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
вторник, 17 апреля 2012 г.
Periodic Problems; Saying Goodbye To PMS
Most women experience some unpleasant or uncomfortable symptoms during their menstrual cycle. For some women, the symptoms can be significant, but are usually of short duration and not disabling.
"Premenstrual Syndrome (PMS) is a medical condition with symptoms of bloating, headaches, mood swings, and depression," says W. Paul Dmowski, M.D. of Good Samaritan Hospital in Downers Grove and the Oak Brook Fertility Center in Oak Brook.
Although the symptoms usually cease with onset of the menstrual period, in some women, symptoms may last through and after their periods, says Dmowski.
Get moving
Dietary modification and physical activity are traditionally among the first recommendations for PMS therapy. Making simple lifestyle changes helps to reduce the occurrence of PMS symptoms.
These changes include regular exercise (30 to 60 minutes a day, 3 to 5 times each week); adequate sleep and rest; and a well-balanced diet, such as an increase in whole grains, vegetables, and fruit, and a decrease in salt, sugar, caffeine, and alcohol.
Don't overdo it
Exercise is can help manage stress, often a component of PMS. It also increases the metabolism and improves cardiovascular circulation. When exercising, more oxygen and nutrients are flowing throughout the body, helping to increase feelings of well-being.
"But don't go overboard," says Dmowski. "Vigorous workouts, such as running or doing step aerobics for two hours a day, may exacerbate rather than relieve some symptoms."
Talk to your doctor
Although no drug has received Food and Drug Administration (FDA) approval as a PMS treatment, many PMS sufferers find relief by taking drugs approved for other disorders.
"We now better understand the emotional and physical effects of cyclical hormone changes," says Dmowski. "Therefore, first-line drug therapy often involves the use of antidepressants."
Any woman who suspects she has PMS or other discomfort related to her menstrual cycle, should mention it to her doctor at her next visit. Often women with PMS do not have symptoms that can be measured with standard lab tests. Because of this, many women suffer in silence, having been told for many years that their problems were emotional.
For more information on women's health topics, including PMS, visit the web site of the National Women's Health Information Center at womenshealth.
For a physician referral, visit advocatehealth.
For a medical practice devoted to reproductive endocrinology, infertility, and assisted reproductive technology, visit oakbrookfertility
W. Paul Dmowski, M.D. Ph.D., is board certified in Reproductive Endocrinology; and is on the medical staff of Advocate Good Samaritan Hospital in Downers Grove.
The Good Samaritan Health and Wellness Center is a 90,000 square foot fitness center with three indoor pools, a track, an extensive fitness floor and weight room, three group exercise studios (including Yoga and Pilates studios) and a basketball court, located in Downers Grove, Illinois. Serving the western suburbs of Chicago, the Wellness Center is the only advisory member of the Medical Fitness Association in DuPage County. As part of Advocate Health Care, Good Samaritan Health and Wellness Center can be reached by visiting advocatehealth/goodsam.
Article Diane Ahern, Good Samaritan Health and Wellness Center.
"Premenstrual Syndrome (PMS) is a medical condition with symptoms of bloating, headaches, mood swings, and depression," says W. Paul Dmowski, M.D. of Good Samaritan Hospital in Downers Grove and the Oak Brook Fertility Center in Oak Brook.
Although the symptoms usually cease with onset of the menstrual period, in some women, symptoms may last through and after their periods, says Dmowski.
Get moving
Dietary modification and physical activity are traditionally among the first recommendations for PMS therapy. Making simple lifestyle changes helps to reduce the occurrence of PMS symptoms.
These changes include regular exercise (30 to 60 minutes a day, 3 to 5 times each week); adequate sleep and rest; and a well-balanced diet, such as an increase in whole grains, vegetables, and fruit, and a decrease in salt, sugar, caffeine, and alcohol.
Don't overdo it
Exercise is can help manage stress, often a component of PMS. It also increases the metabolism and improves cardiovascular circulation. When exercising, more oxygen and nutrients are flowing throughout the body, helping to increase feelings of well-being.
"But don't go overboard," says Dmowski. "Vigorous workouts, such as running or doing step aerobics for two hours a day, may exacerbate rather than relieve some symptoms."
Talk to your doctor
Although no drug has received Food and Drug Administration (FDA) approval as a PMS treatment, many PMS sufferers find relief by taking drugs approved for other disorders.
"We now better understand the emotional and physical effects of cyclical hormone changes," says Dmowski. "Therefore, first-line drug therapy often involves the use of antidepressants."
Any woman who suspects she has PMS or other discomfort related to her menstrual cycle, should mention it to her doctor at her next visit. Often women with PMS do not have symptoms that can be measured with standard lab tests. Because of this, many women suffer in silence, having been told for many years that their problems were emotional.
For more information on women's health topics, including PMS, visit the web site of the National Women's Health Information Center at womenshealth.
For a physician referral, visit advocatehealth.
For a medical practice devoted to reproductive endocrinology, infertility, and assisted reproductive technology, visit oakbrookfertility
W. Paul Dmowski, M.D. Ph.D., is board certified in Reproductive Endocrinology; and is on the medical staff of Advocate Good Samaritan Hospital in Downers Grove.
The Good Samaritan Health and Wellness Center is a 90,000 square foot fitness center with three indoor pools, a track, an extensive fitness floor and weight room, three group exercise studios (including Yoga and Pilates studios) and a basketball court, located in Downers Grove, Illinois. Serving the western suburbs of Chicago, the Wellness Center is the only advisory member of the Medical Fitness Association in DuPage County. As part of Advocate Health Care, Good Samaritan Health and Wellness Center can be reached by visiting advocatehealth/goodsam.
Article Diane Ahern, Good Samaritan Health and Wellness Center.
вторник, 10 апреля 2012 г.
Semen May Aggravate Cervical Cancer And Uterine Cancer
The high levels of prostaglandin, a hormone-like molecule found in semen, may fuel cervical and womb (uterine) cancers in women, say scientists from the Medical Research Council, UK. They say women with either womb or cervical cancer should seriously consider asking their partners to use a condom.
You can read about this in the journal Human Reproduction.
The cells in the lining of the female reproductinve organs contain prostagrandin - it regulates cell growth and makes the womb thicken and also shed during the menstrual cycle. However, prostaglandin levels in semen are about one thousand times higher.
By exposing cervical and uterine cell receptor molecules to prostaglandin, the scientists found that the signalling between the cells increased - leading to faster tumour growth.
The scientists say that by preventing prostaglandin from reaching the tumour cell receptors, there may be treatment one day to undermine the tumour's growth.
Team leader, Dr. Henry Jabbour, said "Sexually active women who are at risk of cervical or uterine cancer should encourage their partners to wear a condom to prevent increased exposure to the prostaglandins that might make their condition worse. This also highlights the potential for a new therapeutic approach that will tackle both possible sources of prostaglandin - those produced naturally by women and those introduced to the body by sperm.''
Jabbour believes it is quite possible that pre-cancerous cells may also have prostaglandin receptors. He said further research is needed.
Cervical cancer is more common in the developing world where screening programmes are less common. In the United Kingdom, for example, screening programmes detect most abnormal cell changes before the cancer progresses. Cervical cancer is usually triggered by long-term human papilloma virus (HPV) infection. Prostaglandins do not cause the cancer - they fuel tumour growth, say the researchers.
"Seminal plasma and prostaglandin E2 up-regulate fibroblast growth factor 2 expression in endometrial adenocarcinoma cells via E-series prostanoid-2 receptor-mediated transactivation of the epidermal growth factor receptor and extracellular signal-regulated kinase pathway"
S. Battersby, K.J. Sales, A.R. Williams, R.A. Anderson, S. Gardner 1, and H.N. Jabbour 1
Human Reproduction, doi:10.1093/humrep/del328
View The Abstract Online
Medical Research Council
You can read about this in the journal Human Reproduction.
The cells in the lining of the female reproductinve organs contain prostagrandin - it regulates cell growth and makes the womb thicken and also shed during the menstrual cycle. However, prostaglandin levels in semen are about one thousand times higher.
By exposing cervical and uterine cell receptor molecules to prostaglandin, the scientists found that the signalling between the cells increased - leading to faster tumour growth.
The scientists say that by preventing prostaglandin from reaching the tumour cell receptors, there may be treatment one day to undermine the tumour's growth.
Team leader, Dr. Henry Jabbour, said "Sexually active women who are at risk of cervical or uterine cancer should encourage their partners to wear a condom to prevent increased exposure to the prostaglandins that might make their condition worse. This also highlights the potential for a new therapeutic approach that will tackle both possible sources of prostaglandin - those produced naturally by women and those introduced to the body by sperm.''
Jabbour believes it is quite possible that pre-cancerous cells may also have prostaglandin receptors. He said further research is needed.
Cervical cancer is more common in the developing world where screening programmes are less common. In the United Kingdom, for example, screening programmes detect most abnormal cell changes before the cancer progresses. Cervical cancer is usually triggered by long-term human papilloma virus (HPV) infection. Prostaglandins do not cause the cancer - they fuel tumour growth, say the researchers.
"Seminal plasma and prostaglandin E2 up-regulate fibroblast growth factor 2 expression in endometrial adenocarcinoma cells via E-series prostanoid-2 receptor-mediated transactivation of the epidermal growth factor receptor and extracellular signal-regulated kinase pathway"
S. Battersby, K.J. Sales, A.R. Williams, R.A. Anderson, S. Gardner 1, and H.N. Jabbour 1
Human Reproduction, doi:10.1093/humrep/del328
View The Abstract Online
Medical Research Council
вторник, 3 апреля 2012 г.
Triple Threat To Health; Lifelong Abuse Creates Serious Consequences For Older African American Women
Older African American women who have experienced high levels of family violence throughout their lives are more likely to suffer worse physical and mental health than their counterparts, found a Temple researcher in the February issue of the Journal of Women's Health.
"In general, there is a higher incidence of mental health issues such as depression and anxiety, and more chronic pain syndromes," said lead author Anuradha Paranjape, M.D., M.P.H., an associate professor of medicine at Temple University School of Medicine and Hospital.
"I think this is an issue for all older women. I have focused on African American women because of my experiences as a busy clinician in downtown Atlanta and now at Temple, where most of my patients are African American. This is an underserved community that experiences health disparities," Paranjape said.
National data shows older African American women are at risk for experiencing poorer health status by virtue of their age, race, and gender. Given this triple threat to their overall health, examining the effect of family violence in this particular demographic group is particularly important, she noted.
These older women have unique service needs since their history of abuse can span across the spectrum of intimate partner violence to other types of abuse later on in life.
"Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status," Paranjape said.
Paranjape advises primary care physicians "to empathize and validate the patient's experiences, and refer them to social support organizations if needed." More importantly, physicians need to know that there may be non-medical reasons why a patient doesn't feel well. If a patient is over the age of 60, it's mandatory for the heath care provider to report the abuse, in Pennsylvania.
For the study, 158 African American women, age 50 or older, were interviewed in ambulatory clinics of a large public hospital. Study participants were asked about the presence and severity of family violence relating to physical violence, emotional, financial, and sexual abuse, neglect, and coercion. Lifetime family violence exposure as well as an adult physical and mental health status were then measured and analyzed by the researchers.
The results found significant differences in scores reflecting poorer health for women who had reported high levels of family violence compared to those who reported low levels or no history of abuse. Unemployment was also found to be strongly associated with worse health status, Paranjape said.
