The question of whether it is appropriate to vaccinate older women against Human papillomavirus (HPV) is presented for debate in the latest issue of the Medical Journal of Australia.
Dr Rachel Skinner - Senior Lecturer at the School of Paediatrics and Child Health at the University of Western Australia - and her co-authors provide a review of the available information and evidence to help doctors advise women over 26 years of age on the risks and benefits of HPV vaccination.
HPVs are the major cause of cervical cancer. Cervical cancer mortality rates in Australia have been reduced through effective screening programs but there are still 800 new cases of cervical cancer and 300 deaths each year.
Two HPV vaccines are currently available for girls aged 12 and older, through a school immunisation program, and to all women up to the age of 26 years through their GP.
"Recently, a bivalent HPV vaccine has been licensed for use in women aged up to 45 years. Older women have robust immune responses to this vaccine and so should derive benefit from vaccination if they are exposed to HPV type 16 or 18 in the future," Dr Skinner says.
"Despite the vaccine's effectiveness in individual women, it is unlikely the Federal Government will fund a vaccination program for women over the age of 26 as it is not likely to be cost-effective.
"However, if a woman up to the age of 45 years desires protection against cervical disease over and above regular Pap screening, and is prepared to pay for this vaccine, there is considerable potential for individual benefit.
"HPV infection is most common in women under 25 years, drops significantly from 30 years of age, and then appears to increase again in those over 45 years.
"Clinical trials evidence shows that vaccination will have no effect on current or prevalent disease, but should provide a high level of protection from future infection."
The Medical Journal of Australia is a publication of the Australian Medical Association.
Australian Medical Association
вторник, 5 июня 2012 г.
вторник, 29 мая 2012 г.
Binge Eating: Short-Term Program Has Long-Term Benefits
A new study finds that a self-guided, 12-week program helps binge eaters stop binging for up to a year and the program can also save money for those who participate. Recurrent binge eating is the most common eating disorder in the country, affecting more than three percent of the population, or nine million people, yet few treatment options are available.
But a first-of-a-kind study conducted by researchers at the Kaiser Permanente Center for Health Research, Wesleyan University and Rutgers University found that more than 63 percent of participants had stopped binging at the end of the program - compared to just over 28 percent of those who did not participate. The program lasted only 12 weeks, but most of the participants were still binge free a year later. A second study, also published in the April issue of the Journal of Consulting and Clinical Psychology, found that program participants saved money because they spent less on things like dietary supplements and weight loss programs.
"It is unusual to find a program like this that works well, and also saves the patient money. It's a win-win for everyone," said study author Frances Lynch, PhD, MSPH, a health economist at the Kaiser Permanente Center for Health Research. "This type of program is something that all health care systems should consider implementing."
"People who binge eat more than other people do during a short period of time and they lose control of their eating during these episodes. Binge eating is often accompanied by depression, shame, weight gain, loss of self-esteem and it costs the healthcare system millions of extra dollars," said the study's principal investigator Ruth H. Striegel-Moore, PhD, a professor of psychology at Wesleyan University. "Our studies show that recurrent binge eating can be successfully treated with a brief, easily administered program, and that's great news for patients and their providers."
Binge eating has received a lot of media attention recently because the American Psychiatric Association is recommending that it be considered a separate, distinct eating disorder like bulimia and anorexia. This new diagnosis can be expected to focus more attention on binge eating and how best to treat it, according to the researchers. It also could influence the number of people diagnosed and how insurers will cover treatment.
This randomized controlled trial, conducted in 2004-2005, involved 123 members of the Kaiser Permanente health plan in Oregon and southwest Washington. More than 90 percent of them were women, and the average age was 37. To be included in the study, participants had to have at least one binge eating episode a week during the previous three months with no gaps of two or more weeks between episodes.
Half of the participants were enrolled in the intervention and asked to read the book "Overcoming Binge Eating" by Dr. Christopher Fairburn, a professor of psychiatry and expert on eating disorders. The book details scientific information about binge eating and then outlines a six-step self-help program using self-monitoring, self-control and problem-solving strategies. Participants in the study attended eight therapy sessions over the course of12 weeks in which counselors explained the rationale for cognitive behavioral therapy and helped participants apply the strategies in the book. The first session lasted one hour, and subsequent sessions were 20-25 minutes. The average cost of the intervention was $167 per patient.
All participants were mailed fliers detailing the health plan's offerings for healthy living and eating and encouraged to contact their primary care physician to learn about more services.
