Wednesday, January 31, 2007

Profession Promotion

33 Reasons Librarians are Still Extremely Important
(and the writer doesn't even get into the fact-checking, analysis, and competitive intelligence roles many librarians now fill - I think we could get this up to at least 50 reasons without breaking a sweat)

Related: Inept and Satisfied, Redux (although, wow, could we use a less charged word than "inept?")

Anorexia Promotion on YouTube

You may already be aware that there are "Pro-Ana" and "Pro-Mia" websites on the internet that promote anorexia, bulimia, and associated behaviors. Internet service providers frequently shut down the pro-eating disorder websites, which often provide tips on how to effectively starve oneself. Many pro-ana sites listed on other webpages had been closed when I followed the links. One site I found offered unhealthy "tips" such as "You can train yourself to forget hunger by gently punching your stomach every time you get hungry because you'll hurt too bad to eat" and "Don't swallow - chew and spit." Another site offered the motto, "What nourishes me destroys me."

Now, pro-ana videos are popping up on YouTube. I'd prefer not to link to these videos, but a few that I have viewed feature montages of startling thin women (sometimes models) with pronounced ribs, pelvic, and collar bones. Some of the images could easily be inserted into a set of photos on Holocaust victims, given the obvious starvation. One video is described as a "Supportive message to Pro Ana Nation," while another boasts that it is a "very beautiful pro ana presentation." YouTube does not block these videos, but they are often flagged as inappropriate. Once you agree to view flagged content once, there is no additional reminder when viewing new videos (at least if you're signed into your account). YouTube reviews the flagged videos to make a determination about whether the video/user can stay. YouTube's community guidelines state that users should not "post videos showing dangerous or illegal acts, like animal abuse or bomb making." Would videos encouraging anorexia (which is certainly dangerous, and arguably a form of self-abuse of the human animal) fall under this guideline? I have an email in to the site to find out what their specific take on these videos is, and how they respond to this type of video once flagged.

I'm not convinced these sites should be censored, but eating disorders are serious business. See links below for resources.

Relevant Links:
  • 'Pro-Ana' Web Sites Glorify Eating Disorders - ABC News
  • Warning over pro-anorexia sites - BBC News
  • Weborexics: The Ethical Issues Surrounding Pro-Ana Websites - ACM Portal
  • How macabre world of the web offers fresh insight on anorexics - Guardian Unlimited
  • Eating disorders FAQ - National Mental Health Information Center
  • Eating Disorders - KidsHealth
  • Kids and Eating Disorders - KidsHealth
  • National Eating Disorders Association
  • Anorexia Nervosa - womenshealth.gov
  • Anorexia Nervosa - MayoClinic.com

    (hat tip to Kevin, MD)
  • Tuesday, January 30, 2007

    Book Review: The Girls Who Went Away

    Fessler A. The girls who went away: the hidden history of women who surrendered children for adoption in the decades before Roe v. Wade. New York, NY: The Penguin Press, 2006.

    I picked up this book at my local library, intending to review it for this blog, and have thus far read it twice. It is truly one of the most moving texts I've ever read. The author, Ann Fessler, has collected oral histories from numerous American women who were coerced into surrendering their babies for adoption in a pre-Roe era. Their tales are chilling and emotional, providing a clear depiction of the shame they endured and the aftermath of being forced to give up their babies.

    In the chapter, Breaking the Silence, Fessler provides the background material to the women's stories. Between 1945 and 1973 (the passage of Roe), sexual activity was fairly common among young men and women, but useful education about sex and pregnancy was scarce, as was access to contraceptives. As a result of the social climate of the time, many young girls were coerced or forced by parents to enter maternity homes and eventually surrender their babies for adoption. It is estimated that between those years, 1.5 million babies were relinquished for nonfamily adoptions.