"The next step is to look at what differentiates the women who do better from those who do worse. It is possible that women who do better have better coping skills. In that case, programs that are designed to help survivors of abuse cope in a healthy way need to be funded, implemented and assessed for efficacy," she said.
Temple University
301 University Services Bldg.1601 N Broad St.
Philadelphia
PA 19122
United States
www.temple.edu
"In general, there is a higher incidence of mental health issues such as depression and anxiety, and more chronic pain syndromes," said lead author Anuradha Paranjape, M.D., M.P.H., an associate professor of medicine at Temple University School of Medicine and Hospital.
"I think this is an issue for all older women. I have focused on African American women because of my experiences as a busy clinician in downtown Atlanta and now at Temple, where most of my patients are African American. This is an underserved community that experiences health disparities," Paranjape said.
National data shows older African American women are at risk for experiencing poorer health status by virtue of their age, race, and gender. Given this triple threat to their overall health, examining the effect of family violence in this particular demographic group is particularly important, she noted.
These older women have unique service needs since their history of abuse can span across the spectrum of intimate partner violence to other types of abuse later on in life.
"Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status," Paranjape said.
Paranjape advises primary care physicians "to empathize and validate the patient's experiences, and refer them to social support organizations if needed." More importantly, physicians need to know that there may be non-medical reasons why a patient doesn't feel well. If a patient is over the age of 60, it's mandatory for the heath care provider to report the abuse, in Pennsylvania.
For the study, 158 African American women, age 50 or older, were interviewed in ambulatory clinics of a large public hospital. Study participants were asked about the presence and severity of family violence relating to physical violence, emotional, financial, and sexual abuse, neglect, and coercion. Lifetime family violence exposure as well as an adult physical and mental health status were then measured and analyzed by the researchers.
The results found significant differences in scores reflecting poorer health for women who had reported high levels of family violence compared to those who reported low levels or no history of abuse. Unemployment was also found to be strongly associated with worse health status, Paranjape said.
"The next step is to look at what differentiates the women who do better from those who do worse. It is possible that women who do better have better coping skills. In that case, programs that are designed to help survivors of abuse cope in a healthy way need to be funded, implemented and assessed for efficacy," she said.
Temple University
301 University Services Bldg.1601 N Broad St.
Philadelphia
PA 19122
United States
www.temple.edu
вторник, 27 марта 2012 г.
Los Angeles Times Examines Expanding Birth Control Options In U.S.
The Los Angeles Times on Monday examined the recent expansion of birth control options in the U.S., including oral contraceptives that can reduce or eliminate monthly menstrual periods. FDA earlier this year approved the oral contraceptives YAZ and Loestrin 24 Fe, which are taken once a day for 24 days followed by four days of placebo pills to induce a menstrual period (Roan, Los Angeles Times, 7/10). Most oral contraceptives are taken for 21 consecutive days followed by seven days of placebo pills. Loestrin is manufactured by Warner Chilcott, and Berlex, a subsidiary of Schering, produces YAZ (Kaiser Daily Women's Health Policy Report, 3/30). FDA also is considering an application to approve the continuous daily oral contraceptive Lybrel and a new contraceptive implant Implanon, which is a single rod placed under the skin of the arm that can prevent pregnancy for three years. According to the Times, the "shift to continuous-use oral contraceptives acknowledges a little known fact: Women don't need to have periods." Some public health experts say taking oral contraceptives daily with no break is safe, will not effect fertility and will not be harmful to fetuses if taken early during a pregnancy. However, some public health experts say there is little data on continuous-use oral contraceptives, the Times reports. According to the Times, the "level of hormones in birth control pills has dropped dramatically in the last two decades." As a result, taking an active pill 365 days a year is considered safe, according to David Portman, director of the Columbus, Ohio, Center for Women's Health Research. Still, researchers continue to study how to reduce the risks associated with hormonal contraceptives, including blood clots, heart attacks, strokes, liver disease and cancers of the breast or sex organs (Los Angeles Times, 7/10).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"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.
вторник, 20 марта 2012 г.
mtm's P16/Ki-67 Dual Immuno-Staining Identifies High-Grade Cervical Disease In ASC-US And LSIL With High Sensitivity And Specificity
mtm laboratories, a privately held diagnostics company developing, manufacturing and globally commercializing in vitro diagnostics for cervical cancer early detection and diagnosis, today announced the publication of a new paper showing that dual staining for p16 and Ki-67 can pinpoint the underlying high-grade cervical disease with a high degree of sensitivity and specificity in women with ASC-US or LSIL cytology results. These are a group of patients currently poorly served by existing screening technologies, with too many referred for unnecessary colposcopy. The paper, which details the EEMAPS study results, has been published electronically in Cancer Cytopathology on March 25, 2011 ahead of print.
The EEMAPS study used the advanced biomarker combination CINtec® PLUS, which was launched by mtm in early 2010 in Europe. Residual materials from a previous pan-European retrospective cytology study were used to prepare additional slides for p16 and Ki-67 dual immuno-staining. In total, 361 ASC-US and 415 LSIL cases with corresponding biopsy results and HPV test results were available for dual stain cytology analysis. The presence of one or more dual-stained cervical epithelial cell(s) defined a positive test result with CINtec® PLUS, independent from morphology interpretation. The clinical results showed that the sensitivity of the dual stain for high-grade disease was 92.2% (71/77) for ASC-US, and 94.2% (129/137) for LSIL cases, which is equivalent to the sensitivity results obtained for HPV testing. However, specificity was significantly higher for CINtec® PLUS as compared to HPV testing; 80.6% vs. 36.3% for ASC-US and 68.0% vs. 19.1% for LSIL.
"mtm's CINtec® PLUS is the first test that provides high sensitivity and high specificity for underlying high-grade cervical disease in a single product, irrespective of women's age and the individual HR-HPV genotype," commented Bob Silverman, CEO of mtm laboratories. "Because the test can pinpoint which women are most likely to have cervical disease and need follow up, this should reduce a large number of the unnecessary, uncomfortable and costly colposcopies carried out on women with ASC-US or LSIL."
ASC-US and LSIL are definitions for equivocal and mild to moderate abnormal cytology findings on Pap tests, and may represent 5-8% of all cervical cytology cases. While most of these findings are negative for high-grade disease, 15-20% of LSIL and 6-10% of ASC-US will harbour high-grade disease. Together, these two categories of cytology represent the source for about 60% of all cases of high-grade cervical disease in women. Unfortunately, these Pap cytology results are not adequate predictors in determining which ASC-US or LSIL cases require intervention due to the low rates of underlying disease. Adjunctive HPV testing also has limitations due to unsatisfactory specificity.
The title of the publication and the authors are as follows:
Schmidt D, Bergeron C, Denton KJ, Ridder R, for the European CINtec Cytology Study Group. p16/Ki-67 Dual-Stain Cytology in the Triage of ASCUS and LSIL Papanicolaou Cytology. Cancer Cytopathol (2011); 119, DOI: 10.1002/cncy.20140
Notes
CINtec® PLUS
CINtec® PLUS is a screening and diagnostic tool combining high sensitivity and high specificity for detecting high-grade cervical disease in a single test. The CINtec® PLUS kit detects and stains for two biomarkers: the multiply validated cell cycle regulatory protein p16INK4a (p16) and Ki-67, a marker of active cell proliferation. Clinical trials involving over 32,000 women have demonstrated that when used together, this biomarker combination is both highly sensitive and highly specific to identify those women most likely to have existing high-grade disease. Moreover, the CINtec® PLUS test is independent of age and HR-HPV type of infection.
Applied in combination the co-detection of p16 plus Ki-67 in the same cell serves as an indicator of cell cycle de-regulation that occurs during HR-HPV induced oncogenic transformation and provides an objective criterion to identify those women who are likely to harbour high-grade disease. CINtec® PLUS can be applied on conventional and liquid based cytology slides. Double immuno-reactive (or: Dual-stained) cells in cytology are positively stained for both proteins:
- Brown cellular staining indicates p16 over-expression
- Red nuclear staining indicates Ki-67 expression
Classification of Cervical Cytology
The Pap smear classifications are related to the nature of the cells sampled from the cervix showing single cells or groups of cells. The most recent classification is the Bethesda system, which divides the results of the morphologic interpretation into four main groups:
1) Cervical specimens negative for intra-epithelial lesions or malignancies (NILM) - cases with morphological interpretation within normal limits
2) Atypical Squamous Cells of Undetermined Significance (ASC-US) - cases with no definitive cellular abnormality but enough suspicion to keep the case from being considered "normal" (this is an ambiguous category)
3) Low-grade Squamous Intraepithelial Lesion (LSIL)
4) High-grade Squamous Intraepithelial Lesion (HSIL)
Broadly speaking LSIL corresponds to mild to moderate pre-cancerous disease and HSIL corresponds to high-grade pre-cancerous disease. Screening with cytology provides an indicator to the physician that something may be wrong with a woman's cervix and can be used to direct this patient towards further evaluation (eg colposcopy).
Source:
mtm laboratories AG
The EEMAPS study used the advanced biomarker combination CINtec® PLUS, which was launched by mtm in early 2010 in Europe. Residual materials from a previous pan-European retrospective cytology study were used to prepare additional slides for p16 and Ki-67 dual immuno-staining. In total, 361 ASC-US and 415 LSIL cases with corresponding biopsy results and HPV test results were available for dual stain cytology analysis. The presence of one or more dual-stained cervical epithelial cell(s) defined a positive test result with CINtec® PLUS, independent from morphology interpretation. The clinical results showed that the sensitivity of the dual stain for high-grade disease was 92.2% (71/77) for ASC-US, and 94.2% (129/137) for LSIL cases, which is equivalent to the sensitivity results obtained for HPV testing. However, specificity was significantly higher for CINtec® PLUS as compared to HPV testing; 80.6% vs. 36.3% for ASC-US and 68.0% vs. 19.1% for LSIL.
"mtm's CINtec® PLUS is the first test that provides high sensitivity and high specificity for underlying high-grade cervical disease in a single product, irrespective of women's age and the individual HR-HPV genotype," commented Bob Silverman, CEO of mtm laboratories. "Because the test can pinpoint which women are most likely to have cervical disease and need follow up, this should reduce a large number of the unnecessary, uncomfortable and costly colposcopies carried out on women with ASC-US or LSIL."
ASC-US and LSIL are definitions for equivocal and mild to moderate abnormal cytology findings on Pap tests, and may represent 5-8% of all cervical cytology cases. While most of these findings are negative for high-grade disease, 15-20% of LSIL and 6-10% of ASC-US will harbour high-grade disease. Together, these two categories of cytology represent the source for about 60% of all cases of high-grade cervical disease in women. Unfortunately, these Pap cytology results are not adequate predictors in determining which ASC-US or LSIL cases require intervention due to the low rates of underlying disease. Adjunctive HPV testing also has limitations due to unsatisfactory specificity.
The title of the publication and the authors are as follows:
Schmidt D, Bergeron C, Denton KJ, Ridder R, for the European CINtec Cytology Study Group. p16/Ki-67 Dual-Stain Cytology in the Triage of ASCUS and LSIL Papanicolaou Cytology. Cancer Cytopathol (2011); 119, DOI: 10.1002/cncy.20140
Notes
CINtec® PLUS
CINtec® PLUS is a screening and diagnostic tool combining high sensitivity and high specificity for detecting high-grade cervical disease in a single test. The CINtec® PLUS kit detects and stains for two biomarkers: the multiply validated cell cycle regulatory protein p16INK4a (p16) and Ki-67, a marker of active cell proliferation. Clinical trials involving over 32,000 women have demonstrated that when used together, this biomarker combination is both highly sensitive and highly specific to identify those women most likely to have existing high-grade disease. Moreover, the CINtec® PLUS test is independent of age and HR-HPV type of infection.
