regarding breastfeeding initation for babies receiving parental and non-parental care, along with the stage at which solid foods were introduced to the infants. Only starting solid foods before 4 months of age was associated with increased overweight among infants.



"Infants who initiated child care before 3 months of age had lower rates of ever having been breastfed and higher rates of early introduction of solid foods," they wrote. "Infants in parental care were more likely to have breastfeeding initiated and solid foods introduced after 4 months of age compared with those in child-care settings."



Further, infants in part-time child care gained more weight -175 grams - by 9 months of age, compared with those receiving only parental care. Those being cared for by relatives also showed a weight gain - 162 grams.



"A strength of our findings," the researchers noted, "is that the observed effects of child-care factors remained significant after controlling for maternal pre-pregnancy BMI (body mass index) and a child's birth weight."



"Although both factors are known to be strong predictors of childhood overweight status, in our study, only birth weight was a significant factor in weight gain."



Kim said there are a couple of important take-home messages from their research results for parents and child-care providers.



"Parents may want to have enough communication with child-care providers about when, what and how to feed their babies during their stay in day care, which is important to avoid potential risk of overfeeding or underfeeding at home," she said.



"Child-care professionals can encourage parents' active involvement in the decision process of what, when and how to feed infants. Child-care providers also need to participate in nutrition-education/training programs to understand the importance of starting solid foods, transition from breast milk or formula to foods, and how to implement recommended practices to ensure a healthy eating environment."



Kim hopes to be able investigate relationships among child care, feeding practices and weight gain in children in other parts of the world.



"It would be interesting to conduct a cross-cultural study," she said. "Considering eating is a socio-economical and cultural event, the impact of child care on infant feeding practices - food consumption - might be different among different countries."







The current research was supported in part by the Berkowitz Fellowship of the department of nutrition, Harvard School of Public Health; an Early Childhood Longitudinal Study, Birth Cohort training grant from the National Center for Education Statistics; and training grants on statistical analysis for education policy from the American Educational Research Association.



Source: Melissa Mitchell


University of Illinois at Urbana-Champaign

Joint Surgery Predicted By Number Of Children And Use Of HRT

According to a study published in the Annals of the
Rheumatic Diseases, women who have many
children, used hormone replacement therapy, and had early puberty are
more likely to have surgery performed on their joints - especially on
their knees.



Researchers from the United Kingdom studied 1.3 million middle-aged UK
women who took part in the Million Women Study. The health of the
participants was tracked beginning around age 50, and they were
monitored for about six years. Baseline information provided data on
the age of the participants when they had their first and last
menstrual events, how many children to whom they had given birth, and
their use of oral contraceptives and hormone replacement therapy (HRT).
The researchers used the follow-up data to see if the women were
admitted to hospital for a knee or hip replacement for the inflammatory
joint disease, osteoarthritis.



Dr Bette Liu (Cancer Epidemiology Unit, University of Oxford, Oxford,
UK) and colleagues report that over 12,000 of the women needed a hip
replacement and a little less than 10,000 required a knee replacement
during the follow-up time period.



What factors most predicted these surgeries? Serial motherhood - or
having additional children - increased the probability of a hip
replacement by 2% and of a knee replacement by 8%. Women who began
menstruation before the age of 11 increased their likelihoods of both
types of surgery by 9 to 15%. The researchers found that previous use
of oral contraceptives did not seem to have a significant effect on the
risk of joint surgery. However, use of HRT raised the probability of a
hip replacement by 38% and of a knee replacement by 58%.



The researchers point out that women on HRT are probably making better
use of health services, which may partly explain their highly
likelihood of joint surgery. They also suggest that female sex
hormones, such as estrogen, may help explain the difference in
osteoarthritis, a condition that is more common among women than men.



"Given the large burden of osteoarthritis and the associated burden of
joint replacement surgery in women worldwide, it is important to
understand the role of potentially modifiable factors for these
conditions. We found that parity, age at menarche and HRT use are all
associated with the risk of hip and knee replacement and that the knee
joint is affected more by these factors than the hip joint. However the
underlying reasons for these findings remain unclear," conclude the
authors.



Reproductive history, hormonal factors and the incidence of
hip and knee replacement for osteoarthritis in middle-aged women

B Liu, A Balkwill, C Cooper, A Roddam, A Brown, V Beral, on behalf of
the Million Women Study Collaborators

Annals of the Rheumatic Diseases (2008).

doi:10.1136/ard.2008.095653

Click
Here to View Journal Website



: Peter M Crosta

Uruguayan Ministers, Public Figures Join Internet Campaign To Legalize Abortion

Two government ministers and other Uruguayan public figures recently joined an Internet-based campaign to legalize abortion in the country, Reuters reports (Avila, Reuters, 6/11). Women who undergo abortion in Uruguay can face a three- to nine-month prison sentence, and anyone who is convicted of performing an abortion can face six to 24 months in prison. Abortion has been illegal in Uruguay since 1938 (Kaiser Daily Women's Health Policy Report, 5/10/04). About 30,000 illegal abortions are performed annually in the country, which has a population of about 3.3 million, according to nongovernmental organizations.

According to Reuters, about 3,500 people have signed a petition at despenalizar.blogspot since June 1, including the interior and social development ministers, writers and artists. The Web site says, "Those of us signing this have violated the law ... either by having an abortion or financing one, by accompanying a woman to have one, (or) knowing the identity of many women who have had one and keeping quiet. Either we are criminals or the law is unjust."

According to a recent poll, 61% of the country's population support legalizing abortion. A bill that would ease restrictions on the procedure was recently introduced in Congress, but Uruguayan President Tabare Vazquez has said he will veto any such legislation. The Senate defeated a similar bill in 2004 after the lower chamber passed it (Reuters, 6/11).