    As the women's stories unfold throughout the text, it becomes clear that the events that took place resulted primarily from the attitudes of schools (most of which immediately expelled pregnant girls), parents (who wanted a way to hide the daughter's "shameful" condition from their own peer group), and social workers (who used coercive methods to secure babies for adoption), rather than choices about the pregnancy made by the girls themselves. The girls themselves interviewed by Fessler often had no voice in their own futures, and no social or familiar support for their impending motherhood. Even when the girls had supportive partners and plans for success, the parents sometimes intervened to sequester the girls at homes against their will. In many cases, the girls were given no information about their rights, and were essentially financially blackmailed into giving away their children. What was done to them was seen as proper punishment for their shameful act of getting caught having sex. The stories directly contradict the myth of the selfish pregnant teenager who surrenders a baby for convenience in order to provide her baby with a better life and a more deserving family. The girls (now women) frequently experienced the relinquishment as a traumatic experience that profoundly shaped the next decades of their lives, explaining that they were never just a "birth mother" or baby incubator, but real mothers whose children were ripped away against their will.

    The stories of coercion, shame, lack of education, lack of choice, isolation, loneliness, fear, and long-term effects are truly astounding. Each chapter and woman in Girls deserves its own consideration and review, and the heartbreaking stories cannot be properly encapsulated by this post. I encourage you to read it, and to consider how present-day policies and practices are not simply hypothetical greater good creators, but have real-life effects on real women.

  • The Girls Who Went Away website
  • Amazon
  • Review from blogger Pseudo-Adrienne
  • Discussion of the book on NPR's Fresh Air
  • NYTimes review
  • Commentary from Planned Parenthood
  • Find it in a library near you - enter your location for a list of libraries nearby with this item (it may automatically open with Nashville as the location, just reset to your location)
  • Response Regarding New Hope Maternity Home Records

    I contacted the Utah Department of Human Services to request information on the New Hope Maternity Home. According to the Department's frequently asked questions, regarding how to find out if complaints have been filed against a service provider, "After making initial contact with a program and questioning the staff or clients, feel free to contact the licensor of the program you are considering. The licensor can give you results of the latest licensing visit, the current license status and basic information on substantiated complaints in the program file."

    I sent a message to the appropriate licensor, and Licensor for New Hope, Kent Callister, responded thusly: "The New Hope Maternity Home's probationary residential support license expires January 31, 2007. The program does not plan to continue to operate. For additional information you can request a GRAMA."

    So, despite what the DHS website says, I'd have to file a request for access to the records through the Utah Attorney General office in order to actually find out about complaints. I haven't decided whether I can do this yet, as there may be fees associated with the request. I'll keep you posted.

    Update: In response to a follow-up email, Mr. Callister says that he has not received any complaints against the program.

    Previous Posts:
    Pregnant Teens Escape, So Does "Maternity Home" Website
    "Pregnant Girls Gone Wild?"

    Truly Sickening

    WARNING: Nauseatingly offensive content below.

    This morning, via Feministing, I read this story of an Australian physician jailed for raping his wife. Snippets from the story:
    "An Adelaide doctor who repeatedly raped his wife while she was unconscious on sleeping pills has been jailed for 10 years. The pathologist, who can't be named, stored photographs of his crimes on his computer, the South Australian District Court was told. Some photographs were of him using foreign objects during anal and vaginal rapes, the court heard.
    She testified she often woke up with bruises, which her husband blamed on "thrashing around" in her sleep. The woman said that in late 2003, she noticed her husband had left the computer on, with the monitor switched off. She turned the monitor on, and called police after finding a photograph of her asleep.
    "
    What's nearly as sickening as this story? The comments from Digg users (also found via Feministing). Normally I wouldn't want to publicize the words of these idiots (which is why I'm not linking to the offenders). However, I think it's worthwhile as an example of how not everything is fine and dandy in many people's perceptions of what is rape and a woman's rights. A few selections:

