Saturday, November 18, 2006

Comment Moderation

I've temporarily turned on comment moderation, because I'm spending too much time deleting spam comments. Now I'll be spending too much time approving and rejecting comments. Let's just see how it goes, okay?

Repeating from the About Me, My Blog post, The Comments Policy:
Comments are expected to be civil. They are also expect not to be spam. If you post a glowing comment about how awesome my blog is, but link to your internet drug site or other venture, it will be deleted. All comments are subject to deletion at my discretion. I don't delete them just because I personally find the argument offensive, but may for any other reason.

People, please don't leave me comments for your website selling vicodin. I'm so over it.

In The News

I apologize for the long post and link dump; just trying to catch up with what has happened while I've been away and clear out the feed aggregator.

FDA to allow silicone breast implants:
NYTimes - FDA will allow breast implants made of silicone
FDA - FDA approves silicone gel-filled breast implants after in-depth evaluation: Agency requiring 10 years of patient follow-up

More FDA: FDA Expands Use of Herceptin for Early Stage Breast Cancer After Primary Therapy

Washington Post: Bush choice for family planning post criticized
"The Bush administration has appointed a new chief of family-planning programs at the Department of Health and Human Services who worked at a Christian pregnancy-counseling organization that regards the distribution of contraceptives as 'demeaning to women.' Eric Keroack, medical director for A Woman's Concern, a nonprofit group based in Dorchester, Mass., will become deputy assistant secretary for population affairs in the next two weeks, department spokeswoman Christina Pearson said yesterday."

Kaiser Network piece
RHReality Check
A profile of Keroack from Talk2Action.
Keroack is part of the Medical Council for Leslee Unruh's Abstinence Clearinghouse, "which is comprised of health professionals around the world who believe in abstinence until marriage and do not counsel, prescribe, or distribute condoms or contraceptives to youth."

Keroack quote: "Abstinence education is the first mechanism that has actually made a positive impact on the devastation caused by the errant sexual education programs of the 1970s and 1980s," said Dr. Eric Keroack, an obstetrician-gynecologist from Boston. "Why would we stop it?" - 12/11/04 Washington Times

Keroack did an (unpublished) study to see if showing women ultrasounds could reduce their incidence of choosing abortion.
"Keroack, who says that he performed 30 to 35 abortions himself during his medical residency at Tufts University and early days as an OB-GYN, is up-front about his study’s chief flaw—it couldn’t follow the 35 percent of clients who didn’t respond. One Washington, D.C.–area ultrasonographer, speaking on the condition of anonymity, said he doubted that 63 percent of women would choose life after seeing the sonogram. He agreed that sonograms persuade women to remain pregnant but estimated that figure was between 20 to 33 percent. Nevertheless, even those figures represent a major step for the pro-life cause."

Keroack also tries to make the argument that sex with more than 1 partner will prevent women from bonding with their husbands - "People who have misused their sexual faculty and become bonded to multiple persons will diminish the power of oxytocin to maintain a permanent bond with an individual." Keep in mind that none of his "studies" have been subjected to the traditional peer review process.

Meanwhile, the GAO reports that abstinence only programs have not been appropriately reviewed for scientific accuracy.
GAO - Abstinence Education: Efforts to Assess the Accuracy and Effectiveness of Federally Funded Programs, GAO-07-87

House Approves Gynecologic Cancers Prevention Bill that "would authorize $16.5 million over two years to create prevention education materials for gynecologic cancers." The bill [HR 1245] will now be considered by the Senate.

Only "40% of U.S. Women Ages 18 to 75 Know About HPV" according to a National Cancer Institute survey, and less than half of those who have heard of HPV know about its connection to cervical cancer.

Our Bodies, Our Blog: Red meat and breast cancer?

Kaiser Network: Gynecologists Inform Fewer Than Half of Women With Uterine Fibroid Tumors of Alternatives to Hysterectomy, Survey Says

Planned Parenthood has a podcast on the recent Supreme Court abortion hearings. Well-Timed Period has a detailed response to the hearings.

Woman kicked off plane for breastfeeding. Oh, hell no. It was a Delta flight, operated by Freedom Airlines (a Delta Connection provider). Register your complaints to Delta using the link here (generic email form), or contact corporate headquarters for Delta:
Delta Air Lines, Inc.
P.O. Box 20706
Atlanta, Georgia 30320-6001

Medgadget: Researchers look for breast cancer vaccine.