By the end of the 12-week program 63.5 percent of participants had stopped binging, compared to 28.3 percent of those who did not participate. Six months later, 74.5 percent of program participants abstained from binging, compared to 44.1 percent in usual care. At one year, 64.2 percent of participants were binge free, compared to 44.6 percent of those in usual care.
Everyone in the trial was asked to provide extensive information about their binge eating episodes, how often they missed work or were less productive at work, and the amount they spent on health care, weight-loss programs and weight loss supplements. Researchers also examined expenditures on medications, doctor visits, and other health-related services.
The researchers then compared these costs between the two groups and found that average total costs were $447 less in the intervention group. This included an average savings of $149 for the participants, who spent less on weight loss programs, over-the-counter medications and supplements. Total costs for the intervention group were $3,670 per person per year, and costs for the control group were $4,098.
As expected, participants in the intervention group spent less on weight loss programs and over-the-counter medications and supplements.
"While program results are promising, we highly encourage anyone who has problems with binge eating to consult with their doctors to make sure this program is right for them," said study co-author Lynn DeBar, PhD, clinical psychologist at the Kaiser Permanente Center for Health Research.
Study authors include: Lynn DeBar, John F. Dickerson, Frances Lynch and Nancy Perrin from the Kaiser Permanente Center for Health Research in Portland, Oregon; Ruth H. Striegel-Moore and Francine Rosselli from Wesleyan University; G. Terence Wilson from Rutgers, The State University of New Jersey; and Helena C. Kraemer from the Stanford University School of Medicine.
Source:
Emily Schwartz
GolinHarris International
But a first-of-a-kind study conducted by researchers at the Kaiser Permanente Center for Health Research, Wesleyan University and Rutgers University found that more than 63 percent of participants had stopped binging at the end of the program - compared to just over 28 percent of those who did not participate. The program lasted only 12 weeks, but most of the participants were still binge free a year later. A second study, also published in the April issue of the Journal of Consulting and Clinical Psychology, found that program participants saved money because they spent less on things like dietary supplements and weight loss programs.
"It is unusual to find a program like this that works well, and also saves the patient money. It's a win-win for everyone," said study author Frances Lynch, PhD, MSPH, a health economist at the Kaiser Permanente Center for Health Research. "This type of program is something that all health care systems should consider implementing."
"People who binge eat more than other people do during a short period of time and they lose control of their eating during these episodes. Binge eating is often accompanied by depression, shame, weight gain, loss of self-esteem and it costs the healthcare system millions of extra dollars," said the study's principal investigator Ruth H. Striegel-Moore, PhD, a professor of psychology at Wesleyan University. "Our studies show that recurrent binge eating can be successfully treated with a brief, easily administered program, and that's great news for patients and their providers."
Binge eating has received a lot of media attention recently because the American Psychiatric Association is recommending that it be considered a separate, distinct eating disorder like bulimia and anorexia. This new diagnosis can be expected to focus more attention on binge eating and how best to treat it, according to the researchers. It also could influence the number of people diagnosed and how insurers will cover treatment.
This randomized controlled trial, conducted in 2004-2005, involved 123 members of the Kaiser Permanente health plan in Oregon and southwest Washington. More than 90 percent of them were women, and the average age was 37. To be included in the study, participants had to have at least one binge eating episode a week during the previous three months with no gaps of two or more weeks between episodes.
Half of the participants were enrolled in the intervention and asked to read the book "Overcoming Binge Eating" by Dr. Christopher Fairburn, a professor of psychiatry and expert on eating disorders. The book details scientific information about binge eating and then outlines a six-step self-help program using self-monitoring, self-control and problem-solving strategies. Participants in the study attended eight therapy sessions over the course of12 weeks in which counselors explained the rationale for cognitive behavioral therapy and helped participants apply the strategies in the book. The first session lasted one hour, and subsequent sessions were 20-25 minutes. The average cost of the intervention was $167 per patient.
All participants were mailed fliers detailing the health plan's offerings for healthy living and eating and encouraged to contact their primary care physician to learn about more services.
By the end of the 12-week program 63.5 percent of participants had stopped binging, compared to 28.3 percent of those who did not participate. Six months later, 74.5 percent of program participants abstained from binging, compared to 44.1 percent in usual care. At one year, 64.2 percent of participants were binge free, compared to 44.6 percent of those in usual care.