  • "Well I hope he at least force fed her dinner first."
  • "This guy is a douche for doing what he did, but she's an idiot for choosing to marry a douche." - - Nice blame-the-victim rhetoric there, jerk.
  • "PICS!! .. or it didn't happen."
  • "I need to ask, how was he doing the insertions? My wife is on sleeping pills and wish to do the same. Don't worry I'll post pics."
  • "Uhh, until she saw the pictures she wasn't humiliated.." - in response to another commenter who said that the wife had been humiliated by her husband's actions
  • "What an idiot... I would have definetly used my penis to rape her @ss and vagina."
  • "how can it be rape if they were married?"
  • "Keep in mind that he's a doctor; assuming they don't have a prenup, she could get a massive settlement in a divorce, in addition to sending the guy to jail. If she wanted to ruin his life, this is an ideal way to do it."
  • "I feel sorry for the guy. Clearly he made a bad decision in marrying her if she was too prudish to even discuss alternative sex, and he felt he had no other option but to do things while she slept to entertain himself."
  • "F**k that b***h, she probably wasn't putting out. I'd like to smell the corks of those bottles..."
  • "looks like i am not the only one that thinks "NO" means "ROOFIE""
  • "Looks like she didnt put out so he took drastic measures."
  • "They are married.. He owns her.. It could never be rape because he is entitled to anything he wants."
  • "Raped by your husband? Oh come on, this woman jus wanted half of the husband assets."
  • "How the hell can you rape your wife? I hate to be chauvinistic, but I thought when you get married, the womans vagina is pretty much the husbands plaything. I mean, he doesn't own the woman nor does he own her, but I just don't see how you can rape your wife."

    A little reminder: rape is any non-consensual sex. If someone is asleep, they cannot consent.
  • Monday, January 29, 2007

    Grants Available for Evidence-Based Midwifery

    The American College of Nurse-Midwives Foundation has issued a request for proposals for its 2007 Hazel Corbin/Childbirth Connection Grant for Evidence-Based Midwifery. The application deadline is April 6, 2007 for grants not to exceed $6,000. According to the announcement:

    "The purpose of the Grant is to further understanding of the safety and/or effectiveness of midwifery practices for mothers and newborns.

    Applicants may meet the objective of this Grant through many different types of projects. Potential projects that meet these objectives include, but are not limited to, work toward:
    -identifying research priorities for building the evidence base for midwifery care
    -preparing or updating a systematic review about effects of a midwifery practice
    -developing and offering a systematic review training course to midwifery researchers
    -carrying out a pilot study that is expected to yield data to support application for a major research grant to evaluate effects of a midwifery practice
    -carrying out a descriptive study to assess the degree to which care provided by midwives is consistent with the best available research
    -promoting among midwives care that is consistent with the best available research
    developing and making accessible resources to help midwifery clients make decisions that are informed by the best available research."

    An online form is available for applications; please see the complete announcement for eligibility guidelines and other details.

    Pregnant Teens Escape, So Does "Maternity Home" Website

    Remember the 3 girls who escaped from the Utah maternity home? They're still missing. The website for the home has also disappeared. Google cache still has it, but it's not in the Wayback Machine. Also, it's just the front page that's gone - you can move from the cached page into the back pages of the website (About, Services, Slideshow, Contact), which are still online. Maybe the home just didn't want the attention (although presumably you could still find their address through some state records). Why does this increase my suspicion that something funny was going on there? Maybe that's not fair, but the whole thing is just odd.

    Update: According to a piece in the Salt Lake Tribune, the couple who run New Hope may be closing up shop. Despite stating that "We've had a lot of parents call us and thank us for giving their girls back the way they used to be. We haven't had one negative experience with a girl," Spencer Moody says that "After this, we've decided it's the end of it." Perhaps that explains the missing homepage?

    Another 1/23/07 news story (found via Musings of the Lame) includes this odd tidbit: "The 16-year-old's mother, Gina Castro of Chicago, is frantic for news of her daughter. 'I'm not getting any information at all from anybody, I'm scared to death for her life. My daughter's in more trouble now than she was before,' Castro said. She said that until Monday the police hadn't called her about the alleged assault. She now believes her daughter is in California but can't get any confirmation. American Fork Police Chief Lance Call said that they were talking to the families through Jana Moody, the caretaker of New Hope, who the girls allegedly bound and assaulted. Police had not talked to the families about their missing daughters."

    Did you read that carefully? The girls escaped on Tuesday, January 16. As of 1/22, the police had not talked to the girls' families, and were speaking to the families only through the woman the girls assaulted, the woman in charge of the home from which the girls fled. I'm very concerned about how this had been handled, and what is going to happen to these 3 girls. How is it that nobody in the media has been able to dig up past residents of the home for testimonials about their treatment there? Or at least has not reported on it?