Big Thanks to the Librarians

Following the AMIA conference in DC, we went on a whirlwind tour of area libraries, where we were provided with tours, lunches, information, and time by many a medical librarian. Thanks to everyone at the following for hosting us, and especially to those of you who so graciously took time out of your busy days to share your brainpower with us:

University of Maryland at Baltimore, Health Sciences and Human Services Library
Johns Hopkins, Welch Medical Library
Howard University,Louis Stokes Health Sciences Library
National Library of Medicine
National Institutes of Health, NIH Library

When I get a chance, I'll update with links to some of the interesting things these folks have been doing, and the resources they've created for their populations that will be useful in my own work.

Free Health Services from Planned Parenthood of Middle and East TN

Planned Parenthood of Middle and East Tennessee is offering free health services during the month of December. See the schedule below.

From an email:
Subject: Does Free Sound Good to You?
Health Week

The Spirit of giving has arrived in Tennessee!

It’s that time of year for good friends, good cheer, and great gifts; but nothing is worth more than your good health - Planned Parenthood of Middle and East Tennessee understands that.

This year, during the month of December, PPMET is helping give you the gift of good health by offering FREE reproductive health screenings and services!

Yes, you read it correctly: FREE! So, no more pondering, putting off or procrastinating! NOW is the time to come to Planned Parenthood. Knowledge is power, but free power is even better!

The schedule of FREE services at our clinic at 412 Dr. D.B. Todd, Jr. Blvd. (near Charlotte Ave and 18th) is as follows:

  • Friday, December 1st, 9:00 am – 2:00 pm
    Free & Confidential HIV Tests

    In commemoration of World AIDS Day, PPMET will be providing free HIV tests.
    Remember, there is no cure for HIV/AIDS, so know yourself and know your partner.
    Educate yourself, your family and friends about HIV prevention and stay safe!

  • Saturday, December 2nd, 9:00 am – 3:30 pm
    Free Cervical Cancer Screening (Pap Smear)

    Cervical cancer is common among women and is one of the easiest cancers to find and treat - in its earliest stages. A yearly Pap smear is your key to early detection!

  • Wednesday, December 6th, 9:00 am – 3:00 pm
    Free Emergency Contraception!

    Accidents happen - condoms break, you have sex without planning to....whatever the reason - EC is your friend in a crisis - that's why it's called Emergency Contraception! It's the most effective way to potentially prevent pregnancy after unprotected sex - and on Dec. 6th - it's FREE!

    Call 615.321.7216 to make your appointment or walk-in!
  • If you have the resources and would like to throw some financial support PPMET's way to help support this kind of free community service, click the "Donate Online" button in the lower left of this page. To specify a PPMET clinic instead of the whole organization, choose the "Local" button on the donation page.

    Alone Time

    In regards to spending the past 7 days surrounded by (very smart) people at least 12 hours per day, it seems appropriate to revisit "Caring For Your Introvert."

    Sunday, November 12, 2006

    Off Topic: The AMIA Report

    From the AMIA conference, in the liveblogging style, but really posted after the fact. I'll add links to resources and people later.

    Note: It has been an extraordinarily busy week. Updates, more details on the sessions, and links to resources will come later.

    -Panel Session: Emergency Response Information Technology.
    -State of the Association Meeting, with box lunch.
    -Presentation Sessions: Optimizing the Clinical Experience; Evaluating the Use of Clinical Systems

    -Would anybody think it was exceptionally weird if I took my pear to the bathroom to wash it?
    -Semi-Plenary Session: James J Morgan, MD of Partners HealthCare, "Framework for a High Performance Health System for the United States." We need changes to daily workflow, culture, and organization in order to improve healthcare. More later - there's a line for computers (but it's a T1 line...).
    -Panel Session: Biosurveillance Systems and Situational Awareness in Public Health: How Far Should We Go to Protect the Public from Bioterrorism?"
    -Lunch in Chinatown at Tony Cheng's. I'm really good with chopsticks and noodles.
    -Afternoon - Smithsonian, Museum of Natural History.
    -Evening - Quesadillas and beer special in the hotel bar.