Applied in combination the co-detection of p16 plus Ki-67 in the same cell serves as an indicator of cell cycle de-regulation that occurs during HR-HPV induced oncogenic transformation and provides an objective criterion to identify those women who are likely to harbour high-grade disease. CINtec® PLUS can be applied on conventional and liquid based cytology slides. Double immuno-reactive (or: Dual-stained) cells in cytology are positively stained for both proteins:
- Brown cellular staining indicates p16 over-expression
- Red nuclear staining indicates Ki-67 expression
Classification of Cervical Cytology
The Pap smear classifications are related to the nature of the cells sampled from the cervix showing single cells or groups of cells. The most recent classification is the Bethesda system, which divides the results of the morphologic interpretation into four main groups:
1) Cervical specimens negative for intra-epithelial lesions or malignancies (NILM) - cases with morphological interpretation within normal limits
2) Atypical Squamous Cells of Undetermined Significance (ASC-US) - cases with no definitive cellular abnormality but enough suspicion to keep the case from being considered "normal" (this is an ambiguous category)
3) Low-grade Squamous Intraepithelial Lesion (LSIL)
4) High-grade Squamous Intraepithelial Lesion (HSIL)
Broadly speaking LSIL corresponds to mild to moderate pre-cancerous disease and HSIL corresponds to high-grade pre-cancerous disease. Screening with cytology provides an indicator to the physician that something may be wrong with a woman's cervix and can be used to direct this patient towards further evaluation (eg colposcopy).
Source:
mtm laboratories AG
вторник, 13 марта 2012 г.
Daily Women's Health Policy Report Summarizes Editorials, Opinion Pieces On Embryonic Stem Cell Policy Change
Several media outlets recently published editorials and opinion pieces responding to President Obama's executive order on Monday that lifted some federal restrictions on embryonic stem cell research, as well as his directive to "guarantee scientific integrity" in federal policymaking. Summaries appear below.
~ William Saletan, Slate: According to Saletan, "The best way to understand" the issue of embryonic stem cell research is "to look at an issue that has become the mirror image of the stem cell fight. That issue is torture." He writes that after Obama "signed an executive order prohibiting interrogation methods used by the Bush administration," former Bush aide Karl Rove "accused Obama of endangering the country by impeding interrogations of the enemy." He continues that most people "believe, as Obama does, that it's possible to save lives without crossing a moral line that might corrupt us" and that the "same Bush-Rove tactics are being used today in the stem-cell fight." According to Saletan, "Proponents of embryo research are insisting that because we're in a life-and-death struggle ... anyone who impedes that struggle by renouncing effective tools is irrational and irresponsible." He writes that proponents are "parroting" the Obama administration's "spin" on the scientific integrity directive, adding, "Think about what's being dismissed here as 'politics' and 'ideology.'" He continues that it is not necessary to see embryos as equal to full-grown human beings to "appreciate the danger of exploiting them" and suggests to "try shifting the context from stem cells to torture." Saletan asks, "How much ruthless violence should we use to defeat ruthless violence? The paradox and the dilemma are easy to recognize." He adds that proponents of stem cell research have made the dilemma "more compelling" by asking opponents, "How precious is that little embryo? Precious enough to forswear research that might save the life of a 50-year-old man?" He continues, "The danger of seeing the stem cell war as a contest between science and ideology is that you bury these dilemmas." Saletan writes, "The stem cell fight wasn't a fight between ideology and science. It was a fight between five-day-olds and 50-year-olds. The 50-year-olds won." He concludes, "The question now is what to do with our five-day-olds, our 5-week-olds, and our increasingly useful parts" (Saletan, Slate, 3/9).
~ Kathleen Parker, Washington Post: Parker, a syndicated columnist, writes that "since Obama began running for president, researchers have made some rather amazing strides in alternative stem cell research. Science and ethics finally fell in love, in other words, and Obama seems to have fallen asleep during the kiss." She adds, "Either that, or he decided that keeping an old political promise was more important than acknowledging new developments." She continues that while a majority of Americans support embryonic stem cell research, "most Americans, including most journalists and politicians, aren't fluent in stem cell research. It's complicated." She explains that what people claim to "know" is that "embryonic stem cells can cure diseases and that all stem cells come from fertility clinic embryos that will be discarded anyway." However, "Neither belief is entirely true." According to Parker, "[E]very single one of the successes in treating patients with stem cells thus far -- for spinal cord injuries and multiple sclerosis, for example -- have involved adult or umbilical cord blood stem cells, not embryonic stem cells." She says that under Obama's executive order, taxpayers are "incentivizing a market for embryo creation and destruction." The "superior claim" that embryonic stem cells were necessary because they are pluripotent -- that is, capable of becoming any type of cell -- "no longer can be made" because of the introduction of induced pluripotent cells, or IPS cells, Parker writes. She continues, "One may agree or disagree with their purposes, but one may also question why taxpayers should have to fund something so ethically charged when alternative methods are available." Parker says, "The objectification of human life is never a trivial matter. And determining what role government plays in that objectification may be the ethical dilemma of the century." She concludes, "In this case, science handed Obama a gift -- and he sent it back" (Parker, Washington Post, 3/11).
~ San Francisco Chronicle: According to the Chronicle editorial, the "era of stem cells has officially begun," although "it could have started eight years ago, when then-President Bush had the opportunity to approve federal funding for new embryonic stem cell research." The editorial continues that Obama's decision to rescind Bush's executive order means that "scientists will have the ability to make choices based on science." According to the Chronicle, "California may profit handsomely from the new order," because of the 2004 approval of Proposition 71, which dedicated $3 billion in bonds to stem cell research. The California Institute for Regenerative Medicine then "negotiated a groundbreaking set of policies to share the profits from any successful therapies with the state," the editorial says. It adds, "When federal money starts flowing into California for stem cell research -- which it will -- California taxpayers will still benefit from those profit sharing policies" (San Francisco Chronicle, 3/10).
~Philadelphia Inquirer: Obama took "a welcome step toward restoring the rightful place of scientific research in guiding public policy" by reversing the Bush administration's restrictions on embryonic stem cell research, an Inquirer editorial says. It continues that although some people oppose the research because days-old embryos are used to create new stem cell lines, University of Pennsylvania medical ethicist Arthur Caplan has noted that nearly all of the approximately 600,000 embryos in storage in the U.S. eventually would be destroyed, regardless. The editorial says, "It would be a lost opportunity for the rest of humankind not to use the embryos that would otherwise be destroyed to save lives," adding that although the field of adult stem cells "holds promise, many scientists agree that research should occur using both strategies." Not doing so would "shut off a field of vast potential without knowing the possible results," according to the editorial, which concludes, "Obama's directive helps to separate ideology from scientific inquiry" (Philadelphia Inquirer, 3/10).
~ Los Angeles Times: "The executive order that Obama signed Monday will open the door to studies on hundreds of newer and more useful stem cell lines," a Times editorial says. It adds, "Stem cell research is a long-term endeavor that should not be subject to the whims of successive administrations." Obama should urge Congress to repeal the Dickey-Wicker Amendment, as "[f]ederal legislation is needed to secure the future" of stem cell research, the editorial says. According to the editorial, "The presidential order is already a boon to California's initiative; now researchers can use federally funded labs and equipment for their state funded research, instead of being forced to duplicate facilities." It concludes, "With established infrastructure and the prospect of future state funding to keep research going, there is no better place for the federal government to invest in embryonic stem cell work" (Los Angeles Times, 3/10).
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.
~ William Saletan, Slate: According to Saletan, "The best way to understand" the issue of embryonic stem cell research is "to look at an issue that has become the mirror image of the stem cell fight. That issue is torture." He writes that after Obama "signed an executive order prohibiting interrogation methods used by the Bush administration," former Bush aide Karl Rove "accused Obama of endangering the country by impeding interrogations of the enemy." He continues that most people "believe, as Obama does, that it's possible to save lives without crossing a moral line that might corrupt us" and that the "same Bush-Rove tactics are being used today in the stem-cell fight." According to Saletan, "Proponents of embryo research are insisting that because we're in a life-and-death struggle ... anyone who impedes that struggle by renouncing effective tools is irrational and irresponsible." He writes that proponents are "parroting" the Obama administration's "spin" on the scientific integrity directive, adding, "Think about what's being dismissed here as 'politics' and 'ideology.'" He continues that it is not necessary to see embryos as equal to full-grown human beings to "appreciate the danger of exploiting them" and suggests to "try shifting the context from stem cells to torture." Saletan asks, "How much ruthless violence should we use to defeat ruthless violence? The paradox and the dilemma are easy to recognize." He adds that proponents of stem cell research have made the dilemma "more compelling" by asking opponents, "How precious is that little embryo? Precious enough to forswear research that might save the life of a 50-year-old man?" He continues, "The danger of seeing the stem cell war as a contest between science and ideology is that you bury these dilemmas." Saletan writes, "The stem cell fight wasn't a fight between ideology and science. It was a fight between five-day-olds and 50-year-olds. The 50-year-olds won." He concludes, "The question now is what to do with our five-day-olds, our 5-week-olds, and our increasingly useful parts" (Saletan, Slate, 3/9).
~ Kathleen Parker, Washington Post: Parker, a syndicated columnist, writes that "since Obama began running for president, researchers have made some rather amazing strides in alternative stem cell research. Science and ethics finally fell in love, in other words, and Obama seems to have fallen asleep during the kiss." She adds, "Either that, or he decided that keeping an old political promise was more important than acknowledging new developments." She continues that while a majority of Americans support embryonic stem cell research, "most Americans, including most journalists and politicians, aren't fluent in stem cell research. It's complicated." She explains that what people claim to "know" is that "embryonic stem cells can cure diseases and that all stem cells come from fertility clinic embryos that will be discarded anyway." However, "Neither belief is entirely true." According to Parker, "[E]very single one of the successes in treating patients with stem cells thus far -- for spinal cord injuries and multiple sclerosis, for example -- have involved adult or umbilical cord blood stem cells, not embryonic stem cells." She says that under Obama's executive order, taxpayers are "incentivizing a market for embryo creation and destruction." The "superior claim" that embryonic stem cells were necessary because they are pluripotent -- that is, capable of becoming any type of cell -- "no longer can be made" because of the introduction of induced pluripotent cells, or IPS cells, Parker writes. She continues, "One may agree or disagree with their purposes, but one may also question why taxpayers should have to fund something so ethically charged when alternative methods are available." Parker says, "The objectification of human life is never a trivial matter. And determining what role government plays in that objectification may be the ethical dilemma of the century." She concludes, "In this case, science handed Obama a gift -- and he sent it back" (Parker, Washington Post, 3/11).
~ San Francisco Chronicle: According to the Chronicle editorial, the "era of stem cells has officially begun," although "it could have started eight years ago, when then-President Bush had the opportunity to approve federal funding for new embryonic stem cell research." The editorial continues that Obama's decision to rescind Bush's executive order means that "scientists will have the ability to make choices based on science." According to the Chronicle, "California may profit handsomely from the new order," because of the 2004 approval of Proposition 71, which dedicated $3 billion in bonds to stem cell research. The California Institute for Regenerative Medicine then "negotiated a groundbreaking set of policies to share the profits from any successful therapies with the state," the editorial says. It adds, "When federal money starts flowing into California for stem cell research -- which it will -- California taxpayers will still benefit from those profit sharing policies" (San Francisco Chronicle, 3/10).