"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.

Primate Ovaries Shielded From Radiation-Therapy-Induced Damage

A strategy developed by Massachusetts General Hospital (MGH) researchers to shield the ovaries of female mammals from the damaging effects of radiation and chemotherapy has passed an important milestone. A collaborative study with investigators from Oregon Health and Sciences University (OHSU), published online in the journal Fertility and Sterility, reports that brief preexposure of the ovaries to an FDA-approved agent called FTY720 preserved the fertility of female rhesus monkeys exposed to potentially lethal doses of radiation. All of the treated animals have had successful pregancies and delivered healthy offspring.



"When we started working on this project in the mid-1990s, the only strategy available to preserve the fertility of cancer patients was collecting and freezing eggs or ovarian tissue for assisted reproduction, neither of which offered much in terms of successful pregnancies," explains Jonathan Tilly, PhD, director of the Vincent Center for Reproductive Biology in the MGH Department of Obstetrics and Gynecology, senior author of the Fertility and Sterility article. "Since then we have brought the concept of protecting the ovaries from damage caused by anticancer treatments all the way from an idea on paper, through a decade of mouse studies, to a proof of concept in living primates."



In 1997 Tilly and collaborators at the MGH and other research centers discovered that treatment with chemotherapy drugs led to the death of egg cells in mice through a process known as apoptosis - used naturally by the body to delete unwanted or damaged cells - and also identified the specific cell-death pathway involved. A follow-up 2000 study from Tilly's group showed that blocking that pathway with a compound called sphingosine-1-phosphate (S1P) preserved the egg cells (oocytes) of mice exposed to radiation therapy, which activates the same cell-death pathway as chemotherapy; and that those oocytes could be fertilized. A third study from Tilly and colleagues at Memorial Sloan-Kettering Cancer Institute reported in 2002 that S1P-pretreated female mice that were mated two months after receiving radiotherapy successfully delivered litters of healthy offspring.



Testing this approach in primates presented several challenges, so before attempting a trial in monkeys, the researchers wanted to be sure that S1P would also protect human oocytes. Ovarian tissue from human patients was grafted into immunodeficient mice, and some of the animals were treated with S1P for an hour before the tissue was exposed to radiation. The experiment showed that the resting pool of follicles from which oocytes develop into mature eggs was protected in the S1P-treated animals but was largely depleted in the human grafts not protected with S1P.



Another potential obstacle to bringing this approach from mice to primates is the fact that rodent ovaries are enclosed in a membrane sac, confining any drug injected into the sac to the ovary. Primate ovaries are free of any such enclosure, presenting the risk that any protective agent applied to the ovary might escape and protect tumor cells as well. Fortunately, investigators at the Oregon National Primate Research Center based at OHSU had already developed an implantable miniature pump that could deliver a drug to the ovaries alone.
















In the current study, the OHSU team, led by Mary Zelinski, PhD, conducted a series of experiments, the first of which confirmed that delivering S1P directly to the ovaries of rhesus monkeys provided the same sort of protection from radiation effects seen in the earlier mouse studies. Since S1P is a rather unstable molecule that is broken down quickly, the researchers then tried using FTY720, a long-acting S1P-like agent with similar effects that also is approved for the treatment of multiple sclerosis. Treatment with FTY720, also called fingolimod, was even more successful than S1P in protecting monkey ovarian follicles from radiation-induced cell death.



In the final experiment, radiation was delivered directly to the ovaries of three female monkeys that had been pretreated with FTY720. A control group of three underwent a sham radiation treatment after receiving an inert infusion. Both groups resumed normal menstrual cycles, were successfully mated, and all have delivered offspring that appear normal and healthy. Two of the three radioprotected females have become pregnant a second time and delivered two more healthy offspring. Because female monkeys without normal ovarian function will not mate, there was no mating test of irradiation without FTY720 protection, since those animals would have complete ovarian destruction.



"This first generation of offspring born to FTY720-protected mothers have been assessed anatomically and behaviorally, as well as with the most sensitive assay we have for propagated genetic damage, and everything looks fine," says Tilly. "They are now about 2 years old and approaching sexual maturation, so we want to make sure they are reproductively normal and that the second-generation offspring will also be normal."



Tilly stresses, "The damage that anticancer treatments inflict on women's ovaries not only destroys their fertility, it also exposes them to the health risks of premature ovarian failure. The animals in this study have maintained ovarian function - they are still having normal menstrual cycles - several years after they were treated, which is critical. There are a handful of approaches out there that might give cancer patients a shot at preserving fertility, but this is currently the only option on the table for preventing premature menopause."



The current study, Tilly adds, is also an illustration of the power of collaboration. "This work could not have been done without the vast experience in primate ovarian biology of Mary Zelinski and her team at OHSU. We brought the science developed from more than a decade of mouse studies and, by working together with Mary's team, successfully translated that work from mice to primates, enabling us now to say with confidence that this approach has a good chance of succeeding in human pateents." A professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, Tilly hopes to next plan a clinical trial in human cancer patients, in collaboration with colleagues from the MGH Cancer Center.



Notes:



In addition to Zelinski, who is lead author, co-authors of the of the Fertility and Sterility paper are Maralee Lawson, Francis Pau, PhD, Natalia Toscano, Darla Jacob and John Fanton, DVM, Oregon Health and Sciences University; Mark Murphy, Battelle Pacific Northwest Division; Andrea Jurisicova, PhD, and Robert Casper, MD, University of Toronto; and Steven Dertinger, PhD, Litron Laboratories. The study was supported by grants from the National Institutes of Health, the Canada Research Chair Program, the Canadian Institutes of Health Research, and Vincent Memorial Hospital Research Funds. The MGH holds patents on the use of S1P and its analogs for protection of oocytes from the side effects of anticancer therapies.