    -Breakfast at the hotel. Was wrong when I said "never again" - no time to go somewhere else. I accidentally ate apspartame. Cue stomach cramps, headache, and general out of it feeling.
    -Another 3.5 hour tutorial, this time early in the morning. "Design and Conduct of Evaluation Studies in Biomedical Informatics," Charles Friedman of the National Heart, Lung and Blood Institute and Jeremy Wyatt of the University of Dundee. Again, very practical and useful. Good discussion and group work. Things to consider in study type and design.
    -Lunch: Polo India Club. Indian buffet. Yum.
    -Plenary Session: Robert Brook of RAND. Both inspiring and terrifying. Some notes from his talk, on improving healthcare:
  • Need e-prescribing systems that detect prescription drug underuse and informs providers
  • Pay providers for transparency rather than performance. Blacklist those who provide misleading data
  • Hospital CEOs should be able to press a button to let them know how many people he hospital killed in the previous 24 hours
  • Make sure patients get the procedures they need, and don't get the procedures they don't need
  • Make real-time quality data available to patients for informed decision-making
  • Incentivize patients to use safer hospitals
    Incentivize hospitals to use electronic medical record systems that provide real-time quality data
  • On coronary angiograms in New York State, re-read elsewhere: 48% exhibited at least one technical inadequacy; only 1/3 of those who got coronary artery bypass for left main disease actually had the disease; 1/3 of those with the disease were not diagnosed; 1/3 read correctly.
  • Using ~500 measures of quality at ~12 sites in the U.S., 50% of things patients needed when they went to the doctor actually happened. About 30% in geriatric patients.
  • This was a great session, and a challenge to everyone to agitate for better measures of and available information on healthcare provider and institution quality.
    -Dinner: Sandwiches at Cosi. Martinis and shrimp cocktail at Annie's with a former colleague who is now at NCBI. It turns out that he can get his hands on the content when JMLA issues are being uploaded to PubMed Central - now I know who to harrass about it. :)

    -Walked from the Hilton Washington to see: Washington Monument, Lincoln Memorial, Reflection Pool, WWII Memorial, White House, Vietnam Memorial. Nice to be there on Veterans' Day. Saw the outside of a World Health Organization building, National Academy of Sciences, Institute of Medicine, and Dept of State. White House is underwhelming.
    -Lunch at the hotel. Tuna salad sandwich, side salad and drink for 3 cost $40. Never again.

    -Tutorial: "The eXtensible Markup Language (XML)", Gretchen Purcell of Vanderbilt. 3.5 hours. Very practical and useful. I think I can do this now.
    -Dinner: Anna Maria's. Italian. Good. I think I ate a bit of a shimp tail.

    -Flew Delta from Nashville to Cincinnati. We were supposed to stay on the same plane, but had to switch at Cinci. The gates are not labelled well.
    -Got to the hotel. Sharing a room with two colleagues. Room has two tiny beds. Called for roll-away; checked at desk 1/2 hour later when it hadn't arrived. DC fire code doesn't allow 3 beds in a room. Hotel is sold out. I'm sleeping on the floor.

    Friday, November 10, 2006

    Light Posting for Next Week

    I'll be at a conference. It's the American Medical Informatics Association conference, which basically translates to "computer geeks in medicine," so I imagine there will be computers available. Unfortunately, the Not Inexpensive Hotel doesn't offer free wireless. They do offer a "modem" in the rooms. Hoo! A modem! Happy 1994!

    Anyway, posts may be few and far between.

    Thursday, November 09, 2006

    I Need to be Dipped in Bleach Now...

    ...just from seeing this video of a "Purity Ball." Now, it's not as though I think kids should be going out and having a ton of sex (although they will), especially if you're not going to teach them about preventing pregnancy or disease. The seeming focus just on girls seems questionable. Making your little girl think that her body is not hers, but rather a "gift" to be passed from father to husband is icky and demeaning. There is something really disturbing about sitting around a cheap hotel conference room while your daddy talks about your vagina.

    (found via Feministing)

    Wednesday, November 08, 2006

    Gonzales v Planned Parenthood Argument Transcript Available

    Here's the transcript [PDF] for Gonzales v Planned Parenthood [05-1382].