Everyone in the trial was asked to provide extensive information about their binge eating episodes, how often they missed work or were less productive at work, and the amount they spent on health care, weight-loss programs and weight loss supplements. Researchers also examined expenditures on medications, doctor visits, and other health-related services.
The researchers then compared these costs between the two groups and found that average total costs were $447 less in the intervention group. This included an average savings of $149 for the participants, who spent less on weight loss programs, over-the-counter medications and supplements. Total costs for the intervention group were $3,670 per person per year, and costs for the control group were $4,098.
As expected, participants in the intervention group spent less on weight loss programs and over-the-counter medications and supplements.
"While program results are promising, we highly encourage anyone who has problems with binge eating to consult with their doctors to make sure this program is right for them," said study co-author Lynn DeBar, PhD, clinical psychologist at the Kaiser Permanente Center for Health Research.
Study authors include: Lynn DeBar, John F. Dickerson, Frances Lynch and Nancy Perrin from the Kaiser Permanente Center for Health Research in Portland, Oregon; Ruth H. Striegel-Moore and Francine Rosselli from Wesleyan University; G. Terence Wilson from Rutgers, The State University of New Jersey; and Helena C. Kraemer from the Stanford University School of Medicine.
Source:
Emily Schwartz
GolinHarris International
вторник, 22 мая 2012 г.
Protein's Power To Preserve Lean Body Mass During Weight Loss
Reducing daily caloric intake is typically the first approach that dieters take to shed those unwanted pounds. However, a new study released in the journal Obesity found that including protein from lean sources of pork in your diet could help you retain more lean body mass, which includes muscle, while losing weight.1
The new research, conducted by Dr. Wayne Campbell, lead researcher at Purdue University's Laboratory for Integrative Research in Nutrition, Fitness and Aging, and his colleagues evaluated the weight loss of 46 overweight or obese women who followed one of two reduced-calorie diets. One group ate a diet that included about 18 percent of their calories from protein. The other group ate a higher protein diet - about 30 percent of total calories from protein, including 6 ounces of lean pork on average per day.
"After 12 weeks, our study found that the group of women who followed a reduced-calorie eating plan while consuming a higher level of protein was more effective in maintaining lean body mass during weight loss compared to those who consumed the same amount of calories with less protein," said Dr. Wayne Campbell. In fact, the higher protein group retained nearly double the amount of lean body mass (losing just 3.3 pounds of lean mass) compared to the women on the normal protein diet (who lost 6.2 pounds of lean mass). Because muscle burns more calories, the finding is important in long-term weight control.
Lean Pork Helps Women Preserve Lean Body Mass With Weight Loss
"In addition to helping preserve lean body mass during weight loss, consuming a higher-protein diet helped retain the women's sense of satiety or fullness after meals. The women on the higher protein diet rated themselves more positively in terms of overall mood and feelings of pleasure during dieting," said Campbell, "which could help dieters stay true to their weight loss plans longer."
The researchers tracked the participants' food intake, body weight and composition, and feelings of fullness throughout the study to compare the effect of the two different diets on these outcomes.
"While previous studies have evaluated the impact higher-protein diets have on a weight-loss program, this is the first study to use pork as the only source of meat," said Ceci Snyder, MS, RD, assistant vice president of consumer marketing for the National Pork Board. "We know consumers may be surprised to learn that pork is a lean protein choice that can help you achieve your weight loss goals. In fact, there are six cuts of pork that meet the U.S. Department of Agriculture's guidelines for 'lean,' with less than 10 grams of fat, 4.5 grams of saturated fat and 95 milligrams of cholesterol per 3-ounce serving."
The study also concluded that a person's weight before dieting might play a role in the amount of lean body tissue lost on higher- versus normal-protein diets. The preservation of lean body mass was more pronounced in the pre-obese women compared with the obese women. The pre-obese group lost 2.6 pounds of lean body mass compared to 6.4 pounds of lean body mass lost by the obese women.
Choosing Lean Sources of Protein
"One of the biggest struggles I hear about with respect to dieting is the need for meal satisfaction. When individuals lack satiety or the feeling of fullness, more often then not they'll feel deprived and overeat," said Kathleen Zelman, MPH, RD. "Eating a variety of lean protein foods can help dieters stay on track."
Pork also packs a significant amount of nutrients in every lean portion. A 3-ounce serving of pork tenderloin is an "excellent" source of protein, thiamin, vitamin B6, phosphorus and niacin, and a "good" source of riboflavin, potassium and zinc, yet contributes only 6 percent of the calories in a 2,000 calorie diet.