~Philadelphia Inquirer: Obama took "a welcome step toward restoring the rightful place of scientific research in guiding public policy" by reversing the Bush administration's restrictions on embryonic stem cell research, an Inquirer editorial says. It continues that although some people oppose the research because days-old embryos are used to create new stem cell lines, University of Pennsylvania medical ethicist Arthur Caplan has noted that nearly all of the approximately 600,000 embryos in storage in the U.S. eventually would be destroyed, regardless. The editorial says, "It would be a lost opportunity for the rest of humankind not to use the embryos that would otherwise be destroyed to save lives," adding that although the field of adult stem cells "holds promise, many scientists agree that research should occur using both strategies." Not doing so would "shut off a field of vast potential without knowing the possible results," according to the editorial, which concludes, "Obama's directive helps to separate ideology from scientific inquiry" (Philadelphia Inquirer, 3/10).
~ Los Angeles Times: "The executive order that Obama signed Monday will open the door to studies on hundreds of newer and more useful stem cell lines," a Times editorial says. It adds, "Stem cell research is a long-term endeavor that should not be subject to the whims of successive administrations." Obama should urge Congress to repeal the Dickey-Wicker Amendment, as "[f]ederal legislation is needed to secure the future" of stem cell research, the editorial says. According to the editorial, "The presidential order is already a boon to California's initiative; now researchers can use federally funded labs and equipment for their state funded research, instead of being forced to duplicate facilities." It concludes, "With established infrastructure and the prospect of future state funding to keep research going, there is no better place for the federal government to invest in embryonic stem cell work" (Los Angeles Times, 3/10).
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, 6 марта 2012 г.
Women's Perspectives On Medical Male Circumcision For HIV Prevention: Community-Led Research In 5 African Countries
A new report from the Women's HIV Prevention Tracking Project (WHiPT), a collaborative initiative of AVAC and the ATHENA Network, features an unprecedented collection of voices from Kenya, Namibia, South Africa, Swaziland and Uganda reflecting on what male circumcision for HIV prevention means for women. It highlights women's perspectives, advocacy priorities and recommendations on this new prevention strategy.
Making Medical Male Circumcision Work for Women is the first report from WHiPT, which was launched in 2009 to bring community perspectives, particularly women's voices, to the forefront of biomedical prevention research and the broader response to HIV.
The report highlights community-level support as well as concerns and misperceptions that can hinder effective implementation.
"Women are excited for medical male circumcision because they're desperate for new prevention options, but they lack detailed factual knowledge of its benefits and risks," says Cebile Dlamini of Swaziland for Positive Living. "For example, the fact that it only provides partial protection can be overlooked and some women and men believe once a man is circumcised, he is by definition HIV-negative."
In total, nearly 500 women in HIV-affected communities completed a questionnaire, developed and administered by the women-led WHiPT teams in five countries. Almost 40 focus groups provided additional information about women's attitudes about medical male circumcision. In each country, research took place in different locales, selected to reflect a diversity of circumcision practices, including communities that practice traditional male circumcision and those that do not circumcise, as well as those practicing female genital mutilation.
The majority of teams conducted their research in settings where male circumcision for HIV prevention had not yet been introduced as part of a national HIV strategy. Therefore many reported perceptions and concerns can be integrated into emerging programs - making this report both timely and urgent.
The Kenyan WHiPT team surveyed women in settings where male circumcision was evaluated in a clinical trial and subsequently introduced. Reports from women reached by the Kenyan WHiPT team underscore women's fears that male circumcision may lead to changes in men's behaviors and perception of risk.
"The women reported their partners either adapting or continuing risky behavior after 'the cut'", says Carol Odada, from Women Fighting AIDS in Kenya.
The report documents women's concerns that medical male circumcision might lead to an increase in heightened stigma for women living with HIV. This would be a result of circumcised men's misperceptions that they could not be HIV positive and/or could not transmit the virus. Thus sex and or safer sex would be less negotiable than before circumcision, putting women at greater risk for gender-based violence and HIV.
The report also highlights perceptions of male circumcision for HIV prevention in the context of traditional practices. Specifically, it underscores the need for communications campaigns that directly address the distinctions between medical male circumcision, traditional circumcision and female genital mutilation.
"Some women report the concern that the promotion of circumcision for men would increase the promotion of female genital mutilation," says Allen Kuteesa from Health Rights Action Group in Uganda.
The myths and misunderstandings identified by WHiPT teams - such as the perception that medical male circumcision is directly protective for women - underscore the urgent need for adequate education campaigns directed at women. Further, for women to access and act on information related to medical male circumcision and HIV, the information needs to be specifically tailored to women, and the socio-cultural context and realities of women's lived experience need to be taken into account.
The report summarizes advocacy activities that WHiPT teams will undertake over the coming year to ensure that male circumcision implementation addresses women's concerns.
Source:
Cindra Feuer
AIDS Vaccine Advocacy Coalition (AVAC)
Making Medical Male Circumcision Work for Women is the first report from WHiPT, which was launched in 2009 to bring community perspectives, particularly women's voices, to the forefront of biomedical prevention research and the broader response to HIV.
The report highlights community-level support as well as concerns and misperceptions that can hinder effective implementation.
"Women are excited for medical male circumcision because they're desperate for new prevention options, but they lack detailed factual knowledge of its benefits and risks," says Cebile Dlamini of Swaziland for Positive Living. "For example, the fact that it only provides partial protection can be overlooked and some women and men believe once a man is circumcised, he is by definition HIV-negative."
In total, nearly 500 women in HIV-affected communities completed a questionnaire, developed and administered by the women-led WHiPT teams in five countries. Almost 40 focus groups provided additional information about women's attitudes about medical male circumcision. In each country, research took place in different locales, selected to reflect a diversity of circumcision practices, including communities that practice traditional male circumcision and those that do not circumcise, as well as those practicing female genital mutilation.
The majority of teams conducted their research in settings where male circumcision for HIV prevention had not yet been introduced as part of a national HIV strategy. Therefore many reported perceptions and concerns can be integrated into emerging programs - making this report both timely and urgent.
The Kenyan WHiPT team surveyed women in settings where male circumcision was evaluated in a clinical trial and subsequently introduced. Reports from women reached by the Kenyan WHiPT team underscore women's fears that male circumcision may lead to changes in men's behaviors and perception of risk.
"The women reported their partners either adapting or continuing risky behavior after 'the cut'", says Carol Odada, from Women Fighting AIDS in Kenya.
The report documents women's concerns that medical male circumcision might lead to an increase in heightened stigma for women living with HIV. This would be a result of circumcised men's misperceptions that they could not be HIV positive and/or could not transmit the virus. Thus sex and or safer sex would be less negotiable than before circumcision, putting women at greater risk for gender-based violence and HIV.
The report also highlights perceptions of male circumcision for HIV prevention in the context of traditional practices. Specifically, it underscores the need for communications campaigns that directly address the distinctions between medical male circumcision, traditional circumcision and female genital mutilation.
"Some women report the concern that the promotion of circumcision for men would increase the promotion of female genital mutilation," says Allen Kuteesa from Health Rights Action Group in Uganda.
The myths and misunderstandings identified by WHiPT teams - such as the perception that medical male circumcision is directly protective for women - underscore the urgent need for adequate education campaigns directed at women. Further, for women to access and act on information related to medical male circumcision and HIV, the information needs to be specifically tailored to women, and the socio-cultural context and realities of women's lived experience need to be taken into account.
The report summarizes advocacy activities that WHiPT teams will undertake over the coming year to ensure that male circumcision implementation addresses women's concerns.
Source:
Cindra Feuer
AIDS Vaccine Advocacy Coalition (AVAC)
вторник, 28 февраля 2012 г.
Most women don't know that smear tests prevent cancer
Two thirds of British women do not know that a cervical smear test is designed to prevent cancer - according to a new survey by Cancer Research UK.
Such widespread ignorance about a screening test that saves thousands of lives each year is alarming. And it is particularly worrying that the 1575 people surveyed were within the 25-64 age bracket when women are regularly invited for cervical screening.
Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "The purpose of the cervical smear is all about prevention. The test detects any abnormal cells that could become cancerous and follow-up treatment will prevent cancer developing.
"As part of Cancer Research UK's Reduce the Risk campaign we are urging women to go for regular screening checks when they are invited. We know that only 50 per cent of women of all ages are aware that a national cervical screening programme exists while 90 per cent know about breast screening.
"It is vitally important to get the message out that screening saves lives because the number of cases of cervical cancer has dropped dramatically since widespread screening was introduced."
Before the national screening programme was introduced the death rate from cervical cancer among British women under 35 was among the highest in the developed world. Only Bulgaria, Hungary and Romania had higher rates than the UK.
Between 1967 and 1987 cervical cancer death rates in Britain trebled.
Since the national screening programme began in 1988 the trend has reversed. It is calculated that the screening programme is today saving more than 1,000 lives each year.
The survey also revealed that almost a quarter of women questioned did not associate the smear test specifically with cancer.
But even among those women who realised the smear test was connected with cancer there was a basic misconception: they thought the test was designed to detect cancer rather than to pick up a potentially pre-cancerous condition.
Dr Walker added: "It is extremely important that women understand this difference. If they think the test only detects cancer they may fear to go for regular checks. It is important to reassure women that cervical screening is designed to prevent cancer developing. Before screening the UK was set to see thousands more women dying from cervical cancer."
Almost 3,000 new cases of cervical cancer are diagnosed in the UK each year. It can affect women of any age who are, or once were, sexually active and is the second most common cancer in women under 35.
Scientists have linked nearly all cases of cervical cancer to human papillomavirus or HPV. Most sexually active women will be infected with HPV at some point as it is very common but the virus usually clears up on its own.
If HPV persists it can lead to changes in the cells of the cervix that may lead to cancer if left untreated. Cervical screening detects these early changes and the abnormal cells can then be removed thereby preventing cancer developing.
You can download a leaflet about reducing your risk of getting cervical cancer . Or send a stamped addressed envelope to CC Prevention, Cancer Information Department, Cancer Research UK, PO Box 123, London WC2A 3PX.
Half of all cancers could be prevented by changes to lifestyle. Cancer Research UK's Reduce the Risk campaign urges people to go for screening when invited. "In the case of cervical screening early detection of abnormalities will ultimately save thousands of lives."
infoncerresearchuk/healthyliving/reducetherisk
cancerresearchuk
Such widespread ignorance about a screening test that saves thousands of lives each year is alarming. And it is particularly worrying that the 1575 people surveyed were within the 25-64 age bracket when women are regularly invited for cervical screening.
Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "The purpose of the cervical smear is all about prevention. The test detects any abnormal cells that could become cancerous and follow-up treatment will prevent cancer developing.
"As part of Cancer Research UK's Reduce the Risk campaign we are urging women to go for regular screening checks when they are invited. We know that only 50 per cent of women of all ages are aware that a national cervical screening programme exists while 90 per cent know about breast screening.
"It is vitally important to get the message out that screening saves lives because the number of cases of cervical cancer has dropped dramatically since widespread screening was introduced."
Before the national screening programme was introduced the death rate from cervical cancer among British women under 35 was among the highest in the developed world. Only Bulgaria, Hungary and Romania had higher rates than the UK.
Between 1967 and 1987 cervical cancer death rates in Britain trebled.
Since the national screening programme began in 1988 the trend has reversed. It is calculated that the screening programme is today saving more than 1,000 lives each year.
The survey also revealed that almost a quarter of women questioned did not associate the smear test specifically with cancer.