    Arguments Up From Gonzales v Carhart

    The transcript of oral arguments from Gonzales v Carhart [05-380] on "partial birth abortion" argued today are now available [PDF].


    Post-Election Roundup

    Tuesday, November 07, 2006

    I &hearts Election Day

    It's election day
    It's election day
    It's raining outside
    But you have to vote to today
    Oh, why did he have to run

    Go Vote.

    Technorati Tags: ; ;

    Sunday, November 05, 2006

    Pregnant Women Support Act

    In a previous post, I mentioned that I would provide some summary information on the Pregnant Women Support Act. I finally had time to wade through the bill (HR6145), so here are some details.

    The findings (essentially the case for why the legislation is needed) are as follows:
    1) There are 1.29 million abortions annually in America.
    2) 48% of all pregnancies in America are unintended. Excluding miscarriages, 54% of unintended pregnancies end in abortion.
    3) 57% of women who have abortions have incomes below 200% of the poverty level.
    4) "Cannot afford a baby" is the second most frequently cited reason women choose to have an abortion; 73% of women having abortions cited this reason as a contributing factor.
    5) This Act is an initiative to gather more complete information about abortion, to reduce the abortion rate by helping women carry their pregnancies to term and bear healthy children, and by affirming the right of women to be fully informed about their options when they seek an abortion.
    6) The initative will work to support women facing unplanned pregnancies, new parents and their children by providing comprehensive measures for health care needs, supportive services and helpful prenatal and postnatal services.

    Unfortunately, the statistics presented above do not appear to be cited in any way in the document. They do seem to correspond approximately with data I found on the Guttmacher Institute website; the most recent data from the CDC is from 2002. However, the data seems to be questionable, as a Health United States report gives two figures for 2002: 854K from the CDC, and 1.29 million from the Guttmacher Institute, with the difference reportedly being that Alaska, California, and New Hampshire did nto report this data to the CDC for 2002.

    Moving on, with some notable highlights...
  • "The Secretary shall enter into an agreement with the Institute of Medicine to study the reasons why women choose to have an abortion. The Secretary shall ensure that a report from the Institute describing the findings of the study is submitted to the Congress not later than January 10, 2010."
    I'm looking forward to seeing this, although it seems like it might have been more efficient to conduct a study on why women have abortions prior to introducing legislation purporting to reduce them.
  • "IN GENERAL.—Health facilities that perform abortions in or affecting interstate commerce shall obtain informed consent from the pregnant woman seeking to have the abortion. Informed consent shall exist only after a woman has voluntarily completed or opted not to complete pre-abortion counseling sessions."
    Informed consent is good, and one hopes it's already in place everywhere.
  • "Counseling sessions under subsection (a) shall include the following information: (1) The probable gestational age and characteristics of the unborn child at the time the abortion will be performed. (2) How the abortion procedure is performed. (3) Possible short-term and long-term risks and complications of the procedure to be performed. (4) Options or alternatives to abortion, including, but not limited to, adoption, and the resources available in the community to assist women choosing these options. (5) The availability of post-procedure medical services to address the risks and complications of the procedure."
    Not sure what is meant by "characteristics." Otherwise, everythiing else seems like standard practice. Civil remedies will be available where informed consent was not obtained.
  • There are several provisions in Title IV of the bill that prohibit insurers from imposing preexisting condition exclusions on pregnancy or denying coverage on the basis of pregnancy, requires insurers to notify women about adding their newborn to their coverage, etc.
  • "The Secretary may make grants for the purchase of ultrasound equipment. Such ultrasound equipment shall be used by the recipients of such grants to provide, under the direction and supervision of a licensed medical physician, ultrasound examinations to pregnant women consenting to such services."
    Grantees are required to be eligible for Public Health Service Act funds, offer women the option of viewing the ultrasound images, and inform women that they have the right to know the general anatomical and physiological characteristics and approximate age of the fetus. I suspect this is a way to increase funding to "crisis pregnancy centers," where the ultrasound is not really being used for medical purposes, but as a tool to steer women into making a specific choice, not necessarily their own choice.
  • Provides services to patients receiving Down Syndrome or other prenatal diagnosis - women should receive "scientific, and nondirective counseling" about the conditions and accuracy of tests. The purpose of this section is described as increaseing patient referrals to support services for women who have received a positive diagnosis, ensure that patients receive accurate information, and approve data availability. They would establish a phone hotline and website for patients, national and local peer-support programs, a national registry of families willing to adopt newborns with this type of condition, and establishment of a clearinghouse of information on thse conditions, and education programs for healthcare providers.
    Education is good. Scientifically accurate information is good. Undue pressure to put up children for adoption is not good. Be careful there, fellows. (I just read "The Girls Who Went Away" - review coming soon)
  • States may obtain funding for a separate program for domsetic violence, dating violence, sexual assault, and stalking screening and treatments for pregnant women and new mothers. This would include training health professionals to identify and respond to patients experiencing abuse, and ensuring that services are provided in a "linguistically and culturally relevant manner." $4,000,000 would be authorized for appropriation for each of the fiscal years 2007-2011.
  • States could receive grants "to increase public awareness of resources available to pregnant women who intent to carry their pregnancy to term and to new parents." This would cover identification of resources, advertising campaigns, establishment of a hotline to direct people to support services, adoption centers, and organizations that provide support to new parents.
  • Grants (not to exceed $25K) to public higher education institutions (read: state colleges and universities) to assist pregnant students who intend to carry their pregnancies to term through on-campus facilities. There is also mention of grants for child care for parenting students, although the details are not entirely clear.
  • Grants to states for early childhood education programs (including Head Start) to work with pregnant/parenting teens to complete high school and prepare for further education.
  • Title XI provides for grants to homes for pregnant and parenting women. The group homes must provide upon request adoption counseling and counseling on parenting skills.
  • Would expand adoption credit to $15K from $10K, with increases for inflation
  • Authorizes appropriations to WIC of $5,388,000,000 for FY 2007, $15,000,000 of which would go for breastfeeding peer counselors, $14 million for "infrastructure" and $30 million for management information systems.
  • I'd like to see those last two spelled out a little better.
  • Grants can be made to local health departments to provide eligible mothers with free home visits by registered nurses. "Eligible" means the infant is 12 months old or less, the woman was <20yo at time of birth, and the infant is the first child of the mother.