Source:

Sue McGreevey

Massachusetts General Hospital

Maternal Mortality Rate In U.S. Highest In Decades, Experts Say

The maternal mortality rate in the U.S. is the highest it has been in decades, according to statistics released this week by CDC's National Center for Health Statistics, the AP/Washington Post reports. According to the figures, the U.S. maternal mortality rate was 13 deaths per 100,000 live births in 2004. The rate was 12 deaths per 100,000 live births in 2003 -- the first year the maternal death rate was more than 10 since 1977 (Stobbe, AP/Washington Post, 8/24). A total of 540 women were reported to have died of maternal causes in 2004, 45 more than were reported in 2003, according to the report (NCHS report, 8/21).

Reasons for Increase
A rise in the number of caesarean sections -- which now account for 29% of all births -- could be a factor in the increased maternal mortality rate, some experts said. According to a review of maternal deaths in New York, excessive bleeding is one of the primary causes of pregnancy-related death, and women who have undergone several previous c-sections are at particularly high risk of death.

Some studies have found that race and quality of care also factor into the maternal mortality rate. The maternal mortality rate among black women is at least three times higher than among white women. Black women also are more susceptible to hypertension and other complications, and they tend to receive inadequate prenatal care. Three studies have shown that at least 40% of maternal deaths could have been prevented with improved quality of care.

The rise in obesity also might be a factor, some experts said. According to researchers, overweight women tend to have diabetes or experience other complications that could affect pregnancy outcomes. Overweight women also might have excessive tissue or larger infants, which could make a vaginal birth more difficult and lead to more c-sections. More women also are giving birth in their late 30s and 40s, when risks of pregnancy complications are higher, according to the AP/Post (AP/Washington Post, 8/24).

In addition, the report says the increase in maternal deaths "largely reflects" more states' use of a separate item on the death certificate indicating pregnancy status of the woman. According to the report, the number of maternal deaths does not include all deaths of pregnant women, but only those deaths reported on the death certificate that were assigned to causes related to or aggravated by pregnancy or pregnancy management (NCHS report, 8/21). California, Idaho and Montana in 2003 changed death certificate questions, the AP/Post reports (AP/Washington Post, 8/24).


The report is available online (.pdf).

"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.

Abstinence-Only Education 'Fails' Texas Children, Editorial Says

"Abstinence is a good message, but teens also must know the dangers of having sex without condoms and contraceptives," a Dallas Morning News editorial says. According to the editorial, Alaska Gov. Sarah Palin's (R) 18-year-old daughter Bristol, who gave birth in December after an unintended pregnancy, recently said on Fox News that abstinence-only education is "not realistic at all." Bristol Palin "knows from experience something that has yet to sink in among Texas education policymakers: An abstinence-only health curriculum fails our children," the editorial says.

Texas "consistently ranks among the top five states for teen pregnancies," the editorial continues, adding that the state was behind only Mississippi and New Mexico in recent federal statistics. A new study conducted by researchers at Texas State University and funded by the Texas Freedom Network, which favors a comprehensive sex education curriculum, found that up to 96% of Texas school districts either teach an abstinence-only curriculum or avoid discussing sex altogether. David Wiley, co-author of the study, wrote that the prevailing attitude among health teachers in the state is that "when it comes to sexuality education, it's best to keep your mouth shut." The editorial writes, "Adding to the fear was the Board of Education's decision in 2004 to adopt health textbooks that preached abstinence while downplaying the benefits of condoms and contraceptives." The editorial writes that Centers for Disease Control and Prevention data show that Texas teens have unprotected sex "far more often" than the national average and that states and cities using an "abstinence-plus" curriculum see rates of unprotected sex below the national average. "Statistics show that when students receive the complete message, they listen," the editorial writes.

The editorial writes that "one Texas teenager gets pregnant every 10 minutes, on average," according to the Texas Department of State Health Services. "In contrast to the Board of Education," the health department "specifically recommends a multifaceted approach including abstinence counseling and advice on the use of condoms and contraceptives," the editorial continues, adding, "That message clearly isn't getting through to the schools." The editorial concludes, "Texas, it's time to get real. It's time to talk to our teens about abstinence and protected sex" (Dallas Morning News, 3/1).


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.

Breast Cancer Survivors And Advocates From Across California Call For Continued Support Of The Every Woman Counts Program

Breast cancer survivors and advocates from across California traveled to Sacramento Wednesday, March 9th, to stress to policymakers the importance of the Every Woman Counts (EWC) program that helps detect breast cancer early. Organized by the state's Susan G. Komen for the Cure® Affiliates, the breast cancer advocates also urged lawmakers to maintain their commitment to women in California, by preserving funding to the EWC program, which provides vital breast cancer screening services for California's uninsured and underinsured women.


"We fully understand the tough economic situation our elected leaders face and the difficult choices they must make," said Jamie Ledezma, Chair of the Komen California Collaborative. "It's important to remember that early detection through regular cancer screening is a key to surviving breast cancer. For many women, the state's screening program ensures that a lost job or lost insurance doesn't result in a lost life."


While in Sacramento for the day, representatives from the seven Affiliates met with legislative leaders and administration officials to discuss the importance of the EWC program. The program, they noted, is essential for detecting cancers early. The 5-year survival rate for breast cancer when found early is 98 percent, but plummets to 23 percent when the cancer has spread to other parts of the body.