    Sunday, January 28, 2007

    South Dakota to Bring Back Abortion Ban

    The Keloland news website is reporting that a bill banning abortion is expected to be introduced in the South Dakota legislature next week, following a voter defeat of the total abortion ban in November. The new bill is expected to inculde exceptions for rape, incest, and the woman's health, but is said to be still in final drafting stages.

    Technorati Tags: ;
    MeSH Tags: Abortion, Induced; Abortion, Legal; Reproductive Rights; South Dakota;

    Saturday, January 27, 2007

    Terminology Inequity

    In looking up the MeSH terms (the official medical terminology coming out of the National Library of Medicine) for the previous post, I made an interesting find. MeSH is set up as a hierarchy - big, broad term, then more specific term, then even more specific term, and so on. The broad concept of sex among humans is "Sexual Behavior." The more specific term, "Coitus," is defined as "the sexual union of a male and a female." There is no equivalent term provided for sex between men or sex between women. Under Sexual Behavior, you also find the term "Sexuality," defined as "The sexual functions, activities, attitudes, and orientations of an individual." Beneath that term, the even more specific terms are "Bisexuality," "Heterosexuality," and "Homosexuality." Still, shouldn't "Coitus" have an equivalent term (and resulting way of finding) for non-heterosexual sex?

    Lest you think "Coitus" is only reserved for some mechanical, heteroexual-specific technical discussion of sex, a search for the term returns results such as:
    -Promoting protection and pleasure: amplifying the effectiveness of barriers against sexually transmitted infections and pregnancy.
    -Sexual behaviour in context: a global perspective.
    -Environmental, social, and personal correlates of having ever had sexual intercourse among American Indian youths.
    -Substance use and sexual risk behavior among South African eighth grade students.
    -Now dear, I have a headache! Immediate improvement of cluster headaches after sexual activity.
    -The role of parent religiosity in teens' transitions to sex and contraception.


    I would expect that each of those topics would have its own gay/lesbian aspects. Why would they not all fall under "Sexual Behavior," or under "Heterosexuality" if all research subjects were heterosexual? Why was the term for the sexual union of a male and a female the appropriate one for these titles? I would prefer that more specific terms be added all around - in addition to the lack of a term for non-heterosexual sex, there is also no term for oral sex, anal sex (these two get picked up by "Sexual Behavior"), sex toys, or specific female-used contraceptives such as vaginal rings, vaginal sponges, cervical caps, or diaphragms (all fall under "Contraceptive Devices, Female"). The male and female condom do get their own entries, as does the IUD.

    It would help researchers interested in these specific ideas if appropriate terminology were available in the MeSH classification. One specific sex act gets a term - penetrative sex between a man and a woman - why not some of the other common acts human beings employ to express their sexuality? Presently, articles having to do with homosexual sex are lumped under different terms, such as Sexual Behavior or Sexuality or Homosexuality, with no clear notion for the searcher of which one to use consistently. Indexing is a big job, and I commend NLM for the job that they do of it. In fact, this previous post outlines some 2007 changes to MeSH that I applaud. I simply hope that the MeSH system will continue to evolve to be more inclusive and representative.

    Okay, that concludes my feminist medical librarian rant for the day. Now back to your regularly scheduled programming.

    Techorati Tags: ; ;
    MeSH Tags: see above; Abstracting and Indexing; Medical Subject Headings

    I Wonder What the Recruitment Material Said?

    This study appears in the January 2007 issue of the journal Archives of Gynecology and Obstetrics: "Flaturia: passage of flatus at coitus. Incidence and pathogenesis." In case you need help interpreting the title, that would be the passing of gas during sex. 9 women who normally had "fecal and flatus control" but who "leaked flatus only during coitus" were studied in comparison to 9 women who do not experience this problem, through studies of rectal and anal pressure "at rest and at on voluntary squeeze." The testing utilized a balloon probe with was inserted 6cm into the anal canal and withdrawn 1cm at a time, with pressure readings recorded. Electrodes, X-rays, and barium enemas were also used. The investigators found that pressure levels in the patients matched those of the healthy volunteers. The authors' conclusions? They're not sure what the exact mechanism is, but think the gas passing is related to penile thrusting and more relaxed rectums.