But even among those women who realised the smear test was connected with cancer there was a basic misconception: they thought the test was designed to detect cancer rather than to pick up a potentially pre-cancerous condition.
Dr Walker added: "It is extremely important that women understand this difference. If they think the test only detects cancer they may fear to go for regular checks. It is important to reassure women that cervical screening is designed to prevent cancer developing. Before screening the UK was set to see thousands more women dying from cervical cancer."
Almost 3,000 new cases of cervical cancer are diagnosed in the UK each year. It can affect women of any age who are, or once were, sexually active and is the second most common cancer in women under 35.
Scientists have linked nearly all cases of cervical cancer to human papillomavirus or HPV. Most sexually active women will be infected with HPV at some point as it is very common but the virus usually clears up on its own.
If HPV persists it can lead to changes in the cells of the cervix that may lead to cancer if left untreated. Cervical screening detects these early changes and the abnormal cells can then be removed thereby preventing cancer developing.
You can download a leaflet about reducing your risk of getting cervical cancer . Or send a stamped addressed envelope to CC Prevention, Cancer Information Department, Cancer Research UK, PO Box 123, London WC2A 3PX.
Half of all cancers could be prevented by changes to lifestyle. Cancer Research UK's Reduce the Risk campaign urges people to go for screening when invited. "In the case of cervical screening early detection of abnormalities will ultimately save thousands of lives."
infoncerresearchuk/healthyliving/reducetherisk
cancerresearchuk
вторник, 21 февраля 2012 г.
Angina, A Common Form Of Heart Disease, Is More Dangerous For Women Than Was Previously Thought
Angina, a common form of heart disease, is more dangerous for women than was previously thought, according to a new study published in the Journal of the American Medical Association (JAMA). The collaborative study, led by UCL (University College London) and funded by the British Heart Foundation, found that angina in women is as common as it is in men, in contrast to heart attacks (myocardial infarction) which have a higher rate in men. The findings suggest that the medical profession should pay more attention to thoroughly investigating and diagnosing women suspected of having angina.
UCL Professor Harry Hemingway and colleagues studied over 100,000 patients aged 45-89 years with angina using electronic health records. They found that each year, two women out of every 100 in the general population developed angina, as the first sign of heart disease. This makes angina much more common than heart attacks (the risks of which are usually measured per 1,000 population).
The study also found that for women, the diagnosis of angina is less frequently confirmed with tests, such as angiograms or treadmill exercise electrocardiograms. In the patients in the study, drug treatment aimed at relieving angina (nitrates) was prescribed solely on the basis of symptom history.
In the study, angina in women was also associated with increased death rates, where women diagnosed without the confirmatory test had significantly higher death rates from heart disease. Such women have often been dismissed as having a 'soft' subjective complaint, without real pathological changes in the heart. The study suggests that this attitude is incorrect.
Among women with angina and diabetes, the annual risk of a heart attack was particularly high and similar to the risk in men (about one in 10).
Professor Hemingway, from the UCL Department of Epidemiology and Public Health, says: "For women, angina is a more significant public health problem than many doctors, or indeed the general public, realise. Women develop angina at a similarly high rate as men. And the angina which women experience is not benign in terms of death rates. We need to understand why women are relatively protected from heart attack but not from angina, and ensure fair access to investigation and treatment services.
"Angina has been a Cinderella in heart disease research because of the difficulties in establishing which patients have angina - many people with symptoms are not tested - and because most patients are not hospitalised. The opposite is true for heart attacks, where nearly all patients are tested to confirm the diagnosis and are admitted as an emergency into hospital."
Angina is a symptom of chest pain or discomfort which is brought on by exercise (or cold or emotional stress) and relieved by rest. These symptoms are due to the supply of oxygen to the heart muscle (myocardium) being insufficient to meet demand (so called myocardial ischaemia). Narrowing and hardening of the blood vessels which supply oxygen to the heart muscle causes angina. Atherosclerosis is the cause of the narrowing and hardening of the coronary (heart) arteries.
Angina is more likely to occur in people who have one or more of the following risk factors: older age, smoking, high blood pressure, high cholesterol, diabetes, obesity, family history.
Angina can be prevented by lifestyle changes (stopping smoking, increasing exercise) and by lowering blood pressure and cholesterol. The symptoms of angina can be relieved with medication (such as nitrates or beta-blockers) and by undergoing a coronary revascularisation procedure. The risk of having a heart attack after having experienced angina can be reduced by taking 'secondary prevention' medications such as aspirin and lipid lowering drugs. There is no cure for the underlying disease process of atherosclerosis.
Contact: Jenny Gimpel
j.gimpelucl.ac
University College London
UCL Professor Harry Hemingway and colleagues studied over 100,000 patients aged 45-89 years with angina using electronic health records. They found that each year, two women out of every 100 in the general population developed angina, as the first sign of heart disease. This makes angina much more common than heart attacks (the risks of which are usually measured per 1,000 population).
The study also found that for women, the diagnosis of angina is less frequently confirmed with tests, such as angiograms or treadmill exercise electrocardiograms. In the patients in the study, drug treatment aimed at relieving angina (nitrates) was prescribed solely on the basis of symptom history.
In the study, angina in women was also associated with increased death rates, where women diagnosed without the confirmatory test had significantly higher death rates from heart disease. Such women have often been dismissed as having a 'soft' subjective complaint, without real pathological changes in the heart. The study suggests that this attitude is incorrect.
Among women with angina and diabetes, the annual risk of a heart attack was particularly high and similar to the risk in men (about one in 10).
Professor Hemingway, from the UCL Department of Epidemiology and Public Health, says: "For women, angina is a more significant public health problem than many doctors, or indeed the general public, realise. Women develop angina at a similarly high rate as men. And the angina which women experience is not benign in terms of death rates. We need to understand why women are relatively protected from heart attack but not from angina, and ensure fair access to investigation and treatment services.
"Angina has been a Cinderella in heart disease research because of the difficulties in establishing which patients have angina - many people with symptoms are not tested - and because most patients are not hospitalised. The opposite is true for heart attacks, where nearly all patients are tested to confirm the diagnosis and are admitted as an emergency into hospital."
Angina is a symptom of chest pain or discomfort which is brought on by exercise (or cold or emotional stress) and relieved by rest. These symptoms are due to the supply of oxygen to the heart muscle (myocardium) being insufficient to meet demand (so called myocardial ischaemia). Narrowing and hardening of the blood vessels which supply oxygen to the heart muscle causes angina. Atherosclerosis is the cause of the narrowing and hardening of the coronary (heart) arteries.
Angina is more likely to occur in people who have one or more of the following risk factors: older age, smoking, high blood pressure, high cholesterol, diabetes, obesity, family history.
Angina can be prevented by lifestyle changes (stopping smoking, increasing exercise) and by lowering blood pressure and cholesterol. The symptoms of angina can be relieved with medication (such as nitrates or beta-blockers) and by undergoing a coronary revascularisation procedure. The risk of having a heart attack after having experienced angina can be reduced by taking 'secondary prevention' medications such as aspirin and lipid lowering drugs. There is no cure for the underlying disease process of atherosclerosis.
Contact: Jenny Gimpel
j.gimpelucl.ac
University College London
вторник, 14 февраля 2012 г.
Public Should Know Views Of Supreme Court Candidates, Opinion Piece Says
The next Supreme Court justice to replace retiring Justice David Souter, as well as the confirmation process, "should represent a clear break with the policies" of former President George W. Bush, Kate Michelman, NARAL Pro-Choice America president from 1985 to 2004, writes in a Philadelphia Inquirer opinion piece. She adds, "The clearest sign that President Obama is committed to the demand for change would be the nomination of a justice who is committed to forthrightly and unapologetically defending America's fundamental liberties," including a "commitment to the constitutional rights to privacy and equality that found crucial meaning and historic expression for women in Roe v. Wade."
Obama has indicated that he believes in these rights, and it is likely that he will choose a nominee who also does; however, the U.S. public might never know what the nominee believes because of "the conspiracy of silence that governs judicial nominations," according to Michelman. She writes that the "generally accepted 'rules'" of judicial nominations -- in which presidents "promise not to apply 'litmus tests,'" and nominees pledge to be silent on cases and precedents -- should change, adding, "We should no more confirm a nominee who refuses to discuss these fundamental rights than one who claims to have no position on the rights to free speech, freedom of religion or jury trials."
According to Michelman, the "reality" is that presidents "do consider the concrete judicial views of potential nominees. Bush did. Obama will. They would be irresponsible if they did not." Supreme Court nominees would not be qualified to be on the court if they did not have "opinions on issues they claim they are compelled not to discuss." While this is well-known, "confirmation debates are conducted in a theater of shadows," she continues, adding that the "American people are denied forthright knowledge about an irreversible appointment to an institution whose impact on their lives is immense." Although justices should be neutral toward cases and the people involved, Americans are "entitled to know what he or she thinks" about the Constitution, which they take an oath to "preserve, protect and defend." She continues that Obama "is correct that jurists must also understand the effect of their decisions on the lives of real people," an effect that "weighs especially heavily on the women whom the court has required to clear higher and increasingly intrusive hurdles to act on their freedom to choose."
Michelman writes that Supreme Court nominees "seek appointment to a court from which he or she could turn those thoughts into constitutional precedent the nation will be compelled to accept, without appeal, for decades or longer." She concludes, "The only question in this nomination process will be whether the country will be allowed to know what the nominee's thoughts are. That is one basic right everyone should be able to agree we have" (Michelman, Philadelphia Inquirer, 5/11).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
Obama has indicated that he believes in these rights, and it is likely that he will choose a nominee who also does; however, the U.S. public might never know what the nominee believes because of "the conspiracy of silence that governs judicial nominations," according to Michelman. She writes that the "generally accepted 'rules'" of judicial nominations -- in which presidents "promise not to apply 'litmus tests,'" and nominees pledge to be silent on cases and precedents -- should change, adding, "We should no more confirm a nominee who refuses to discuss these fundamental rights than one who claims to have no position on the rights to free speech, freedom of religion or jury trials."
According to Michelman, the "reality" is that presidents "do consider the concrete judicial views of potential nominees. Bush did. Obama will. They would be irresponsible if they did not." Supreme Court nominees would not be qualified to be on the court if they did not have "opinions on issues they claim they are compelled not to discuss." While this is well-known, "confirmation debates are conducted in a theater of shadows," she continues, adding that the "American people are denied forthright knowledge about an irreversible appointment to an institution whose impact on their lives is immense." Although justices should be neutral toward cases and the people involved, Americans are "entitled to know what he or she thinks" about the Constitution, which they take an oath to "preserve, protect and defend." She continues that Obama "is correct that jurists must also understand the effect of their decisions on the lives of real people," an effect that "weighs especially heavily on the women whom the court has required to clear higher and increasingly intrusive hurdles to act on their freedom to choose."
Michelman writes that Supreme Court nominees "seek appointment to a court from which he or she could turn those thoughts into constitutional precedent the nation will be compelled to accept, without appeal, for decades or longer." She concludes, "The only question in this nomination process will be whether the country will be allowed to know what the nominee's thoughts are. That is one basic right everyone should be able to agree we have" (Michelman, Philadelphia Inquirer, 5/11).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
вторник, 7 февраля 2012 г.
UK Government Is Failing Sex Workers
The UK government is failing sex workers by continuing to promote discriminatory laws and practices, argue experts in this week's BMJ.
Professor Michael Goodyear and Dr Linda Cusick call on the prime minister to protect women by decriminalising all aspects of sex work now.