"We are all just one biopsy away from a changed life. That's why we need to focus on prevention and early detection measures so that we begin treatment early, when it's more successfully and cost effectively treated," said Ledezma.


In January 2010, the California Department of Public Health (DPH) shut the EWC's doors for the remainder of the fiscal year and closed access to the program for women ages 40 to 49. That last cut was particularly troubling because almost half of the women screened by EWC are in their 40s.


The California Affiliates of Susan G. Komen for the Cure® applaud the bipartisan effort of our state leaders for honoring their commitment to women in California by restoring funding to EWC in the state budget last October. On December 1, 2010, the DPH officially reopened the doors and began providing life-saving breast cancer screening to eligible women ages 40 and over. The California Affiliates call on our state leaders to protect funding for EWC for the next fiscal year.


The California Affiliates recognized the efforts of Senator Noreen Evans (SD-2) by awarding her the "Legislator of the Year" for leading the way to restoring EWC for women in California last year.


The California Affiliates also honored the tireless commitment by late Senator Jenny Oropeza for her work on women's health issues during her tenure in the state legislator. As a tribute to Senator Oropeza's dedication to fostering protections for women's health issues, the Los Angeles County Affiliate, in joint collaboration with the California Affiliates, have established the Senator Jenny Oropeza Public Policy Internship. Ms. Rebecca Rodstein, a Master's of Public Health student at USC, is the first intern to serve in the Senator Jenny Oropeza Public Policy Internship.


The Komen Affiliates noted that they are critical community partners. Komen has invested more than $23 million in active research grants in California and there are currently 73 active research grants in the state, including awards to UCLA, UCSF, Cedars Sinai Medical Center, California Pacific Medical Center, Stanford University, UC Davis School of Medicine and the Burnham Institute for Medical Research.


The Komen Affiliates that serve California invested over $10 million in their local communities last year for early detection and treatment of breast cancer, breast health education and outreach. Nationwide, Komen Affiliates invested a total of $130 million in their local communities.


Source:

Susan G. Komen for the Cure

Progesterone Reduces Rate Of Early Preterm Birth In At Risk Women

A new study published online in the journal Ultrasound in Obstetrics and Gynecology has found that progesterone, a naturally occurring hormone, reduced the rate of preterm birth before the 33rd week of pregnancy by 45 percent among one category of at risk women.



The women in the study had a short cervix, which is known to increase the risk for preterm birth. The cervix is the part of the uterus that opens and shortens during labor.



The study also found that infants born to women who had received progesterone were less likely to develop respiratory distress syndrome, a breathing complication occurring in preterm infants.



The study was undertaken by physicians of the Perinatology Research Branch at NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) along with 44 medical centers around the world (including Asia, Africa, Europe, North and South America). The study was a collaboration between the NIH and Columbia Laboratories, Inc., in Livingston, N.J.



"Our study demonstrates that progesterone gel reduces the rate of early preterm delivery - less than 33 weeks - in women with a short cervix," said Roberto Romero, M.D., program head for Perinatology Research and Obstetrics and chief of the Perinatology Research Branch. "Women with a short cervix can be identified through routine ultrasound screening. Once identified, they could be offered treatment with progesterone."



Dr. Romero explained that progesterone is a naturally occurring hormone which is essential to maintain pregnancy and that a short cervix is thought to be a sign of a possible shortage of progesterone.



The study authors reasoned that by giving progesterone to women with a short cervix, they could, in many cases, prolong pregnancy.



A total of 458 women with a short cervix (10-20 millimeters) were randomly assigned to receive either a vaginal gel progesterone preparation or a placebo between the 19th and 23rd week of pregnancy.



Progesterone treatment was associated with a lower rate of preterm delivery at less than 33 weeks (8.9 percent in the progesterone group versus 16.1 percent in the placebo group). Differences in the rate of preterm birth were also seen in births before 28 and 35 weeks of pregnancy.



Infants born to women who received progesterone had a lower rate of respiratory distress syndrome than those in the placebo group (3 percent versus 7.6 percent).




Full citation:

"Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized, double-blind, placebo-controlled trial"

Romero et al..

Ultrasound in Obstetrics and Gynecology;
April 6, 2011.

Alexandria, Va., Honors Progressive-Era Advocate Kate Waller Barrett, Washington Post Columnist Writes

Washington Post columnist John Kelly recently examined the legacy of Kate Waller Barrett, a Progressive-era advocate who worked to improve the lives of sex workers and women who gave birth out of wedlock. On Thursday, the city of Alexandria, Va., honored Barrett by declaring May 20 to be Kate Waller Barrett Day and unveiling a plaque at a local library named after the activist, who died in 1925.

According to Kelly, "At a time when such social ills as prostitution and out-of-wedlock childbirth were not thought appropriate subjects for polite society, [Barrett] rolled up her sleeves and plunged in."

Kelly continues, "Barrett said it was the arrival of an unwed mother at her door, clutching a child in the rain and desperate for a handout, that spurred her to action." Barrett became a doctor and went on to open the Florence Crittenton Home for Unfortunate Women, where residents learned skills such as nursing, cooking and sewing. Kelly notes, "There was a nursery for the children" because "Barrett didn't approve of taking them from their mothers and putting them up for adoption" (Kelly, Washington Post, 5/20).


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


© 2010 National Partnership for Women & Families. All rights reserved.

Obstetrics Gynecology & Infertility, 6th Edition PDA Software

USBMIS, a leading provider of mobile medical software, announced the release of Obstetrics, Gynecology & Infertility for Palm and Pocket PC handhelds.


