понедельник, 30 апреля 2012 г.

Washington Times Opinion Piece Discusses Emergency Contraception

At the same time as health experts and advocates marked the annual Back Up Your Birth Control Campaign Day of Action on Wednesday - dedicated to increasing awareness about emergency contraception - some also are calling for a greater focus on pregnancy prevention methods other than EC, Washington Times columnist and reporter Cheryl Wetzstein writes. In an article in the March issue of Perspectives on Sexual and Reproductive Health, EC expert James Trussell and two colleagues acknowledged that research shows that EC has not reduced pregnancy or abortion rates and wrote, "A constructive response to this disappointment [about EC] requires that we identify new directions and approaches."

The Times reports that when EC first became available in the U.S. about 10 years ago, some health experts had high hopes for the contraceptive's potential to reduce unintended pregnancies, about half of which end in abortion.

Samantha Levine, spokesperson for the National Institute for Reproductive Health, said that women might not have accurate information about the availably of EC. "Some women still don't know that it's available behind the counter at your pharmacy, for women 17 and older," Levine said, adding, "The thing that's important about emergency contraception is that it's there as a backup method."

Trussell and colleagues suggested that easier access to long term methods such as the levonorgestrel intrauterine system Mirena or the implantable method Implanon could reduce unintended pregnancy. Simple changes in practice such as allowing women to obtain intrauterine devices when they request them, rather than wait for during a subsequent visit to a health care provider, could increase use.

The researchers also called for exploration into situations in which women are at risk for unintended pregnancies. They noted that postpartum women typically do not resume birth control for six weeks, even though some studies suggest they might be able to use contraceptives sooner. Studies also should examine how often obese women experience "pill failure," Trussell and his colleagues said (Wetzstein, Washington Times, 3/25).


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


© 2010 The Advisory Board Company. All rights reserved.









View drug information on Mirena.

понедельник, 23 апреля 2012 г.

Concern Over Strong Media Influence On Women's Body Image

As France's parliament considers a landmark bill that would outlaw media images glamorizing the extremely thin, psychology researchers are reporting some of the most definitive findings yet on how these images affect women.



In the May issue of Psychological Bulletin, University of Wisconsin-Madison postdoctoral researcher Shelly Grabe and psychology professor Janet Hyde describe a sweeping analysis of 77 previous studies involving more than 15,000 subjects. In it, they found that exposure to media depicting ultra-thin actresses and models significantly increased women's concerns about their bodies, including how dissatisfied they felt and their likelihood of engaging in unhealthy eating behaviors, such as excessive dieting.



Although on one level the results seem obvious, Grabe believes many people still resist the idea that a societal influence, like the media, can have a real impact on how women view themselves. When individual experiments have found this relationship in the past, she explains, critics have often dismissed them for focusing on groups of particularly body-conscious women, such as college students, or exposing test subjects to unusually racy photos.



Grabe and Hyde, in contrast, analyzed data from every well-designed study on the topic they could find, thus avoiding much of this criticism.



"We've demonstrated that it doesn't matter what the exposure is, whether it's general TV watching in the evening, or magazines, or ads showing on a computer," says Grabe. "If the image is appearance-focused and sends a clear message about a woman's body as an object, then it's going to affect women."



The effect also appears to be growing. The researchers' analysis reveals that, on average, studies conducted in the 2000s show a larger influence of the media on women's body image than do those from the 1990s, says Grabe.



"This suggests that despite all our efforts to teach women and girls to be savvy about the media and have healthy body practices, the media's effect on how much they internalize the thin ideal is getting stronger," she says.



The results are troubling because recent research has established body dissatisfaction as a major risk factor for low self-esteem, depression, obesity, and eating disorders, such as bulimia. At the same time, women's displeasure with their bodies has become so common that it's now considered normal, says Grabe. She hopes that wider recognition of the media's role will encourage people to see the issue as a societal one, rather than as a problem of individual women as it's viewed now.



"I think we need to consider how we're using media images as a culture to share the values we think are important, and the effect that has on our well-being, " she says.
















The approach Grabe and Hyde took in their study, called meta-analysis, offers a way to quantitatively examine an entire body of research at once. In their case, this meant 77 carefully selected studies of the effects of appearance-focused media images on women's body dissatisfaction, investment in their looks, adoption of the thin ideal, and eating behaviors and beliefs. The analysis also included controlled, experimental studies, in which these effects were tested directly, and investigations that correlated body concerns with women's self-reported consumption of media.



In simple terms, the meta-analysis placed test subjects from every study into two groups: those who were exposed to media images portraying women's bodies and the thin ideal, and those who weren't. It then asked whether differences existed between the two and the magnitude of the differences.



In the end, the researchers did find a significant difference, with women who were exposed to media reporting less satisfaction with their bodies. Notably, this difference was also seen across all four measures of body image concerns.



So, what's the answer? The French government may try to control the media, but don't women also need to learn to be a little less concerned with their looks"



Grabe replies that the issue lies not with our attraction to images of beauty or with women's desire to emulate them, but with what we've come to define as beautiful: bodies that are unnaturally and unhealthily thin.