Sex workers around the world continue to be murdered, write Professor Goodyear of Dalhousie University, Canada and Dr Cusick of the University of Paisley, Scotland. The five young women killed in Suffolk last month raised questions about our collective duty to protect such women and how best to achieve it.
Governments and health and social services have a duty of care without discrimination, yet they argue that UK government policies discriminate against the most disadvantaged.
Criminalisation of prostitution limits access to health and social care and contravenes United Nations' guidelines on human rights. "Only by moving prostitution out of the criminal justice system and focusing on public health and social care can we provide optimum support and help break the cycle of violence," they say.
The status quo in the UK is unacceptable moral cowardice, they add. The prime minister has opposed reform and stalled demands for the protection of women; he must show leadership and restore human rights by decriminalising all aspects of sex work now.
They believe that the deaths of Gemma Adams, Tania Nicol, Anneli Alderton, Paula Clennell, and Annette Nicholls were almost inevitable. "They deserved better, but we failed them. We will honour them best by now doing the right thing."
Contact: Emma Dickinson
BMJ-British Medical Journal
Professor Michael Goodyear and Dr Linda Cusick call on the prime minister to protect women by decriminalising all aspects of sex work now.
Sex workers around the world continue to be murdered, write Professor Goodyear of Dalhousie University, Canada and Dr Cusick of the University of Paisley, Scotland. The five young women killed in Suffolk last month raised questions about our collective duty to protect such women and how best to achieve it.
Governments and health and social services have a duty of care without discrimination, yet they argue that UK government policies discriminate against the most disadvantaged.
Criminalisation of prostitution limits access to health and social care and contravenes United Nations' guidelines on human rights. "Only by moving prostitution out of the criminal justice system and focusing on public health and social care can we provide optimum support and help break the cycle of violence," they say.
The status quo in the UK is unacceptable moral cowardice, they add. The prime minister has opposed reform and stalled demands for the protection of women; he must show leadership and restore human rights by decriminalising all aspects of sex work now.
They believe that the deaths of Gemma Adams, Tania Nicol, Anneli Alderton, Paula Clennell, and Annette Nicholls were almost inevitable. "They deserved better, but we failed them. We will honour them best by now doing the right thing."
Contact: Emma Dickinson
BMJ-British Medical Journal
вторник, 31 января 2012 г.
GSK'S Innovative Adjuvant In Candidate HPV Vaccine (Cervarixtm) Induces Stronger & Sustained Immune Response Compared To Conventional Adjuvant
The immune response against the virus that causes cervical cancer is stronger and sustained following vaccination with GlaxoSmithKline's (GSK) candidate HPV vaccine formulated with the innovative AS04 adjuvant compared to using the same vaccine formulated with a conventional aluminium salt adjuvant. 1
Data from the first studies to directly compare two different formulations of GSK's HPV vaccine has revealed that the antibody response induced by the vaccine formulated with the innovative AS04 adjuvant was higher, compared to the same vaccine formulated with a conventional aluminium salt adjuvant. This enhanced immune profile observed with the AS04 formulation was shown to persist for at least 3.5 years post-vaccination. 1
Furthermore, these data, published in Vaccine, showed that the AS04 adjuvanted vaccine also induced a more robust immune memory response - specifically, the AS04 formulation elicited an increased number (2.5 to 5.2 fold) of HPV 16/18 specific memory B-cells - compared to that observed after vaccination with the same vaccine formulated with a conventional aluminium salt adjuvant.
In previously published studies, GSK's HPV vaccine, formulated with the innovative AS04 adjuvant, has demonstrated sustained efficacy up to 4.5 years against HPV 16/18 infections, associated abnormal cytology and precancerous lesions (CIN). 2,3
Clinical trials are currently ongoing to determine the duration of protection that results from HPV vaccination. They aim to establish whether the higher antibody levels seen following vaccination with the AS04 adjuvanted HPV vaccine will have a positive impact on long term protection.
Dr Philippe Monteyne, Head of Global Vaccine Development of GSK Biologicals, said: "For a HPV vaccine to be effective, it must induce a strong immune response and provide protection that lasts. These new data demonstrate a genuine immunological benefit with the AS04 adjuvant by contributing to a strong and sustained vaccine-induced immune response of high quality."
What is an adjuvant?
The word adjuvant comes from the Latin word adjuvare which means 'to help'.
Adjuvants are substances, which when used in combination with antigens in vaccines, enhance the immune response. The use of adjuvants in vaccines is very common. Vaccines have conventionally been formulated with aluminium salt as the adjuvant.
About GSK's AS04 adjuvant
GSK's candidate HPV vaccine is formulated with the innovative adjuvant AS04. AS04 is composed of aluminium salt and monophosphoryl lipid A (MPL). MPL is an immunostimulant, capable of directly activating key immune mechanisms. The combination of aluminium salt and MPL has been shown, in these studies, to further enhance the immune response to antigens included in the vaccine compared to aluminium salt alone.
About the studies
In these studies, GSK's HPV vaccine, formulated with the innovative AS04 adjuvant, and the same vaccine formulated with a conventional aluminium salt adjuvant were compared to assess the quality of the immune response generated after vaccination.
In human studies, subjects received a three-dose course (at 0, 1 and 6 months) of GSK's HPV vaccine formulated with either the innovative AS04 adjuvant or a conventional aluminium salt adjuvant. Following vaccination, antibody levels and immune memory B-cells were measured.
Results in human subjects showed that enhanced antibody levels induced by the AS04 adjuvanted HPV vaccine were 1.5 and 2.1 times higher for HPV 16 and HPV 18 respectively, at 3.5 years post-vaccination, compared to those induced following vaccination with the same vaccine formulated with a conventional aluminium salt adjuvant.
The studies also demonstrated the ability of the AS04 adjuvanted vaccine to increase the number of immune memory B-cells. One month following completion of a three-dose course of GSK's HPV vaccine formulated with the innovative AS04 adjuvant, observed numbers of memory B-cells were 2 and 3.6 times higher for HPV 18 and HPV 16 respectively than those observed following vaccination with the same vaccine formulated with a conventional aluminium salt adjuvant. Recent observations have indicated that immune memory B-cells play a key role in the persistence of antibody levels following vaccination.
Full results of the studies may be viewed online at:
sciencedirect or Vol. 24 of Vaccine, publication date 14 August 2006.
About GSK's candidate HPV vaccine
GSK's HPV vaccine has been developed to prevent infection and precancerous lesions caused by the two most common HPV types associated with cervical cancer, HPV 16 and 18. In addition, GSK's candidate HPV vaccine has shown protection against incident infection with the third and fourth most common HPV types associated with cervical cancer, HPV 45 and 31. 2,3 HPV types 16, 18, 45 and 31 are collectively responsible for approximately 80 per cent of cervical cancers globally. 2,3
GSK submitted a marketing application for its HPV vaccine to the European Agency for the Evaluation of Medicinal Products (EMEA) in March 2006.
An ongoing Phase III clinical trials programme involving more than 30,000 women worldwide continues.
About HPV and cervical cancer
Cervical cancer and precancerous lesions together represent a significant health and psychological burden for women in the UK. 4-9
In the UK each year, almost 3,000 new cases of cervical cancer are reported 5 and there are more than 1,000 deaths. 4 It is the second most common cancer in women under the age of 35 years.5
Cervical cancer is not hereditary. It is caused by high risk types of human papillomavirus (HPV). Two high risk types of the virus, HPV 16 and 18, together cause approximately 70 per cent of cervical cancers. 12
Anyone who has had a sexual relationship is at risk of infection with HPV, as it is very common and easily transmitted through skin to skin contact in the genital area. 13-14 Up to 80 per cent of sexually active women will be infected with a type of HPV at some point in their lives. 16-17
Most infections will be cleared naturally but, if infection persists, women are at risk of developing cervical cancer. It is not possible to predict which women with persistent infection will go on to develop precancerous lesions and/ or cancer. 17
Risk of exposure to high risk HPV can continue throughout a sexually active woman's life 18 and prior HPV infection may not always provide sufficient immunity to protect against subsequent infections. 12, 13, 19, 20
Detection and treatment of precancerous lesions through screening has reduced cervical cancer incidence and mortality in the UK, highlighting the importance of attending regular cervical screening. 6
It has been estimated that without a screening programme, up to 5,000 more UK women would die each year from cervical cancer. 21
About GlaxoSmithKline and GlaxoSmithKline Biologicals
GlaxoSmithKline - one of the world's leading research-based pharmaceutical and healthcare companies - is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For company information please visit gsk.
GSK Biologicals (GSK Bio), one of the world's leading vaccine manufacturers, is headquartered in Rixensart, Belgium, where the majority of GlaxoSmithKline's activities in the field of vaccine research, development and production are conducted. GSK Bio employs more than 1,500 scientists, who are devoted to discovering new vaccines and developing more cost-effective and convenient combination products to prevent infections that cause serious medical problems worldwide.
In 2005, GSK Bio distributed more than 1.2 billion doses of vaccines to 165 countries in both the developed and the developing world, an average of more than 3 million doses per day.
References
1. Giannini SL et al. Vaccine 2006
2. Harper D et al. Lancet 2006; 367: 1247-1255
3. Harper D et al. Lancet 2004;364:1757-65
4. Ferlay J et al. Globocan 2002: Cancer incidence, mortality and prevalence worldwide. IARC Cancerbase No. 5. Version 2.0, IARC Press, Lyon, 2004. www.depdb.iarc.fr/globocan/GLOBOframe.htm
5. CancerStats Jan 2003
6. Cervical Screening Programme England 2004/5. National Statistics Bulletin 2005/09/HSCIC
7. Office of National Statistics. Cancer registration statistics 2002
8. Rogstad KE. BJOG 2002; 109 (4):364-8
9. Peto J et al. British Journal of Cancer 2004; 91: 942-953
10. Walboomers J et al. J Pathol 1999; 189: 12-19
11. Bosch FX et al. J Clin Pathol 2002; 55: 244-65
12. Munoz N et al. Int J Cancer 2004; 111: 278-85
13. Baseman J and Koutsky L. J Clin Virol 2005
14. Winer et al. Am J Epidemiol 2003; 157(3): 218-26
15. Koutsky L. American Journal of Medicine 1997; 102 (5A); 3-8
16. Moscicki A-B et al. J Pediatr 1998: 132: 277-84
17. Choma K. Am J Nursing 2003; 103(2): 42-50
18. Grainge et al. Em Infect Dis 2005; 11 (11): 1680-1685
19. De Jong A et al. Cancer Res 2004; 64: 5449-55 20. Franco EL and Harper DM. Vaccine 2005; 23: 2388-94
21. Peto et al. Lancet 2004 (July 17); 364: 249-256
Data from the first studies to directly compare two different formulations of GSK's HPV vaccine has revealed that the antibody response induced by the vaccine formulated with the innovative AS04 adjuvant was higher, compared to the same vaccine formulated with a conventional aluminium salt adjuvant. This enhanced immune profile observed with the AS04 formulation was shown to persist for at least 3.5 years post-vaccination. 1
Furthermore, these data, published in Vaccine, showed that the AS04 adjuvanted vaccine also induced a more robust immune memory response - specifically, the AS04 formulation elicited an increased number (2.5 to 5.2 fold) of HPV 16/18 specific memory B-cells - compared to that observed after vaccination with the same vaccine formulated with a conventional aluminium salt adjuvant.