Obstetrics, Gynecology & Infertility provides useful information for immediate patient care, as well as a basis of practical knowledge for a career in obstetrics and gynecology. Based on the completely rewritten, revised, and updated 6th edition handbook, this PDA software offers mobile access to everything needed to provide comprehensive healthcare to women.


Obstetrics, Gynecology & Infertility PDA software has over 400 tables, flowcharts and figures making each topic easier to recall. In addition, there is information on the subspecialties of maternal-fetal medicine, reproductive endo?¬crinology, and gyn-oncology, as well as a broad base of general medicine reflecting the new emphasis on Ob/Gyn as it expands to include primary care for women.


" This is a superb contribution that is essential for the practice of OB/GYN and womens health in todays setting. As hard as I tried I could not find anything that was missing. This is a treasure. " - Alan DeCherney, M.D., Editor, Fertility and Sterility.


USBMIS, a respected software developer for the medical industry, plans to shortly release a BlackBerry version of this valuable product, along with other top medical references over the coming months. In addition to the Palm and Pocket PC versions currently available at www.usbmis, a desktop edition of Obstetrics Gynecology & Infertility is also available. The desktop edition is a larger version of the printed handbook bundled with the PDA edition at a discounted price and is on hand at all major medical bookstores.


For more information about Obstetrics, Gynecology & Infertility, powered by USBMIS, please visit usbmis.


About USBMIS, Inc.


US Biomedical Information Systems is a leading developer of handheld reference software for medical professionals. USBMIS software solutions create user-friendly programs that work to the exacting standards of physicians at the bedside, in the clinic, and in the medical laboratory. Since 1999, USBMIS medical software has helped medical professionals in over 150 different countries find important information quickly on their handheld computers.


About Obstetrics Gynecology & Infertility, Desktop edition


Includes print edition and 1 year PDA software subscription. Available at all major medical bookstores.

usbmis

Abstinence-Only Sex Education Is 'Ideology In Search Of A Methodology,' Opinion Piece Says

Although the U.S.' "national investment" in abstinence-only sex education "may not be a scam on the scale of Bernie Madoff, ... this industry has had standards for truth as loose as some mortgage lenders," syndicated columnist Ellen Goodman writes in a Pittsburgh Post-Gazette opinion piece. Goodman writes that a recent Johns Hopkins study about teenagers and virginity pledges found "absolutely no difference" in the sexual behavior of those who took pledges and those who did not. She writes, "In fact, the only difference" was that teens who took pledges were "significantly less likely to use birth control, especially condoms." She adds that the "lesson many students seemed to retain from their abstinence-only program was a negative and inaccurate view of contraception." The study is "not just a primer on the capacity for teenage denial or the inner workings of adolescent neurobiology," Goodman writes. She adds, "What makes this study important is simply this: 'virginity pledges' are one of the ways that the government measures whether abstinence-only education is 'working.' They count the pledges as proof that teens will abstain," which is "like counting New Year's resolutions as proof that you lost 10 pounds."

Goodman continues, "Over the last eight years, a cottage industry of 'abstinence-only-until-marriage' purveyors became a McMansion industry." According to Goodman, annual funding for abstinence-only programs increased from $73 million in 2001 to $204 million in 2008, for "a grand total of $1.5 billion in federal money for an ideology in search of a methodology." Goodman writes that, "By now, there's an archive of research showing that the binge was a bust," and that "abstinence-only programs have been given failing grades for truth and effectiveness."

The "sorry part is that sex education got caught in the culture wars," continues Goodman. She writes that Bill Albert of the National Campaign to Prevent Teen and Unplanned Pregnancy said sex education has been framed "as a battle between 'those who wanted virginity pledges and those who wanted to hand out condoms to 14-year-olds.'" According to Goodman, "Meanwhile, six in 10 teens have sex before they leave high school and 730,000 teenage girls will get pregnant this year ... What the overwhelming majority of protective parents actually want is not a political battle. They want teens to delay sex and to have honest information about sexuality, including contraception." Goodman says that the "programs that work best combine those lessons." She concludes that teenagers "are not the only masters of denial. But we are finally stepping back from the culture wars. We are, with luck, returning to something that used to be redundant -- evidence-based science. That's a pledge worth signing ... and remembering" (Goodman, Pittsburgh Post-Gazette, 1/2).


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


© 2008 The Advisory Board Company. All rights reserved.

Obstetric Fistula In Tanzania Fueled By Poverty, Inadequate Health Services, Lack Of Knowledge, Report Says

Poverty, inadequate health care services, lack of knowledge about maternal health and pregnancy-related emergencies are fueling the problem of obstetric fistula in Tanzania, according to a report released last week by the nongovernmental organization EngenderHealth and the Tanzania Women's Dignity Project, IRIN News reports (IRIN News, 6/14).

Obstetric fistula develops when a fetus becomes lodged during labor in the narrow birth canal of a girl or young woman, causing pressure that blocks the flow of blood to vital tissues and tearing holes in the bowel, urethra or both, causing incontinence. Physicians can repair a small fistula surgically in less than two hours, but repairing a larger fistula and restoring a woman's continence sometimes requires more than one surgery (Kaiser Daily Women's Health Policy Report, 6/14). According to the report, titled "Risk and Resilience: Obstetric Fistula in Tanzania," the fetus dies in nearly all fistula cases.

For the report, researchers in 2006 conducted case studies of 61 girls and women living with fistula in the Singida Rural, Songea Rural and Ukerewe districts of Tanzania. The report also included studies of the women's families, health care providers and community members. According to the report, lack of preparation for childbirth, including basic information, increases women's risk of fistula. In addition, although prenatal care is widely available in Tanzania, it is inconsistent and inadequate, the report found.