Lean Pork Helps Women Preserve Lean Body Mass With Weight Loss
"When increasing the amount of protein you eat, it's important to make lean choices, such as pork tenderloin. According to the U.S. Department of Agriculture, pork tenderloin contains the same amount of fat and slightly less calories than the same size serving of skinless chicken breast2, often a welcomed surprise for many dieters," says Zelman.
"To find the leaner cuts of pork, I encourage my clients to look for the word 'loin' on the label, such as 'loin chop' or 'tenderloin'," added Zelman.
For additional information on the study and pork recipes, visit mailto:TheOtherWhiteMeat.
This research was funded by the National Pork Board.
Leidy H, Carnell N, Mattes R, Campbell W. Higher protein intake preserves lean mass and satiety with weight loss in pre-obese and obese women. Obes Res. 2007;15:421-429.
2 U.S. Department of Agriculture, Agricultural Research Service National Nutrient Database for Standard Reference, Release 19 and the Revised USDA Nutrient Data Set for Fresh Pork, 2006.
Contact: Sarah Kittel
National Pork Board
The new research, conducted by Dr. Wayne Campbell, lead researcher at Purdue University's Laboratory for Integrative Research in Nutrition, Fitness and Aging, and his colleagues evaluated the weight loss of 46 overweight or obese women who followed one of two reduced-calorie diets. One group ate a diet that included about 18 percent of their calories from protein. The other group ate a higher protein diet - about 30 percent of total calories from protein, including 6 ounces of lean pork on average per day.
"After 12 weeks, our study found that the group of women who followed a reduced-calorie eating plan while consuming a higher level of protein was more effective in maintaining lean body mass during weight loss compared to those who consumed the same amount of calories with less protein," said Dr. Wayne Campbell. In fact, the higher protein group retained nearly double the amount of lean body mass (losing just 3.3 pounds of lean mass) compared to the women on the normal protein diet (who lost 6.2 pounds of lean mass). Because muscle burns more calories, the finding is important in long-term weight control.
Lean Pork Helps Women Preserve Lean Body Mass With Weight Loss
"In addition to helping preserve lean body mass during weight loss, consuming a higher-protein diet helped retain the women's sense of satiety or fullness after meals. The women on the higher protein diet rated themselves more positively in terms of overall mood and feelings of pleasure during dieting," said Campbell, "which could help dieters stay true to their weight loss plans longer."
The researchers tracked the participants' food intake, body weight and composition, and feelings of fullness throughout the study to compare the effect of the two different diets on these outcomes.
"While previous studies have evaluated the impact higher-protein diets have on a weight-loss program, this is the first study to use pork as the only source of meat," said Ceci Snyder, MS, RD, assistant vice president of consumer marketing for the National Pork Board. "We know consumers may be surprised to learn that pork is a lean protein choice that can help you achieve your weight loss goals. In fact, there are six cuts of pork that meet the U.S. Department of Agriculture's guidelines for 'lean,' with less than 10 grams of fat, 4.5 grams of saturated fat and 95 milligrams of cholesterol per 3-ounce serving."
The study also concluded that a person's weight before dieting might play a role in the amount of lean body tissue lost on higher- versus normal-protein diets. The preservation of lean body mass was more pronounced in the pre-obese women compared with the obese women. The pre-obese group lost 2.6 pounds of lean body mass compared to 6.4 pounds of lean body mass lost by the obese women.
Choosing Lean Sources of Protein
"One of the biggest struggles I hear about with respect to dieting is the need for meal satisfaction. When individuals lack satiety or the feeling of fullness, more often then not they'll feel deprived and overeat," said Kathleen Zelman, MPH, RD. "Eating a variety of lean protein foods can help dieters stay on track."
Pork also packs a significant amount of nutrients in every lean portion. A 3-ounce serving of pork tenderloin is an "excellent" source of protein, thiamin, vitamin B6, phosphorus and niacin, and a "good" source of riboflavin, potassium and zinc, yet contributes only 6 percent of the calories in a 2,000 calorie diet.
Lean Pork Helps Women Preserve Lean Body Mass With Weight Loss
"When increasing the amount of protein you eat, it's important to make lean choices, such as pork tenderloin. According to the U.S. Department of Agriculture, pork tenderloin contains the same amount of fat and slightly less calories than the same size serving of skinless chicken breast2, often a welcomed surprise for many dieters," says Zelman.