"I want to stress that it's totally normal for women to want to be attractive," says Grabe. "But what's happening in our society is that many women are striving toward something that's not very realistic or obtainable, and that leads to a lot of health consequences."







The study's other author is L. Monique Ward of University of Michigan. The work was funded by a grant from the National Institutes of Health to Grabe.



Source: Shelly Grabe


University of Wisconsin-Madison

понедельник, 16 апреля 2012 г.

When Pregnancies Fail Early: Privacy And Efficiency More Important Than Being In A Hospital

Women who undergo surgery due to an early pregnancy failure usually are treated in an operating room, often under general anesthesia, but a new study raises questions about whether women prefer that approach.



Early pregnancy failure - or EPF - occurs in 14 to 19 percent of recognized pregnancies. Cases treated with surgery typically haven't been performed in an office-based setting, even while many other procedures have moved from the OR to the office. Now, a study from the University of Michigan Health System suggests that many women would choose the option of having the procedure done in the relative privacy of an office, without general anesthesia.



"We found that managing an early pregnancy failure in the office is an acceptable option for many women," says Vanessa K. Dalton, M.D., MPH, lead author of the study, which appeared recently in the journal Obstetrics & Gynecology. "This is a real shift in the way we can approach the care of women with EPF. Many other procedures have moved from the operating room into an ambulatory setting, but for the most part, the management of EPF has not.



"This is a difficult experience for women, and we want to make sure that we are offering them the type of care that works best for them and which they prefer," Dalton says.



Studies indicate that sharp curettage (scraping) and general anesthesia are still common when performing this procedure in the operating room - despite evidence associating them with higher complication rates than suction removal without general anesthesia, says Dalton, assistant professor of obstetrics and gynecology at the U-M Medical School.



The study also found:



* Costs were more than twice as much in the operating room compared to the office procedures, and the procedure was 80 percent longer. Physician reimbursement did not differ between the two groups.



* While the study did not demonstrate that office-based procedures are safer than traditional operating room management, the authors said they are concerned about the four-fold increase in bleeding-related complications in the operating room group in this study. The most likely explanation for this finding was that all but one of the operating room procedures were done under general anesthesia, which may contribute to increased blood loss.



* Patients opting to have the office procedure reported expecting higher levels of pain than those going to the operating room, and as anticipated, they reported higher pain scores.



* There were no major complications in either group. Further, no office procedure was moved to the operating room or converted to general anesthesia for patient discomfort.



Those enrolled in the study were women 18 and older who came to the U-M Department of Obstetrics and Gynecology for surgical management of a first-trimester early pregnancy. In all, 165 women enrolled in the study, including 115 in the office group and 50 who chose the operating room.
















Participants completed a self-administered questionnaire at the time of enrollment. Immediately before discharge, they completed a second questionnaire addressing pain, bleeding and satisfaction with care.


The findings "dispute the notion that current practices are based on patient preferences," Dalton says. "Overall, our institution's experience has been that about half of women choose to have their procedures completed in the office. In the study group, only 25 percent of study participants reported that being asleep for the procedure was highly important. Instead, many participants opted for an office procedure that better meets other needs such as privacy and efficiency.



"It is important that we pay attention to their wishes and offer the services that best meet their needs," she says.







Senior author on the paper was Dan Lebovic, M.D., assistant professor in the Department of Obstetrics and Gynecology and co-director of the Endometriosis Center. Other U-M authors were Lisa Harris, M.D., assistant professor in the Department of Obstetrics and Gynecology; and Ken Guire, M.S., statistician with the Department of Biostatistics at the U-M School of Public Health. Laura Castleman, M.D., MPH, medical director of Ipas, an organization that works globally to increase women's ability to exercise their sexual and reproductive rights; and Carol S. Weisman, Ph.D., of the Division of Health Services Research at the Penn State College of Medicine, also were authors.



Dalton was supported by the National Institutes of Health-sponsored Building Interdisciplinary Research Careers in Women's Health (BIRCWH) program. Harris and Castleman receive funding from Ipas, a manufacturer of a manual vacuum aspirator. Both have received honoraria from Ipas for unrelated work in the past three years.



Citation: Obstetrics & Gynecology, July 2006, Volume 108, Issue 1.



Contact: Katie Gazella

University of Michigan Health System

понедельник, 9 апреля 2012 г.

MIDIRS Calls For Urgent Action In Raising Funds For Safer Motherhood In Ethiopia

With only 8 weeks to go until the start of the SafeHands for Mothers' Pilgrims Walk for Life, MIDIRS has issued a further plea to health care professionals worldwide to lend their support to the fund-raising campaign, which aims to raise ??350,000 in support of reducing maternal morbidity in Ethiopia.


Andy Fisher, MIDIRS Business Manager, who is lending his own support by participating in the 130 kilometre pilgrimage, said 'As today is International Day of the Midwife, it seemed wholly appropriate to revisit the purpose of the Walk for Life fund-raising campaign and to remind people that up to 600,000 women each year continue to die from pregnancy related causes in under-developed countries '.


'If the Millennium Development Goal of reducing the maternal mortality ratio by 75% by 2015 is to be met, then there is still a huge amount of work to be done. We are hoping that health care professionals worldwide will rise to the occasion by giving their wholehearted support to the SafeHands mission'.