Barriers to "facility-based delivery" -- including lack of money, distance to a hospital and transportation are the "critical reasons why women ... do not get the care they need," according to the report. The report also found that surgery to repair fistula is expensive and inaccessible for many women in the country and urged that fistula repair services be available at no cost or at reduced prices. The report also found that women living with fistula and their families had substantial emotional and economic effects because of stigma and the cost of care, IRIN News reports (IRIN News, 6/14).


The 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.

Percentage Of U.S. Women Breast-Feeding Their Infants Reaches Highest Level On Record, Report Says

The percentage of women in the U.S. who breast-feed their infants has reached the highest level on record amid growing evidence that the practice provides many health benefits to infants and women, according to a study published in the Aug. 3 issue of CDC's Morbidity and Mortality Weekly Report, Reuters reports.

According to CDC, breast-feeding has been associated with a decreased risk of many diseases and conditions -- including ear infections, respiratory tract infections, obesity, eczema, sudden infant death syndrome and diarrhea -- among infants. It also is associated with benefits for women, including a reduced risk of the most common form of diabetes, and breast and ovarian cancer, the agency said (Dunham, Reuters, 8/3).

The report, based on a survey of about 17,000 respondents, found that the percentage of women who started breast-feeding increased from 71% to 74% between 2000 to 2004. However, the report found that the rate of exclusive breast-feeding during the first three and six months after birth was 31% and 11%, respectively (Stobbe, AP/Forbes, 8/2). The goal of the federal government's Healthy People 2010 campaign is to have 50% or more of women breast-feeding at six months and 25% at one year (Kaiser Daily Women's Health Policy Report, 2/2).

According to the study, rates of exclusive breast-feeding were lowest among black women and women who are low-income, unmarried, live in rural areas, have a high school diploma or less education and are younger than age 20 (AP/Forbes, 8/2).

"We've made quite a bit of progress," CDC epidemiologist and lead author of the report Celeste Philip said. She added that she hopes the new statistics will prompt physicians to renew efforts to promote breast-feeding among women. CDC is working with hospitals to encourage support of breast-feeding in the days after birth, Philip said (Reuters, 8/2).


The report is available online.

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.

Asthmatic Girls And Children Exposed To Tobacco Smoke Benefit More From Montelukast (Singulair)

Girls and children exposed to tobacco smoke respond particularly well to montelukast (Singulair) according to researchers at National Jewish Medical and Research Center. Associate Professor of Pediatrics Nathan Rabinovitch, MD, and his colleagues also identified two biomarkers that may help physicians predict even more precisely which patients will benefit from montelukast.



"These findings will help doctors know in advance which patients are most likely to benefit from montelukast and to tailor an effective treatment regimen for specifically them," said Dr. Rabinovitch.



The study was recently published online and will appear in the June issue of the Journal of Allergy and Clinical Immunology.



Inhaled corticosteroids are considered the first-line treatment for cases of persistent asthma. However, steroids alone do not effectively control asthma in 30 percent to 40 percent of patients and they may have some side effects, especially in children. In those cases, a secondary medication is often used. Montelukast is one such medication.



Montelukast, one of the most widely prescribed medications for asthma and allergies, blocks the action of chemicals called leukotrienes, which contribute to inflammation. However, physicians have found that montelukast is quite variable in its effectiveness, helping some patients but not others. Dr. Rabinovitch and his colleagues set out to better understand its variable effectiveness.



They followed the 27 asthmatic students from the Kunsberg School on the National Jewish campus for five months. The children received daily montelukast or a placebo without any change in their other asthma medications. The primary measure of asthma control was how often children needed to use their short-acting rescue medication albuterol.



Before the children began taking montelukast, researchers found that when leukotriene levels in their urine rose, the children used 20 to 25% more albuterol two days later. Once they began taking montelukast, however, children did not need to take albuterol as often when their leukotriene levels rose. Two groups of children responded particularly well to montelukast: girls and children with high levels of cotinine in their urine, which indicated exposure to secondhand tobacco smoke. Both had statistically significant reduced sensitivity to leukotrienes once they began taking montelukast.



"When looking at a general population of patients, montelukast does not appear to be very effective," said Dr. Rabinovitch. "However, in certain patients, the choice of motelukast may be warranted, particularly in school-age girls and children exposed to tobacco smoke."



Dr. Rabinovitch and his colleagues also found that measuring exhaled nitric oxide, a measure of inflammation in patients' breath, and leukotrienes in their urine, could also help them predict which patients would respond well to montelukast-- those with a high leukotriene/nitric oxide ratio.



"Increasingly we have come to understand that asthma is not just one disease; it is more likely several diseases that present with similar symptoms. Thus different medications are likely to work for different patients," said Dr. Rabinovitch. "It is important that we be more selective and tailor our medication regimen so that each child receives the most safe and effective treatment for their type of asthma."







Source: William Allstetter


National Jewish Medical and Research Center




View drug information on Singulair.

A Woman's Age At First Menstruation Influences Risk Of Obesity For Her Children

A new study published in PLoS Medicine suggests that the age when a woman's periods start may affect her children's growth rate during childhood,
final height and risk of obesity in later life. Researchers from the Medical Research Council and University of Cambridge, led by Dr Ken Ong, studied
the association between mother's age at first menstruation, mother's adult body size and obesity risk, and children's growth and obesity risk in 6,009
children from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) in Bristol.


In mothers, earlier age of periods was associated with shorter adult height, increased weight, and body mass index compared with women whose periods
started later. The children of women whose periods started earlier had a faster growth tempo, characterised by rapid weight gain and growth,
particularly during infancy, which led to taller childhood stature. However this pattern of childhood growth is likely to result in earlier maturation
and therefore shorter adult stature. This growth pattern is known to confer an increased risk of childhood and adult obesity.