In previously published studies, GSK's HPV vaccine, formulated with the innovative AS04 adjuvant, has demonstrated sustained efficacy up to 4.5 years against HPV 16/18 infections, associated abnormal cytology and precancerous lesions (CIN). 2,3
Clinical trials are currently ongoing to determine the duration of protection that results from HPV vaccination. They aim to establish whether the higher antibody levels seen following vaccination with the AS04 adjuvanted HPV vaccine will have a positive impact on long term protection.
Dr Philippe Monteyne, Head of Global Vaccine Development of GSK Biologicals, said: "For a HPV vaccine to be effective, it must induce a strong immune response and provide protection that lasts. These new data demonstrate a genuine immunological benefit with the AS04 adjuvant by contributing to a strong and sustained vaccine-induced immune response of high quality."
What is an adjuvant?
The word adjuvant comes from the Latin word adjuvare which means 'to help'.
Adjuvants are substances, which when used in combination with antigens in vaccines, enhance the immune response. The use of adjuvants in vaccines is very common. Vaccines have conventionally been formulated with aluminium salt as the adjuvant.
About GSK's AS04 adjuvant
GSK's candidate HPV vaccine is formulated with the innovative adjuvant AS04. AS04 is composed of aluminium salt and monophosphoryl lipid A (MPL). MPL is an immunostimulant, capable of directly activating key immune mechanisms. The combination of aluminium salt and MPL has been shown, in these studies, to further enhance the immune response to antigens included in the vaccine compared to aluminium salt alone.
About the studies
In these studies, GSK's HPV vaccine, formulated with the innovative AS04 adjuvant, and the same vaccine formulated with a conventional aluminium salt adjuvant were compared to assess the quality of the immune response generated after vaccination.
In human studies, subjects received a three-dose course (at 0, 1 and 6 months) of GSK's HPV vaccine formulated with either the innovative AS04 adjuvant or a conventional aluminium salt adjuvant. Following vaccination, antibody levels and immune memory B-cells were measured.
Results in human subjects showed that enhanced antibody levels induced by the AS04 adjuvanted HPV vaccine were 1.5 and 2.1 times higher for HPV 16 and HPV 18 respectively, at 3.5 years post-vaccination, compared to those induced following vaccination with the same vaccine formulated with a conventional aluminium salt adjuvant.
The studies also demonstrated the ability of the AS04 adjuvanted vaccine to increase the number of immune memory B-cells. One month following completion of a three-dose course of GSK's HPV vaccine formulated with the innovative AS04 adjuvant, observed numbers of memory B-cells were 2 and 3.6 times higher for HPV 18 and HPV 16 respectively than those observed following vaccination with the same vaccine formulated with a conventional aluminium salt adjuvant. Recent observations have indicated that immune memory B-cells play a key role in the persistence of antibody levels following vaccination.
Full results of the studies may be viewed online at:
sciencedirect or Vol. 24 of Vaccine, publication date 14 August 2006.
About GSK's candidate HPV vaccine
GSK's HPV vaccine has been developed to prevent infection and precancerous lesions caused by the two most common HPV types associated with cervical cancer, HPV 16 and 18. In addition, GSK's candidate HPV vaccine has shown protection against incident infection with the third and fourth most common HPV types associated with cervical cancer, HPV 45 and 31. 2,3 HPV types 16, 18, 45 and 31 are collectively responsible for approximately 80 per cent of cervical cancers globally. 2,3
GSK submitted a marketing application for its HPV vaccine to the European Agency for the Evaluation of Medicinal Products (EMEA) in March 2006.
An ongoing Phase III clinical trials programme involving more than 30,000 women worldwide continues.
About HPV and cervical cancer
Cervical cancer and precancerous lesions together represent a significant health and psychological burden for women in the UK. 4-9
In the UK each year, almost 3,000 new cases of cervical cancer are reported 5 and there are more than 1,000 deaths. 4 It is the second most common cancer in women under the age of 35 years.5
Cervical cancer is not hereditary. It is caused by high risk types of human papillomavirus (HPV). Two high risk types of the virus, HPV 16 and 18, together cause approximately 70 per cent of cervical cancers. 12
Anyone who has had a sexual relationship is at risk of infection with HPV, as it is very common and easily transmitted through skin to skin contact in the genital area. 13-14 Up to 80 per cent of sexually active women will be infected with a type of HPV at some point in their lives. 16-17
Most infections will be cleared naturally but, if infection persists, women are at risk of developing cervical cancer. It is not possible to predict which women with persistent infection will go on to develop precancerous lesions and/ or cancer. 17
Risk of exposure to high risk HPV can continue throughout a sexually active woman's life 18 and prior HPV infection may not always provide sufficient immunity to protect against subsequent infections. 12, 13, 19, 20
Detection and treatment of precancerous lesions through screening has reduced cervical cancer incidence and mortality in the UK, highlighting the importance of attending regular cervical screening. 6
It has been estimated that without a screening programme, up to 5,000 more UK women would die each year from cervical cancer. 21
About GlaxoSmithKline and GlaxoSmithKline Biologicals
GlaxoSmithKline - one of the world's leading research-based pharmaceutical and healthcare companies - is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For company information please visit gsk.
GSK Biologicals (GSK Bio), one of the world's leading vaccine manufacturers, is headquartered in Rixensart, Belgium, where the majority of GlaxoSmithKline's activities in the field of vaccine research, development and production are conducted. GSK Bio employs more than 1,500 scientists, who are devoted to discovering new vaccines and developing more cost-effective and convenient combination products to prevent infections that cause serious medical problems worldwide.
In 2005, GSK Bio distributed more than 1.2 billion doses of vaccines to 165 countries in both the developed and the developing world, an average of more than 3 million doses per day.
References
1. Giannini SL et al. Vaccine 2006
2. Harper D et al. Lancet 2006; 367: 1247-1255
3. Harper D et al. Lancet 2004;364:1757-65
4. Ferlay J et al. Globocan 2002: Cancer incidence, mortality and prevalence worldwide. IARC Cancerbase No. 5. Version 2.0, IARC Press, Lyon, 2004. www.depdb.iarc.fr/globocan/GLOBOframe.htm
5. CancerStats Jan 2003
6. Cervical Screening Programme England 2004/5. National Statistics Bulletin 2005/09/HSCIC
7. Office of National Statistics. Cancer registration statistics 2002
8. Rogstad KE. BJOG 2002; 109 (4):364-8
9. Peto J et al. British Journal of Cancer 2004; 91: 942-953
10. Walboomers J et al. J Pathol 1999; 189: 12-19
11. Bosch FX et al. J Clin Pathol 2002; 55: 244-65
12. Munoz N et al. Int J Cancer 2004; 111: 278-85
13. Baseman J and Koutsky L. J Clin Virol 2005
14. Winer et al. Am J Epidemiol 2003; 157(3): 218-26
15. Koutsky L. American Journal of Medicine 1997; 102 (5A); 3-8
16. Moscicki A-B et al. J Pediatr 1998: 132: 277-84
17. Choma K. Am J Nursing 2003; 103(2): 42-50
18. Grainge et al. Em Infect Dis 2005; 11 (11): 1680-1685
19. De Jong A et al. Cancer Res 2004; 64: 5449-55 20. Franco EL and Harper DM. Vaccine 2005; 23: 2388-94
21. Peto et al. Lancet 2004 (July 17); 364: 249-256
вторник, 24 января 2012 г.
New Mothers Benefit From Community-Based Internet Forums But Fathers Could Be Marginalized
Researchers believe that local online forums could play a key role in helping new mothers to share experiences and concerns, according to a study published in the January issue of the UK-based Journal of Advanced Nursing.
Professor Wendy Hall from the University of British Columbia and Assistant Professor Valerie Irvine from the University of Victoria, Canada, studied online communication threads between a group of 40 women, who had all given birth in the same year and joined a local forum based in a moderate-sized Canadian city.
They concluded that these forums could provide a viable alternative to face-to-face groups, especially in rural communities where travel and professional support are limited.
As a result of the study, the researchers are encouraging healthcare professionals to help mothers with young children to set up, or access, similar community-based networks as they believe they offer more tailored support than existing corporate web-based forums with unlimited international access.
But they have warned that there is a danger that women-only forums can marginalise fathers and that if fathers are not actively involved in discussions about childcare this could pose particular problems for working mothers.
"The 12 women who initially set up the forum met while they were attending parent education classes" explains Professor Hall. "They invited a community health nurse to monitor their communications and correct any information that was wrong."
New members were then invited by word of mouth.
The 40 women who took part in the study gave the researchers permission to monitor their archived posts, which covered a one-year period. They were highly educated, with an average age of 36. The group included pregnant women as well as the mothers of babies up to 11 months of age. Eight out of ten were married and 88 per cent had above average incomes. Sixty-one per cent were employed outside the home, nine per cent worked at home for pay and 14 per cent were on maternity leave.
The researchers found that the women used the online support group to:
Develop community connections in the small geographical area that the membership covered. It was used to share information about accessing community programmes and classes, suggest and share the names of service providers, organise dates for events, sell or trade children's items, share videos and plan get-togethers.
Request and provide emotional support. The women shared their stories, experiences and feelings, expressed sympathy, thanked others for their help and talked about their beliefs and expectations. For example they discussed practical issues, like breastfeeding, finding child care, teething and healthcare experiences, and emotional issues, like how they felt about going back to work.
Share information that they had gleaned from websites, reading or care providers, and learn. For example, they talked about the best ways to get their babies to sleep, useful websites and books they had discovered or advice they had been given by their healthcare provider on issues such as milk allergies. They also helped other members whose computer skills were less developed.
Normalise the experiences they were having with their babies and as mothers. The women found it helpful to discuss problems and compare notes about problems as it made them realise that other mothers had similar issues. They also talked about how they had solved problems, the advice they had received and how their experiences would change as their children developed.
The authors have pointed out that the experiences of mothers on a tightly-knit geographical forum could be more similar than women on a website that draws membership from diverse communities across the world.
"The mothers who became part of this online community obviously drew great benefits from the advice, support and friendship they received from other local women" says Professor Hall.
"However some of the women did report that their partners were commenting on how much time they spent on the computer and they acknowledged that social activities were organised that excluded fathers.
"There were some indications that our study group felt that parenting was primarily their responsibility and that fathers didn't need to be included in the discussions. Supporting mothers is very important but it is also vital that fathers are not sidelined in a way that discourages them from being active parents."
The authors conclude that local online support groups can play an important role in helping to support women in what can be an isolating experience, by bringing them together with other mothers with similar expectations, beliefs and knowledge.
"This self-sufficient grass-roots group required limited monitoring by the community health nurse and this format could offer an alternative to face-to-face support groups" says Professor Hall. "Nurses and other healthcare providers could also help women to identify online local or regional resources.
"The forum we studied clearly shows that the opportunity to share experiences with like-minded, local women can stop pregnant women and mothers from feeling isolated and worrying about giving birth and parenting."
Notes:
E-communication among mothers of infants and toddlers in a community-based cohort: a content analysis. Hall W and Irvine V. Journal of Advanced Nursing. 65.1 pp 175-183 (January 2009).
Journal of Advanced Nursing is read by experienced nurses, midwives, health visitors and advanced nursing students in over 80 countries. It informs, educates, explores, debates and challenges the foundations of nursing health care knowledge and practice worldwide. Edited by Professor Alison Tierney, it is published 24 times a year by Blackwell Publishing Ltd, part of the international Blackwell Publishing group. journalofadvancednursing
About Wiley-Blackwell: Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley's Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit blackwellpublishing/ or interscience.wiley/.