Nancy Durrell McKenna, Founder Director of SafeHands for Mothers and the driving force behind the 'Walk for Life' pilgrimage added 'This pilgrimage will be a physical endurance for all and yet our exertion will pale in significance to the daily hardships endured by those women for whom life is one of daily physical endurance.'


The walk, which starts on Sunday 14th June 2009 and covers up to 130 kilometres of the famous El Camino de Santiago or Way of St James ancient pilgrim's route to Santiago de Compostela in northern Spain, has attracted widespread international interest.


Six Western Australian health care professionals have pledged their support by joining the walk, five of whom are indigenous Aboriginal women who wish to show their support by walking for the indigenous women of Ethiopia. In addition, two teams of Extremist Runners plan to cover the whole route in one day (equivalent to 2.5 marathons) on the 19th June 2009, in acknowledgment of Father's Day on Sunday 21st June 2009.


Journalist Caroline Phillips will also be covering the walk for the Daily Mail newspaper.


Those who wish to share their support can do so by visiting www.justgiving/SafeHands_trek


Reference


(1) World Health Organization (2000). Maternal mortality in 2000: estimates developed by WHO, UNICEF and UNFPA. Geneva: WHO


Those who wish to share their support can do so by visiting justgiving/SafeHands_trek


Notes


1. MIDIRS (midirs) is a Bristol based not-for-profit organisation offering a complete information service to all health professionals, non-statutory agencies or anyone involved in the care of women and their babies during and after pregnancy. Its organisational mission is 'to be the leading international information resource relating to childbirth and infancy, disseminating this information as widely as possible to assist in the improvement of maternity care'.


2. SafeHands for Mothers' (safehands) vision is to contribute to a reduction in maternal mortality and morbidity from pregnancy-related causes and to protect and promote health of the newborn in developing countries. Its aim is to achieve this through the production of high quality films and visual materials to support government and non governmental training and advocacy programmes. Portable, robust solar powered DVD players enable SafeHands to take training where it is most needed - the remote and isolated areas.


Every year between 500,000 and 600,000 women die from pregnancy-related causes; 99% of these deaths occur in developing countries.


SafeHands calls for a renewed effort to combat the unnecessarily high number of women who die during pregnancy and childbirth. A woman living in sub-Saharan Africa has a 1 in 16 chance of dying during pregnancy and childbirth (ref 1). An international goal has been set to achieve a 75% reduction by 2015.


3. 'El Camino de Santiago' or The Way of St. James or St. James' Way, is the pilgrimage to the Cathedral of Santiago de Compostela in Galicia in North Western Spain, where tradition has it that the remains of the apostle, Saint James, are buried. The Way of St James has existed for over a thousand years. It was one of the most important Christian pilgrimages during medieval times, and is still undertaken by modern day pilgrims.


Source
MIDIRS

понедельник, 2 апреля 2012 г.

Endometriosis Pain Strikes a Nerve, FSU Study

Women with endometriosis often have several types of chronic pain conditions because their abnormal growths develop a
nerve supply that communicates with the brain, new research suggests.


Florida State University Professor of Neuroscience Karen Berkley was the lead researcher in a study that shows that
endometrial cysts become supplied by sympathetic and sensory nerves that could contribute to both the different types of pain
associated with endometriosis and the body's ability to maintain the disease. The new nerves likely sprout from those that
supply the blood vessels that grow along with and nourish the cysts, Berkley said.


Berkley, Andrea Rapkin of the University of California at Los Angeles and Raymond Papka of Northeastern Ohio Universities
College of Medicine drew the conclusion after research on human tissue replicated results Berkley and her colleagues found
last year on rats with surgically induced endometriosis. Their findings will be published in the June 10 issue of the journal
Science.


"It's been a mystery - clinically - why there is such a co-occurrence between endometriosis and other painful conditions we
wouldn't think would be related: irritable bowel syndrome, interstitial cystitis and even migraines," Berkley said. "It may
happen in part because this new nerve supply comes into the central nervous system and interacts with information coming from
other organs, such as the colon and bladder, that the brain may interpret as pain."


The types of nerves that develop in the cysts, the agents that activate them, the sites in the central nervous system where
the nerves deliver information and how the information is modulated by estrogen all influence how the disease will manifest
itself, the researchers suggest.


The variability of the nerve supply of the cysts in different individuals may help explain why symptoms and severity of pain
vary so greatly in women who have endometriosis, a disease that may affect up to 50 percent of women in their reproductive
years, according to Berkley.


Endometriosis is thought to occur when cells from the lining of the uterus escape into the pelvic cavity during menstruation
and attach themselves to the outside of the uterus, ovaries or other organs in the abdomen. The cells can develop into
growths or cysts that impact fertility and may cause severe menstrual cramps and other pelvic pains.


Berkley said she and her colleagues hope their findings may lead to new treatments for endometriosis. Currently the disease
is treated with hormone therapy or surgery.


Florida State University

114 Westcott Bldg.

Tallahassee, FL 32306-1430

United States

fsu.edu/~unicomm