The researchers conclude that "earlier age at menarche may indicate a transgenerational influence toward a faster tempo of childhood growth, which
is transmitted from the mother to her offspring" and that "understanding the genetic, epigenetic, or behavioural factors that underlie this
process will identify processes that regulate both the timing of puberty and the risk of childhood-onset obesity."


-- Citation: Ong KK, Northstone K, Wells JC, Rubin C, Ness AR (2007)

Earlier mother's age at menarche predicts rapid infancy growth and childhood obesity.

PLoS Med 4(4): e132.

Click here to see article online


PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit www.plosmedicine


About the Public Library of Science


The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit www.plos

BJOG Release: Further Risks Highlighted For Obese Pregnant Women, UK

New research published in BJOG: An International Journal of Obstetrics and Gynaecology has reported obesity, and having previously given birth, as the two largest risk factors for blood clots in the lungs during pregnancy (antenatal pulmonary embolism).


Blood clotting in the lungs is the most important cause of death directly related to pregnancy in women in the UK today, and obese women were found to have an increased risk of 165% compared with non-obese women.


The study was conducted by the National Perinatal Epidemiology Unit (NPEU), in collaboration with doctors and midwives throughout the UK, using information collected from the UK Obstetric Surveillance System (UKOSS). The study addressed management, outcomes and the extent to which preventive and management guidelines are followed in the United Kingdom. All 229 consultant-led maternity units throughout the UK took part over a 19 month period from February 2005 until August 2006.


During this time there were a total of 143 antenatal pulmonary embolisms in an estimated 1 132 964 maternities, giving an incidence rate of 1.3 per 10 000 maternities or 1 per 7700 maternities. Of these cases, there were five maternal deaths.


The study suggested that 62% of pulmonary embolism cases could be attributed to a number of births of one or more, and 21% to obesity (a BMI of 30kg/m2 or greater).


However, while 70% of women had a documented "classical" risk factor (as listed in current UK guidelines), such as a history of blood clots, age of 35 or older, recent bedrest, five or more previous births, obesity (BMI ?? 30 kg/m2), recent long haul travel, surgery during pregnancy, or known thrombophilia (abnormal blood clotting) worryingly, nearly one-third of women had no classical risk factors at all, and only 18% had more than one. This meant that only nine women with classical risk factors were eligible for preventive treatment under current guidelines. Preventive treatment (usually subcutaneous injections of low molecular weight heparin) has been shown in large studies to be remarkably safe, and so in the light of these results, there may be scope to revisit national guidelines, in particular whether the threshold for preventive treatment should be lower.


The study also found a need for further work on guideline implementation. Only two of the nine women with an antenatal pulmonary embolism received the appropriate dose of preventive medication as recommended in the guidelines. Half the women who received antenatal treatment were given lower than the recommended dosage.


Dr Marian Knight, Senior Clinical Research Fellow and Honorary Consultant in Public Health at the National Perinatal Epidemiology Unit, University of Oxford, said "Pulmonary embolism remains an important cause of death in pregnant women in the UK.















"This national study shows that for every woman who dies, more than thirty have a blood clot but survive. Overweight and obese pregnant women were at particular risk, with a more than two and a half times increased risk compared with women of normal weight. This is an especially important observation given the increasing prevalence of obesity in our population.


"Both women and their doctors and midwives should be aware of the risk factors for blood clotting in order that preventive measures can be undertaken where appropriate."


Professor Philip Steer, BJOG editor in chief, said "Antenatal pulmonary embolism is a rare but very serious pregnancy complication and this study has produced some striking results. One of the most interesting is the relatively weak association between pulmonary embolism and many of the classical risk factors for the condition, alerting clinicians to remain ever vigilant when assessing the women in their care.


"Because of the rarity of the condition and thus fairly small numbers of women affected, further multi-national studies are required to ascertain the need for guidelines to be updated regarding diagnosis and treatment."


Notes


- BJOG: An International Journal of Obstetrics and Gynaecologyis owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Blackwell Publishing. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote ' BJOG' or ' BJOG: An International Journal of Obstetrics and Gynaecology ' when referring to the journal.


- The National Perinatal Epidemiology Unit (NPEU) is a research unit at Oxford University established in 1978 by the Department of Health. The unit has expanded considerably in recent years and now has well over 40 staff including epidemiologists, obstetricians, midwives, nurses, paediatricians, social scientists, and information specialists. The NPEU is funded by the Department of Health in England. The views expressed in this paper are those of the authors and do not necessarily reflect the views of the Department of Health.


- UKOSS is a joint research initiative between the NPEU and the Royal College of Obstetricians and Gynaecologists, in collaboration with the Royal College of Midwives, the Obstetric Anaesthetists Association, the National Childbirth Trust, the Faculty of Public Health of the Royal College of Physicians, and the Confidential Enquiry into Maternal and Child Health, and is supported by the Department of Health.


- UKOSS is a UK-wide obstetric surveillance system to describe the epidemiology of a variety of uncommon disorders of pregnancy. The aim is to use this system to lessen the burden on reporting clinicians of multiple requests for information from different sources.


- The recent report "Saving Mothers Lives: Reviewing maternal deaths to make motherhood safer - 2003-2005" from the Confidential Enquiry into Maternal and Child Health showed that 27% of women who died from causes directly or indirectly related to pregnancy were obese.