"To find the leaner cuts of pork, I encourage my clients to look for the word 'loin' on the label, such as 'loin chop' or 'tenderloin'," added Zelman.
For additional information on the study and pork recipes, visit mailto:TheOtherWhiteMeat.
This research was funded by the National Pork Board.
Leidy H, Carnell N, Mattes R, Campbell W. Higher protein intake preserves lean mass and satiety with weight loss in pre-obese and obese women. Obes Res. 2007;15:421-429.
2 U.S. Department of Agriculture, Agricultural Research Service National Nutrient Database for Standard Reference, Release 19 and the Revised USDA Nutrient Data Set for Fresh Pork, 2006.
Contact: Sarah Kittel
National Pork Board
вторник, 15 мая 2012 г.
Ethicists Debate New York State's Decision To Pay Egg Donors Who Aid Stem Cell Research
New York state's decision last month to allow state-funded embryonic stem cell researchers to pay women for donating their eggs had drawn support from many scientists and doctors but fueled debate among some ethicists, Long Island Newsday reports. The state's Empire State Stem Cell Board said that researchers can pay women up to $10,000 as compensation for their time and the invasive nature of the procedure.
Scientists and research advocates say the decision could boost important research into cures of serious diseases while attracting investments and new jobs to the state. Opponents raise ethical concerns about using taxpayer money for research that some people find morally objectionable. Some also contend that payment might exploit low-income women, according to Newsday. The National Academy of Sciences and NIH do not permit payments to research participants beyond reimbursement.
Thomas Berg -- director of the Westchester Institute for Ethics and the Human Person and a Roman Catholic priest opposed to embryonic stem cell research -- cast the sole dissenting vote in the stem cell board's decision. Berg said the board ignored his suggestions to open the discussion to the public. However, Samuel Packer -- a member of the board and chair emeritus at the North Shore-Long Island Jewish Health System's Department of Ophthalmology -- said the decision was made during a public meeting following a "long, lively debate." Packer said, "At some point the dissenting voice can't stop the progress of science or anything else in society." He added, "There is a direct link between having better eggs and doing better research" (Ochs, Long Island Newsday, 7/9).
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.
Scientists and research advocates say the decision could boost important research into cures of serious diseases while attracting investments and new jobs to the state. Opponents raise ethical concerns about using taxpayer money for research that some people find morally objectionable. Some also contend that payment might exploit low-income women, according to Newsday. The National Academy of Sciences and NIH do not permit payments to research participants beyond reimbursement.
Thomas Berg -- director of the Westchester Institute for Ethics and the Human Person and a Roman Catholic priest opposed to embryonic stem cell research -- cast the sole dissenting vote in the stem cell board's decision. Berg said the board ignored his suggestions to open the discussion to the public. However, Samuel Packer -- a member of the board and chair emeritus at the North Shore-Long Island Jewish Health System's Department of Ophthalmology -- said the decision was made during a public meeting following a "long, lively debate." Packer said, "At some point the dissenting voice can't stop the progress of science or anything else in society." He added, "There is a direct link between having better eggs and doing better research" (Ochs, Long Island Newsday, 7/9).
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.
вторник, 8 мая 2012 г.
Macho Men Not In Women's Long Term Sights
When a woman is contemplating a long-term relationship, she is less likely to opt for macho men and seems to prefer males with more feminine traits, according to an article in the journal Personality and Individual Differences. Women, it seems, find virile features, such as small eyes and a generous nose are signs of a less affectionate and less loyal man, who is more likely to be a poor parent, compared to men with feminine features.
The researchers examined data on 400 British male and female adults who rated photographs of people whose features were subtly modified.
Team leader, Dr Lynda Boothroyd, Durham University, UK, said "This research shows a high amount of agreement between women about what they see, personality-wise, when asked to judge a book by its cover. They may well use that impression of someone to decide whether or not to engage with that person. That decision-making process all depends on what a woman is looking for in a relationship at that stage of her life."
When inspecting the photographs, the volunteers had to rate the photos according to their perception of the person's..
-- ..Ambition
-- .mitment
-- ..Dominance
-- ..Faithfulness
-- ..Parenting
-- ..Warmth
-- ..Wealth
The participants had to click on a scale.
A skilled person will spot the slight alterations to the photographs; a man with a feminine face has curvier eyebrows; the forehead is arched while the cheekbones are higher. The photo will more likely show the man smiling slightly - also a more feminine trait. For the untrained eye, the photo alterations are more difficult to point out.