    I'm on board with all of the post-birth assistance, referral to community services, consent, education, and promotion of breastfeeding. I do think this bill does some very worthwhile things, and at least partially addresses the old argument that if you want to reduce abortions, you have to make it easier for women to have children and support them after birth. On the other hand, the folks involved with this bill have proposed it as a means to reduce abortion, and I don't see a single thing in it about comprehensive sex education (big surprise) or contraceptives. There is nothing in here that addresses preventing pregnancy in the first place. Also, I think it's good if more women are referred to appropriate community agencies, but outside of the public health and Head Start things, I don't see an increase in funding for existing providers. If they suddenly become swamped with women, will they be able to afford it, and will women receive good service? I also see that universities and schools have the option to apply for grants to help their childbearing students complete school, but I wonder how many of these institutions will have the time and resources to put such grant applications together and follow up with good programming. There is nothing automatic here, but hopefully some of the schools will apply. With regards to high school students, the language states that the money is for early childhood education programs, but is not clear on whether high schools can directly receive these funds. I also don't see much that truly makes it easier for women to afford to have a baby, because there isn't a lot of substantial funding increase for prenatal care, the actual birth, or all the expenses that come with children (especially after the first year covered by the home visits, which are education rather than medical in any care). The WIC increase is not an increase in the amount of money women can get to actually feed their children. Finally, this legislation could be read as an attempt to push women into carrying a pregnancy to term (even when there is a serious genetic defect - the language beyond Down Syndrome is very vague) and giving up the child for adoption, while it does not in any way address the psychological consequences or provide post-surrender counseling for these women. It will be interesting to see how this plays out. Talk to Action also has interesting commentary on this.

    Technorati Tags:
    MeSH Tags: Legislation; Pregnancy; Social Work
  • Supreme Court Abortion Case: Gonzales v Planned Parenthood

    The Supreme Court is scheduled to hear arguments on Wednesday in the case of Gonzales v Planned Parenthood, regarding the question of "Whether, notwithstanding Congress's determination that a health exception was unnecessary to preserve the health of the mother, the Partial-Birth Abortion Ban Act of 2003 is invalid because it lacks a health exception or is otherwise unconstitutional on its face." It is related to another case, Gonzalez v Carhart.