Source: Annette Whibley
Wiley-Blackwell
Professor Wendy Hall from the University of British Columbia and Assistant Professor Valerie Irvine from the University of Victoria, Canada, studied online communication threads between a group of 40 women, who had all given birth in the same year and joined a local forum based in a moderate-sized Canadian city.
They concluded that these forums could provide a viable alternative to face-to-face groups, especially in rural communities where travel and professional support are limited.
As a result of the study, the researchers are encouraging healthcare professionals to help mothers with young children to set up, or access, similar community-based networks as they believe they offer more tailored support than existing corporate web-based forums with unlimited international access.
But they have warned that there is a danger that women-only forums can marginalise fathers and that if fathers are not actively involved in discussions about childcare this could pose particular problems for working mothers.
"The 12 women who initially set up the forum met while they were attending parent education classes" explains Professor Hall. "They invited a community health nurse to monitor their communications and correct any information that was wrong."
New members were then invited by word of mouth.
The 40 women who took part in the study gave the researchers permission to monitor their archived posts, which covered a one-year period. They were highly educated, with an average age of 36. The group included pregnant women as well as the mothers of babies up to 11 months of age. Eight out of ten were married and 88 per cent had above average incomes. Sixty-one per cent were employed outside the home, nine per cent worked at home for pay and 14 per cent were on maternity leave.
The researchers found that the women used the online support group to:
Develop community connections in the small geographical area that the membership covered. It was used to share information about accessing community programmes and classes, suggest and share the names of service providers, organise dates for events, sell or trade children's items, share videos and plan get-togethers.
Request and provide emotional support. The women shared their stories, experiences and feelings, expressed sympathy, thanked others for their help and talked about their beliefs and expectations. For example they discussed practical issues, like breastfeeding, finding child care, teething and healthcare experiences, and emotional issues, like how they felt about going back to work.
Share information that they had gleaned from websites, reading or care providers, and learn. For example, they talked about the best ways to get their babies to sleep, useful websites and books they had discovered or advice they had been given by their healthcare provider on issues such as milk allergies. They also helped other members whose computer skills were less developed.
Normalise the experiences they were having with their babies and as mothers. The women found it helpful to discuss problems and compare notes about problems as it made them realise that other mothers had similar issues. They also talked about how they had solved problems, the advice they had received and how their experiences would change as their children developed.
The authors have pointed out that the experiences of mothers on a tightly-knit geographical forum could be more similar than women on a website that draws membership from diverse communities across the world.
"The mothers who became part of this online community obviously drew great benefits from the advice, support and friendship they received from other local women" says Professor Hall.
"However some of the women did report that their partners were commenting on how much time they spent on the computer and they acknowledged that social activities were organised that excluded fathers.
"There were some indications that our study group felt that parenting was primarily their responsibility and that fathers didn't need to be included in the discussions. Supporting mothers is very important but it is also vital that fathers are not sidelined in a way that discourages them from being active parents."
The authors conclude that local online support groups can play an important role in helping to support women in what can be an isolating experience, by bringing them together with other mothers with similar expectations, beliefs and knowledge.
"This self-sufficient grass-roots group required limited monitoring by the community health nurse and this format could offer an alternative to face-to-face support groups" says Professor Hall. "Nurses and other healthcare providers could also help women to identify online local or regional resources.
"The forum we studied clearly shows that the opportunity to share experiences with like-minded, local women can stop pregnant women and mothers from feeling isolated and worrying about giving birth and parenting."
Notes:
E-communication among mothers of infants and toddlers in a community-based cohort: a content analysis. Hall W and Irvine V. Journal of Advanced Nursing. 65.1 pp 175-183 (January 2009).
Journal of Advanced Nursing is read by experienced nurses, midwives, health visitors and advanced nursing students in over 80 countries. It informs, educates, explores, debates and challenges the foundations of nursing health care knowledge and practice worldwide. Edited by Professor Alison Tierney, it is published 24 times a year by Blackwell Publishing Ltd, part of the international Blackwell Publishing group. journalofadvancednursing
About Wiley-Blackwell: Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley's Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit blackwellpublishing/ or interscience.wiley/.
Source: Annette Whibley
Wiley-Blackwell
вторник, 17 января 2012 г.
Michigan Senate Approves Bills That Would Require Girls To Receive HPV Vaccine Before Entering Sixth Grade
The Michigan Senate on Wednesday voted 36-1 to approve two bills (SB 1416, SB 1417) that would require girls in the state entering the sixth grade in the 2007-2008 school year and beyond to have received Merck's human papillomavirus vaccine Gardasil, the AP/Detroit Free Press reports (AP/Detroit Free Press, 9/20). FDA in July approved Gardasil for sale and marketing to girls and women ages nine to 26. According to Merck, the vaccine -- which is given in three injections over six months and costs $360 -- in clinical trials has been shown to be 100% effective in preventing HPV infection with strains 16 and 18, which together cause about 70% of cervical cancer cases, in women who do not already have the virus, and about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases. Gardasil also protects against vaginal and vulvar cancers, two other gynecological cancers that are linked to HPV, according to a study presented in June at a meeting of the American Society of Clinical Oncology in Atlanta. CDC's Advisory Committee on Immunization Practices in July recommend that all girls ages 11 and 12 receive the vaccine and that Gardasil be covered by the Vaccines for Children Program, which provides no-cost immunizations to children covered by Medicaid, Alaska-Native and American Indian children, and some uninsured and underinsured children. Health insurers Aetna, Cigna and WellPoint have said they will offer coverage for Gardasil.
Bill Details, Debate
The Michigan bills allow exceptions for the vaccination requirement for girls whose parents have medical, religious or philosophical issues with having their daughters receive Gardasil. State Sen. Beverly Hammerstrom (R) said that more than 75% of girls who would need to receive the vaccine would be covered by private health insurance or government programs and that the state would have to allocate funding to cover Gardasil through the Michigan Department of Community Health (Kaiser Daily Women's Health Policy Report, 9/14). According to Hammerstron, most employer health plans in the state will cover the vaccine, and girls who are uninsured could be eligible for coverage through the federal Vaccines for Children program. The state Legislature will be in recess until after the November election, so it is not certain when the state Assembly will consider the two bills, the AP/Free Press reports (AP/Detroit Free Press, 9/20).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . ??? 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
View drug information on Gardasil.
вторник, 10 января 2012 г.
Low-Income, Minority Women in Florida Increasingly Avoiding Mammograms Because of Cost
New studies have found that thousands of Florida women, particularly low-income blacks and Hispanics without health insurance, are not receiving mammograms because they cannot afford to pay for screenings, the... South Florida Sun-Sentinel reports. According to the Sun-Sentinel, "[h]igh out-of-pocket medical costs, low Medicaid reimbursements, long wait times at radiology centers and a shortage of doctors conducting the exams" are making the annual breast exams "off limits" to women in Florida who do not have traditional health insurance. In Florida, 21.2% of non elderly residents are uninsured, compared with 17.5% nationwide, according to the Kaiser Family Foundation's statehealthfacts. A series of studies conducted by a committee of health experts for the state Legislature found that 2,500 of the 13,000 Florida women who are diagnosed with breast cancer annually will die from the disease. The studies found that women had to wait an average of 28 days or longer to get tested in 17 of 121 centers that perform breast exams in Broward, Palm Beach and Miami-Dade counties. At 67 cancer-testing sites Orlando, Fla., 40% of women had to wait about a month or more to be screened, the study found. Breast cancer awareness groups, such as the Susan G. Komen Foundation, say long waiting periods are one of main reasons why women avoid testing. To address the issue, several Republican state lawmakers have proposed bills that would limit lawsuit judgments against radiologists by placing a $150,000 cap per claimant on noneconomic damages for negligence in mammogram screening or $300,000 for all claimants. One bill (SB 2470), sponsored by state Sen. Evelyn Lynn (R), also would "toughen the burden of proof in medical liability lawsuits involving breast cancer," the Sun-Sentinel reports. However, attorneys and other lawmakers say that increasing Medicaid reimbursements for screenings will do more to encourage breast cancer screening. Currently, 21% of radiology centers in Florida do not accept Medicaid, and only 4% of women who are Medicaid beneficiaries receive mammograms, according to committee member Betsey Herd (Hollis, South Florida Sun-Sentinel, 3/15).
"Reprinted with permission from kaisernetwork kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork 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.
вторник, 3 января 2012 г.
Stem Cells Found In Amniotic Fluid Appear To Offer Research Benefits, Study Says
Stem cells derived from human amniotic fluid appear to offer many of the benefits of embryonic stem cells -- including the ability to grow into brain, muscle, bone and other tissues -- according to a study published in the Jan. 7 online edition on the journal Nature Biotechnology, the Washington Post reports. For the study, researchers from the Institute for Regenerative Medicine at Wake Forest University and Children's Hospital Boston found that amniotic cells in the laboratory can grow into all of the major types of cells, dividing at the rate of once every 36 hours. Researchers coaxed amniotic fluid stem cells to develop into brain cells and injected them into the skulls of mice with diseased brains. The stem cells replaced the diseased areas and appeared to create new connections with surrounding healthy neurons, the researchers reported. Researchers also coaxed amniotic fluid stem cells to become bone cells and implanted them in a mouse. The study found the stem cells calcified and turned into dense, healthy bone. The researchers also coaxed amniotic fluid stem cells to develop into muscle, fat, blood vessel and liver cells. Stem cells extracted from amniotic fluid can be isolated starting at 10 weeks' gestation from fluid taken during tests performed to identify birth defects, according to the study. The stem cells, even after more than two years in the laboratory, did not show signs of aging or of having the potential to grow into tumors, the study found. Amniotic stem cells can be frozen for later use, the Post reports.
Reaction
According to the Post, amniotic fluid stem cells are "adding credence to an emerging consensus among experts that the popular distinction" between human embryonic stem cells and adult stem cells is "artificial" and that there is a "continuum of stem cell types" (Weiss, Washington Post, 1/8). Amniotic fluid stem cells are a "different kind of stem cell" that is "not as early as a human embryonic stem cell, and it's not as late as the adult stem cells," Anthony Atala, senior author of the study and director of the Institute for Regenerative Medicine at Wake Forest, said, adding, "So far, we've been successful with every cell type we've attempted to produce from these stem cells" (Kaplan, Los Angeles Times, 1/8). Atala said that if 100,000 women donated their amniotic stem cells to a cell bank, it would provide enough cells for "99% of the U.S. population with a perfect match for genetic transplantation" (Weise, USA Today, 1/8). He added that the stem cells can be found not only in amniotic fluid but also in the placenta, which is discarded after birth (Washington Post, 1/8). Richard Doerflinger, deputy director of the U.S. Conference of Catholic Bishops Secretariat for Pro-Life Activities, said that the study "is one in a line of studies showing very versatile stem cells can be obtained from a number of different products after live birth -- amniotic membrane, amniotic fluid, cord blood, placenta, even umbilical cord tissue," adding, "There is no reason why the amniotic fluid couldn't be obtained, raising no moral problem whatever" (Hall, San Francisco Chronicle, 11/8). Atala said it is unclear how many different cell types can be produced from amniotic stem cells, and researchers said that it will be several years before preliminary tests can be performed on patients, the AP/Houston Chronicle reports (Elias, AP/Houston Chronicle, 1/7). "[Amniotic fluid stem cells] can clearly generate a broad range of important cell types, but they may not do as many tricks as embryonic stem cells," Robert Lanza, head of scientific development for Advanced Cell Technology, said (Los Angeles Times, 1/8).
The study 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.
Подписаться на:
Комментарии (Atom)