Not only did the women opt for men with feminine features when judging according to faithfulness, parenting, warmth and commitment, the men did too (when judging photos of men). The participants judged the more macho-looking men as being more dominant. However, there was no difference when it came to spotting who was ambitious or wealthy, both the macho and more feminine-looking men fared equally.
"Partner characteristics associated with masculinity, health and maturity in male faces"
Lynda G. Boothroyd, Benedict C. Jones, D. Michael Burt and David I. Perrett
Personality and Individual Differences
doi:10.1016/j.paid.2007.03.008
Click here to see articles online
The researchers examined data on 400 British male and female adults who rated photographs of people whose features were subtly modified.
Team leader, Dr Lynda Boothroyd, Durham University, UK, said "This research shows a high amount of agreement between women about what they see, personality-wise, when asked to judge a book by its cover. They may well use that impression of someone to decide whether or not to engage with that person. That decision-making process all depends on what a woman is looking for in a relationship at that stage of her life."
When inspecting the photographs, the volunteers had to rate the photos according to their perception of the person's..
-- ..Ambition
-- .mitment
-- ..Dominance
-- ..Faithfulness
-- ..Parenting
-- ..Warmth
-- ..Wealth
The participants had to click on a scale.
A skilled person will spot the slight alterations to the photographs; a man with a feminine face has curvier eyebrows; the forehead is arched while the cheekbones are higher. The photo will more likely show the man smiling slightly - also a more feminine trait. For the untrained eye, the photo alterations are more difficult to point out.
Not only did the women opt for men with feminine features when judging according to faithfulness, parenting, warmth and commitment, the men did too (when judging photos of men). The participants judged the more macho-looking men as being more dominant. However, there was no difference when it came to spotting who was ambitious or wealthy, both the macho and more feminine-looking men fared equally.
"Partner characteristics associated with masculinity, health and maturity in male faces"
Lynda G. Boothroyd, Benedict C. Jones, D. Michael Burt and David I. Perrett
Personality and Individual Differences
doi:10.1016/j.paid.2007.03.008
Click here to see articles online
вторник, 1 мая 2012 г.
GAO Report Finds Veterans Affairs Facilities Do Not Comply With Privacy Standards For Women
All Department of Veterans Affairs outpatient clinics and hospitals are failing to fully comply with federal privacy standards for women, according to a Government Accountability Office report, the AP/Boston Globe reports. The report comes as thousands of female veterans are entering the VA health system after returning from Iraq and Afghanistan.
GAO auditors said that many VA facilities had gynecological tables that faced the door. In one instance, a gynecological table faced a door opening to a waiting room. The investigation also found cases where women had to walk through waiting rooms to use the restroom -- a violation of VA policy requiring adjoining restrooms. Four VA hospitals did not guarantee women access to private bathing facilities. In two of those cases, the facilities did not have locks.
Nearly 20% of female veterans have been diagnosed with post-traumatic stress disorder, and many of them have experienced sexual trauma while serving, according to the report. The report also said that most female veterans at VA facilities are ages 20 to 29. On average, female veterans using VA facilities are much younger than male VA patients, it noted.
Randall Williamson, director of health care issues at GAO, said that although top VA officials are committed to improving care for female veterans, facilities are not always taking simple steps, such as repositioning exam tables. Patricia Hayes, chief consultant for VA's veterans strategic health care group, said that the agency recognizes issues and is making changes to address disparities in care. She noted that VA is creating a long-term plan for construction improvements to address space and building layout challenges (AP/Boston Globe, 7/15).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
GAO auditors said that many VA facilities had gynecological tables that faced the door. In one instance, a gynecological table faced a door opening to a waiting room. The investigation also found cases where women had to walk through waiting rooms to use the restroom -- a violation of VA policy requiring adjoining restrooms. Four VA hospitals did not guarantee women access to private bathing facilities. In two of those cases, the facilities did not have locks.
Nearly 20% of female veterans have been diagnosed with post-traumatic stress disorder, and many of them have experienced sexual trauma while serving, according to the report. The report also said that most female veterans at VA facilities are ages 20 to 29. On average, female veterans using VA facilities are much younger than male VA patients, it noted.
Randall Williamson, director of health care issues at GAO, said that although top VA officials are committed to improving care for female veterans, facilities are not always taking simple steps, such as repositioning exam tables. Patricia Hayes, chief consultant for VA's veterans strategic health care group, said that the agency recognizes issues and is making changes to address disparities in care. She noted that VA is creating a long-term plan for construction improvements to address space and building layout challenges (AP/Boston Globe, 7/15).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
вторник, 24 апреля 2012 г.