Reference


Antenatal pulmonary embolism: risk factors, management and outcomes.
Knight M on behalf of UKOSS.
BJOG 2008; DOI: 10.1111/j.1471-0528.2007.01622.x.
Please click here to view article online

Royal College of Obstetricians and Gynaecologists

Health Care for Muslim Women in the USA, Post Conference News Brief

A conference titled, "Patient-centered Health Care for Muslim Women in the United States," the first of its kind in North
America, was held on March 4 and 5, 2005 at the University of Illinois at Chicago. This event was the first in a series of
activities designed to identify and overcome patient, provider and health services related factors that are barriers to the
provision of high quality, culturally appropriate, patient-centered care for Muslim women. Participation was not limited to
any professional, racial or ethnic group. More than 200 participants from across the country attended the conference.



The conference was sponsored by the Department of Family Medicine of the UIC College of Medicine and funded by the Agency for
Healthcare Research and Quality, United States Department of Health and Human Services. This collaborative project was
supported by several UIC Colleges and Centers including the National Center of Excellence in Women's Health; Center for
Research on Women and Gender; School of Public Health; College of Nursing; and, the Great Cities Institute. The project also
was supported by the Illinois Department of Public Health and the Society for Teachers of Family Medicine.


Proceedings began with a welcome address by Dr. Patrick Tranmer, Professor of Clinical Family Medicine and Head, Department
of Family Medicine, College of Medicine, University of Illinois at Chicago. He stressed the importance of addressing health
care needs of diverse populations as a core principle for all health providers and particularly family physicians.


Dr. Memoona Hasnain, Director of Research, Department of Family Medicine, College of Medicine, University of Illinois at
Chicago, principal investigator and conference chair, presented the conference overview, describing the background and
rationale for the project. She touched upon the concepts of patient-centered care and cultural competence. Dr. Hasnain
stated that the religious and cultural beliefs of Muslim women impact their health care needs and they face major barriers
while seeking health care that the rest of the population, particularly health care providers, often are unaware of. The
paucity of research on issues related to health care for Muslim women in the US demands further research in this area. She
also emphasized the importance of keeping in mind that Muslims in America are a diverse group and said that in addition to
the African Americans who are indigenous to this country, immigrant Muslims come from over 150 countries and it would be a
fallacy to lump them all together in one group.


In addition to presentations by national experts, conference highlights included the opportunity for participants to work in
small groups to discuss barriers to culturally appropriate patient-centered health care for Muslim women and develop a
research, action and best practice agenda for future work; as well as to interact with a panel of Muslim women clients who
discussed their health experiences and concerns. Throughout the conference, participants actively engaged in discussions and
voiced strong support for additional conferences on this topic on an ongoing basis.
















Plenary presentations included a variety of topics:


Dr. Asma Barlas, Professor, Department of Politics at Ithaca College, New York, and author of "Believing Women" In Islam:
Unreading Patriarchal Interpretations of the Qur'an (University of Texas Press, 2002) gave the keynote address, "Women in
Islam: Facts and Perceptions." She focused her talk on health care needs of Muslim women within the context of Islamic
tenets; dispelling misconceptions about gender preferences, the young age of marriage for girls, views of the wife as her
husband's sexual property, and polygamy, stating that of these issues raise practical problems for Muslim women and are
bogged down in misleading stereotypes.


Dr. Rosaly Correa-de-Araujo, Senior Advisor on women's health at the Agency for Healthcare Research and Quality, presented an
interactive lecture on "Patient Centered Care: Relevance to Women's Health." Dr. Correa contextualized Muslim women's health
care within the broader realm of patient-centered care and provided an overview of key research findings from national
studies on minority and underserved women's health.


Dr. Fauzia W. Lodhi, Director, Palliative Care and Hospice Program, Rush University Medical Center and member of the Board of
Directors of the Muslim Community Center in Chicago, gave a presentation on "Culturally Appropriate Health Care for Muslim
Women." Dr. Lodhi's talk emphasized the need for health care providers to respect the customs and beliefs of patients from
every religions and culture.



Dr. Nawal M. Nour, Assistant Professor, Harvard Medical School and Director, African Women's Health Center, Brigham and
Women's Hospital, presented "Clinical Perspective: Female Genital Cutting," a topic of great interest to clinicians. Dr.
Nour emphasized that this tradition transcends all religions and geographical locations. People continue the practice of FGC
due to a multitude of complex beliefs, fears and societal pressures that we may never completely comprehend. She explained
that by not circumcising their daughters, parents who, believe in female genital cutting, feel they have done them a great
disservice. She also stressed that providers need to continue to help victims of female genital cutting in a manner that
does not make the patient feel guilty.



The presentation "Patient-Physician Communication: the Case of the Muslim Woman Patient," by Dr. Elizabeth A. Burns,
Professor and Chair, Department of Family Medicine, University of North Dakota School of Medicine and Health Sciences,
provided an example of a US physician who has worked successfully with Muslim women patients by closely understanding and
accommodating their religious and cultural needs.


The conference concluded with a wrap-up by Dr. Memoona Hasnain who thanked all the participants for their input and
reemphasized that the purpose of this line of work is to understand, and raise awareness about the health care issues faced
by Muslim women in this country and design interventions to educate both providers and clients to improve outcomes.


Additional information about the conference is available at: uic.edu/depts/ci/mwhconf


UIC ranks among the nation's top 50 universities in federal research funding and is Chicago's largest university with 25,000
students, 12,000 faculty and staff, 15 colleges and the state's major public medical center. A hallmark of the campus is the
Great Cities Commitment, through which UIC faculty, students and staff engage with community, corporate, foundation and
government partners in hundreds of programs to improve the quality of life in metropolitan areas around the world. For more
information about UIC, please visit uic.edu