    I'll update with a link to the arguments when available.
    New York Times: The Roberts Court Takes on Abortion
    Planned Parenthood: U.S. Supreme Court to Review Gonzales v Planned Parenthood
    Center for Reproductive Rights
    Commentary from The Well-Timed Period

    Technorati Tags: ; ; ; ;
    MeSH Tags: Abortion, Induced/legislation and jurisprudence; Jurisprudence [for articles 1974-2002]; Supreme Court Decisions [for articles 2003-present]; "partial birth abortion" [keyword search - this is not medical terminology]

    I just noticed that the NLM folks are indexing some "partial birth abortion" articles with the term "Infanticide," although it generally falls under "Abortion, Induced." Is this appropriate indexing, or a political bias? Discuss.

    Note to the Foot Flushers

    This NYTimes articles, Germs Never Sleep, makes a very good point in this piece on the measures people take to avoid germs:

    "But some of the resulting behavior makes no sense, Mr. Sleeper said. The company’s studies have found bathroom users covering their fingers in toilet paper before flushing and using more tissue to open stall doors, even though there is almost no health reason to do so, because their next stop is the sink to wash their hands with soap and water."

    Resource: The CDC's Handwashing Guidelines, just in time for flu season. When's the last time you washed your hands for a full 20 seconds, as the guidelines recommend?

    Technorati Tags: ;
    MeSH Tags: Antisepsis; Fomites; Handwashing

    Saturday, November 04, 2006

    Off Topic: Animal Cams

    The National Zoo has multiple cameras that you let you view many of the animals from your computer. See the complete list and select the exhibit you'd like to watch; so far, I've been watching pandas and cheetahs and giraffes, oh my! The resolution can be kind of poor, but I happened to catch them feeding a tiger cub. Very cool.

    On a related note, check out this recording of a Florida panther from All Things Considered.

    Technorati Tags: ; ;
    MeSH Tags: Animals, Zoo

    About Me, My Blog

    Since David full on outed me (although you could have put it together, and I do have a picture up), the time has come for an About the Author post.

    About Me:
    I'm a medical librarian. I have a graduate degree in library and information science (MLIS) from the University of Pittsburgh, where I focused on medical librarianship. I currently work in a prominent academic medical center library, where I was promoted from the paraprofessional ranks and am now a Library Fellow (I worked there while obtaining my degree). I serve as Editorial Assistant for the Journal of the Medical Library Association and handle clinical questions for medical center. I have also worked with our digital library, budget, weeding, our management contract of another medical library, proposal-writing, reference and circulation, web updates, staff training, job candidate screening and interviews, and other projects.

    Previously, I worked as Program Assistant and then Communications Coordinator for a non-profit organization focused on promoting renewable energy and energy efficiency. We also worked on mitigating the health effects of dirty power sources. I handled technical problems, website management, database management (10K+ records in a Filemaker Pro database I periodically customized), distribution of emails, faxes, and press releases to donors, members, and activists, politicians, and news outlets, and served as co-editor of the quarterly newsletter. On occassion, I did public outreach at events. See how that ties in to librarianship?

    Prior to my graduation from Oberlin College (where I was a geology major), I worked as a Student Assistant and then Student Manager of the Oberlin College Science Library. I received a Metcalf Award for outstanding library service. As a result, I have a lifetime membership to the Friends of the Oberlin College Library. Also while at Oberlin, I took an EXCO course entitled, "Menstrual Health and Politics."

    Why Women's Health?:
    I like technology, and wanted to play around with blogging. I had (and still have) an interest in women's health, and at the time was taking a course [#326] in Vanderbilt's graduate nursing program on women's health issues. (As a project for this course, two colleagues and I created an online tutorial for nursing students on how to search popular databases for women's health literature.) I knew I needed a focus, and focusing on a health topic is a good continuing education exercise for me. I think a lot of women are underinformed about their bodies, their health, and the policies affecting their health choices, and I hope to use this blog to provide a source of information about those topics.

    The Comments Policy:
    Comments are expected to be civil. They are also expect not to be spam. If you post a glowing comment about how awesome my blog is, but link to your internet drug site or other venture, it will be deleted. All comments are subject to deletion at my discretion. I don't delete them just because I personally find the argument offensive, but may for any other reason.