Women With Osteoporosis More Likely To Stay On Once-Monthly Oral Bonviva(R) Than On A Once-Weekly Treatment Regimen
Women taking highly effective once-monthly oral Bonviva(R) (ibandronic acid) for postmenopausal osteoporosis were more likely to stay on treatment during the first six months relative to those on a weekly bisphosphonate (alendronate or risedronate) according to findings presented today at the 28th Annual Meeting of the American Society for Bone Mineral Research (ASBMR)1.
The ongoing real-life study, conducted by Silverman and colleagues at Cedars-Sinai/ University of California, Los Angeles, US, was based on two managed care databases called HealthCore and i3 Innovus, which include prescription and health information on approximately 17.5 and 16 million lives respectively. These two analyses assessed the actual time patients stayed on treatment and were controlled for factors that could affect persistence, including age, other medical conditions, and out-of-pocket costs for the medications,1 as recommended by leading health and pharmacoeconomic research organisations. [ISPOR and WHO 2003] It showed that women taking Bonviva were approximately 25% more like to keep taking their pills relative to those on a weekly bisphosphonate.
Growing wealth of evidence demonstrates important role of once monthly Bonviva in helping patients stay on treatment
The results of the study are consistent with previous findings linking the once-monthly oral Bonviva treatment programme with improved persistence in a real-life setting.2 Furthermore, patients have also stated a clear preference (71%) for the once-monthly oral Bonviva regimen 3,4 over a weekly treatment regimen in clinical trials. Further information presented at ASBMR indicates that the convenience of once-monthly dosing and the reduced exposure to the potential gastrointestinal side effects associated with bisphosphonate therapy, are the main reasons for this preference.5
With up to 69% of new patients on a weekly bisphosphonate stopping within a year, 6 this growing wealth of evidence suggests that monthly dosing is set to play an important role in helping to address the issue of non-persistence to osteoporosis treatments.
Stuart L. Silverman, M.D., lead investigator and clinical professor of medicine and rheumatology at Cedars-Sinai/ University of California, Los Angeles, said: "Treatment with bisphosphonates clearly reduces the risk of fractures, but only if patients keep taking their treatment. Osteoporosis is a disease that often shows no symptoms, which reduces a patient's motivation to stay on treatment and, thereby, increases their risk of breaking bones. The greater persistence seen with once-monthly compared to once-weekly bisphosphonates is very encouraging, particularly because the findings were consistent across two large and robust U.S. claims databases."
Improved persistence leads to fewer fractures and lower healthcare costs
Also at ASBMR, a three-year retrospective analysis found that improved persistence with bisphosphonate treatment is linked with lower rates of osteoporosis-related hospitalisation, shorter hospital stays and significantly reduced healthcare costs. 7,8 These findings emphasise the importance of a newly published study showing that women who were persistent in taking daily or weekly bisphosphonate treatments had significantly fewer fractures. 9
Peyman Hadji, M.D., Head of the Department of Endocrinology, Osteoporosis and Reproductive Medicine at Philipps-University of Marburg, Germany, said: "With the number of osteoporosis-related fractures in Europe estimated at 3.79 million, 10 improvements in the management of this disease are essential. These findings presented at ASBMR show that getting a patient's treatment right first time can not only improve their quality of life, but also have a significant positive outcome for healthcare services. Taking a bisphosphonate treatment for the long-term clearly reduces this risk, which is why persistence and patient preference need to be major considerations when prescribing osteoporosis treatments."
About the Persistence Data
The study showing greater persistence with once-monthly oral Bonviva was based on two managed care databases called HealthCore and i3 Innovus, which contain prescription and health information on approximately 17.5 and 16 million patients, respectively.
The HealthCore and i3 Innovus analyses included data for 6,127 and 10,526 women respectively, 45 years of age or older, who received a prescription for bisphosphonate treatment for postmenopausal osteoporosis (277 and 1,025 took once-monthly oral Bonviva and 5,850 and 9,501 took a once-weekly bisphosphonate).
Unlike other studies comparing persistence among monthly versus weekly treatment regimens, this study uses rigorous criteria for defining persistence for both once-monthly oral Bonviva and weekly treatments, as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organisation.
Patients were considered persistent if the time between prescription refills was more than 45 days for once-monthly oral Bonviva or more than 30 days for a weekly bisphosphonate.
To further ensure the validity of the results, study authors adjusted the data for potential confounding factors - including age, other medical conditions, and out-of-pocket costs for the medications - as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organisation.
At six months, once-monthly Bonviva users were 27.2% and 21.7% more likely to persist with therapy versus weekly users (p = 0.0002 and p
The ongoing real-life study, conducted by Silverman and colleagues at Cedars-Sinai/ University of California, Los Angeles, US, was based on two managed care databases called HealthCore and i3 Innovus, which include prescription and health information on approximately 17.5 and 16 million lives respectively. These two analyses assessed the actual time patients stayed on treatment and were controlled for factors that could affect persistence, including age, other medical conditions, and out-of-pocket costs for the medications,1 as recommended by leading health and pharmacoeconomic research organisations. [ISPOR and WHO 2003] It showed that women taking Bonviva were approximately 25% more like to keep taking their pills relative to those on a weekly bisphosphonate.
Growing wealth of evidence demonstrates important role of once monthly Bonviva in helping patients stay on treatment
The results of the study are consistent with previous findings linking the once-monthly oral Bonviva treatment programme with improved persistence in a real-life setting.2 Furthermore, patients have also stated a clear preference (71%) for the once-monthly oral Bonviva regimen 3,4 over a weekly treatment regimen in clinical trials. Further information presented at ASBMR indicates that the convenience of once-monthly dosing and the reduced exposure to the potential gastrointestinal side effects associated with bisphosphonate therapy, are the main reasons for this preference.5
With up to 69% of new patients on a weekly bisphosphonate stopping within a year, 6 this growing wealth of evidence suggests that monthly dosing is set to play an important role in helping to address the issue of non-persistence to osteoporosis treatments.
Stuart L. Silverman, M.D., lead investigator and clinical professor of medicine and rheumatology at Cedars-Sinai/ University of California, Los Angeles, said: "Treatment with bisphosphonates clearly reduces the risk of fractures, but only if patients keep taking their treatment. Osteoporosis is a disease that often shows no symptoms, which reduces a patient's motivation to stay on treatment and, thereby, increases their risk of breaking bones. The greater persistence seen with once-monthly compared to once-weekly bisphosphonates is very encouraging, particularly because the findings were consistent across two large and robust U.S. claims databases."
Improved persistence leads to fewer fractures and lower healthcare costs
Also at ASBMR, a three-year retrospective analysis found that improved persistence with bisphosphonate treatment is linked with lower rates of osteoporosis-related hospitalisation, shorter hospital stays and significantly reduced healthcare costs. 7,8 These findings emphasise the importance of a newly published study showing that women who were persistent in taking daily or weekly bisphosphonate treatments had significantly fewer fractures. 9
Peyman Hadji, M.D., Head of the Department of Endocrinology, Osteoporosis and Reproductive Medicine at Philipps-University of Marburg, Germany, said: "With the number of osteoporosis-related fractures in Europe estimated at 3.79 million, 10 improvements in the management of this disease are essential. These findings presented at ASBMR show that getting a patient's treatment right first time can not only improve their quality of life, but also have a significant positive outcome for healthcare services. Taking a bisphosphonate treatment for the long-term clearly reduces this risk, which is why persistence and patient preference need to be major considerations when prescribing osteoporosis treatments."
About the Persistence Data
The study showing greater persistence with once-monthly oral Bonviva was based on two managed care databases called HealthCore and i3 Innovus, which contain prescription and health information on approximately 17.5 and 16 million patients, respectively.
The HealthCore and i3 Innovus analyses included data for 6,127 and 10,526 women respectively, 45 years of age or older, who received a prescription for bisphosphonate treatment for postmenopausal osteoporosis (277 and 1,025 took once-monthly oral Bonviva and 5,850 and 9,501 took a once-weekly bisphosphonate).
Unlike other studies comparing persistence among monthly versus weekly treatment regimens, this study uses rigorous criteria for defining persistence for both once-monthly oral Bonviva and weekly treatments, as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organisation.
Patients were considered persistent if the time between prescription refills was more than 45 days for once-monthly oral Bonviva or more than 30 days for a weekly bisphosphonate.
To further ensure the validity of the results, study authors adjusted the data for potential confounding factors - including age, other medical conditions, and out-of-pocket costs for the medications - as recommended by the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) and the World Health Organisation.
At six months, once-monthly Bonviva users were 27.2% and 21.7% more likely to persist with therapy versus weekly users (p = 0.0002 and p
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