    Can I Send You My Film, Book, or Other Material to Review?
    Please do, but send me an email first so I can give you my address. The item should be women's health, general health, healthcare policy, or otherwise related to the content of this blog. I will not guarantee that the review will be positive, or even posted, and all reviews will mention that the item was provided for review (as opposed to found to be of interest by me independently).

    Can I Link to You?:
    Yes. Without reservation. I think attempts to prevent links or deep-linking are intellectually dishonest and a hindrance to the benefits of online media.

    What's With the Ads?:
    Librarianship doesn't pay a lot. The ads pay even less. I do block some advertisers if I have a personal issue with their content or the product or persons they represent. Thus far, I have blocked ads for an infant formula maker, censorware (website blocking technology), a diet pill site, and a conservative book club. I do not vouch for the usefulness or even accuracy of the material presented behind the ad links.

    A Final Note:
    The opinions expressed here do not represent those of my employer. This blog is my work, independent of my actual paying job, and it is my responsibility alone.

    Technorati Tags: ; ; ; ;
    MeSH Tags: Librarians; Libraries, Medical

    New Studies, Health News, and Your Government in Action

    FDA offers buying, storage, and preparation tips for reducing your risk of foodborne illness from fresh produce

    Danish study finds HPV test better that Pap for women >40yo. The study is: Kjaer S, Hogdall E, Frederiksen K, Munk C, van den Brule A, Svare E, Meijer C, Lorincz A, Iftner T. The absolute risk of cervical abnormalities in high-risk human papillomavirus positive, cytologically normal women over a 10-year period. Cancer Res. 2006 Nov 1;66(21):10630-6. [Abstract]
    This prospective cohort study was conducted in ~10,000 Danish women who were available for both initial examination and follow-up examination via Pap test and cervical swab for HPV detection. The women were divided into two groups, the younger group (n=7,219) and the older group (n=2,200). Denmark has a personal identification system and pathology data bank that allowed the researchers to track cervical cytology in the study population. From the authors:
    "Results from this prospective cohort study with a long-term follow-up of women from the general population through the routine screening system showed that among women 40 to 50 years old, who were cytologically negative with a concurrent positive HPV DNA test (high-risk types), nearly 25% developed cytologic abnormalities (atypia) within 5 years, and after 10 years, more than 35% had had an abnormal Pap test. These risk estimates were higher than those observed among women with both negative cytology and negative HPV DNA test (high-risk types), which were as low as 4% and 10% after 5 and 10 years, respectively. Also among younger HPV-positive women (22-32 years old at enrollment), we found a high absolute risk of subsequent cervical abnormalities (atypia), 18% after 5 years and 24% after 10 years, and a low risk among HPV-negative women, 5% after 5 years."

    Feministing has a summary of the latest government vs sex education brouhaha.

    The Kaiser Network's Women's Health Policy Daily Update brings us this info:
  • CDC To Add HPV Vaccine Gardasil to Subsidized Immunization Program for Children - this means the vaccine should be available at "no-cost immunizations to children ages nine to 18 covered by Medicaid, Alaska Native and American Indian children, and some uninsured and underinsured children."
  • Kansas AG Kline Receives Late-Term Abortion Records
  • Millions of Women Worldwide Have Unsafe Abortions, Lack Access to Family Planning, Lancet Series Says
  • Endometriosis Diagnosis, Treatment Increasing for Young Women
  • Federal Guidelines Expand Scope of Abstinence Education Funds To Include People up to Age 29 - "According to Wade Horn, HHS assistant secretary for children and families, the revised guidelines for 2007 are aimed at people ages 19 to 29 because recent data show that more unmarried women in that age group are having children." The program in question requires that contraception not be discussed, and the teaching that sex within marriage is the expected behavior. Is it really the best idea public health-wise to try to keep 20-somethings (i.e., adults) ignorant about contraception and infection-prevention? Is a 29-year-old woman having a child outside of marriage really among the important things we're facing as a nation? Does it really promote the general welfare? Or is it just about the [perceived] ickiness of adult women having sex and sexual freedom, and making their own life-choices?

    Our government wants to make it more difficult for the U.S.-born children (i.e., citizens) of immigrants to get healthcare, by requiring further proof of citizenship before receiving Medicaid. Critics think the parents may be reluctant to jump through the hoops for fear of deportation. This seems like the time to introduce my device for remembering which is Medicaid and Medicare: "We aid the poor, but we care for the elderly."

    Technorati Tags: ; ; ; ; ; ; ; ; ;
    MeSH Tags: Abortion, Induced/legislation and jurisprudence; Endometriosis; Food Poisoning; Medicaid; Papillomavirus, Human; Sex Education; Sexual Abstinence; Uterine Cervical Neoplasms; Vaginal Smears
  • Friday, November 03, 2006

    Are you in DC?

    I'll be in DC from Nov 10-17 for the AMIA conference, and will be making stops at the medical libraries of Johns Hopkins, University of Maryland @ Baltimore, and Howard University, as well as the National Library of Medicine. If you're at the conference or in the area, and are a librarian, health or librarianship blogger, or women's health advocate who would like to get together, send me an email.

    [Note to stalkers or other weirdos: The husband will be holding down the fort at home, accompanied by the 4-member army of attack kitties.]

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    MeSH Tags: Librarians; Libraries, Medical

    Shameless Medical Librarian Promotion

    The director at my workplace* is the Editor-in-Chief of the Journal of the Medical Library Association, and I am the Editorial Assistant (3 other librarians serve as co-editors). We have added a new case study feature to the journal, which highlights example real-life questions medical librarians address in support of clinical care and outlines the strategies for doing so. Happily, we have also set up a blog for posting additional material related to the case, and for further discussion of the question at hand.

    This issue's case question is: What is the evidence basis for the use of intravenous colistin for multi-drug resistant Acinetobacter infections in the adult, non-neutropenic, critical care population?

    JMLA is an open access journal, so the case is freely available for anyone to read. For the non-librarians, check it out if you want a peek behind the medlib curtain. The blog and column are curated by clinical librarian extraordinaire Rebecca Jerome, MLIS, MPH, who has kindly mentored me in searching and filtering the medical literature.

    *This is a good time to remind you that this blog is in no way related to or sanctioned by my workplace. The opinions expressed here do not necessarily represent those of my employer. Pay no attention to the library behind the curtain.

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    MeSH Tags: Acinetobacter; Acinetobacter Infections; Colistin; Evidence-Based Medicine; Librarians; Libraries, Medical

    Wednesday, November 01, 2006

    Men With Cramps Part III

    Okay, remember how we talked about how the MacInnes & Porritt site was either a joke or woefully inept/misleading/suspicious and the later Men With Cramps videos that proved it was a joke of some sort? Some folks thought it was pretty funny. I was interested to see where it would go - maybe it was a promo for some kind of web series or performer that would turn out to be entertaining. Nope. It's reportedly just a viral marketing campaign for a boring heat patch product, for women with cramps. Yawn.

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    MeSH Tags: Dysmenorrhea; Marketing

    The Great American Condom Campaign

    The Great American Condom Campaign seeks to facilitate "newer, bolder, and more direct methods of condom distribution, education about condoms, and dialogues around condoms." Individuals and organizations can sign up to be a "Safe Site" condom distributer to give people easy access to condoms at the time of need, in their neighborhoods, when stores are closed, etc. - whenever obtaining contraception might be difficult - "SafeSites is a new method of condom distribution relying on peer-to-peer networking technology and direct social-access points." The organization also intends to produce a dcoumentary. From the website:

    "The goal is a feature length film documentary that will explore the social, political, demographic, logistical, and stigma-related issues regarding the distribution of condoms in the United States. The question affords an opportunity to consider America’s sexual behaviors, attitudes, perceptions, politics, and stigmas from an entirely new perspective that puts the condom at the center of attention and its distribution the thematic thread that connects the very complex issue of American sexuality juxtaposed against very real public health threats related to sexual infections.

    The Great American Condom Campaign (GACC) will acquire 5,000,000 condoms (the amount that fills a standard shipping container) and, simply, try distributing them all. The documentary will illuminate the deep-seeded stigmas associated with condoms by capturing the everyday interactions, societal constructs, and dialogue of Americans about condoms, while also turning towards the messaging sources of the anti-condom stigma."

    (found via the Reproductive Rights Blog)

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    MeSH Tags: Condoms; Contraception