    This research really isn't that notable, but I wonder how they found and convinced women to participate in the study?

    Technorati Tags: ;
    MeSH Tags: Flatulence; Coitus

    Appalling Quote of the Day

    Regarding mandatory (with parent opt-out) HPV vaccination for Kansas girls, Dawn Richardson, from a nutty anti-vaccine group (in Texas), says, "What they are proposing is vaccinating a bunch of healthy girls that are responsible and that do come from good homes for the benefit of irresponsible people.”

    Nevermind that according to the CDC, "Approximately 20 million people are currently infected with HPV. At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percent of women will have acquired genital HPV infection. About 6.2 million Americans get a new genital HPV infection each year." I suppose 80% of women just come from bad homes and are irresponsible.

    Folks, remember not to let extreme bias that would endanger girls and women for the sake of appearing to be from "a good home" be the only source you go to for vaccination information. While it's true that long-term safety data is not yet available for this very new vaccine, you should be aware that many opponents of the vaccine are so because of reasons that have nothing to do with actual scientific data.

    Friday, January 26, 2007

    MedGadget on Women's Health Technology

    Medical technology blog medGadget reviews two women's health-related products today. The first, the Z-Tech breast scanning device, is still in testing but is intended to be "a painless, radiation-free, and less costly alternative to mammography for women at high risk for the disease." MIT Technology Review also has a piece on the device, which raises questions about whether it would lead to a high rate of false positives (finding a problem when it's not really there). medGadget previously covered these concerns in an April 2005 post.
    Note: the photo accompanying the medGadget post is not safe for work, unless you work in radiology.

    The second XX device is the FemSuite FemEye One, described as "the Cadillac of intravaginal scopes." The portion of this scope/videocamera device that is inserted in the vagina is apparently only 8mm wide, or about 1/3 of an inch. It's handheld, and portable, and costs about $300.

    Survey Finds Slight Decline in Mammogram Rates

    Today's issue of Morbidity & Mortality Weekly Report includes the piece, "Use of Mammograms Among Women Aged >40 Years --- United States, 2000--2005," which describes findings from the Behavioral Risk Factor Surveillance System (BRFSS) telephone survey indicating that the rate of getting mammograms reported by U.S. women has declined. Based on the surveys, the percentage of women age 40 or older reporting having had a mammogram in the past two years decreased from 76.4% in 2000 to 74.6% in 2005; the National Cancer Institute recommends that all women in this age group have a mammogram every 1-2 years. While this seems like a small percentage change, it was considered statistically significant. According to a Washington Post article on the findings, "The decline of less than 2 percentage points may seem small, but it could be terribly significant, Lichtenfeld [of the American Cancer Society] said. But if you consider that about 80 million U.S. women should be getting a mammogram every year, it means more than 1 million fewer women are getting the screening test, he said."

    The Healthy People 2010 (a set of national health objectives) recommendation of having 70% of these women reporting mammogram was still met, despite the decline. The MMWR piece describes several limitations of the study, such as small sample size, representing only certain states, lack of confirmation with medical records, and overestimation of breast cancer screening by including mammograms that were done for reasons other than routine screening.

    Resources:
  • Screening Mammograms: Questions and Answers - National Cancer Institute
  • Mammograms: Not Just Once, But For a Lifetime - National Cancer Institute
  • Mammograms (frequently asked questions) - National Women's Health Information Center
  • Mammograms - Food and Drug Administration
  • Frequently Asked Questions About Digital Mammography - Food and Drug Administration
  • Mammograms and Other Breast Imaging Procedures - American Cancer Society
  • Mammograms - Information from Medicare on mammogram coverage
  • Mammography: Search for a Qualified Facility - Food and Drug Administration
  • Thursday, January 25, 2007

    Pseudoscience and Public Policy

    RH Reality Check has a great post today, Top 10 Reasons Why You Should Be Terrified that Dr. Eric Keroack is in Charge of the U.S. Federal Family Planning Program. Among them - the doctor who did the oxytocin studies Keroack uses to support his claim that premarital/too much sex causes women not be able to bond properly with their husbands calls Keroack's interpretation of her work "pseudoscience."

    The RH Reality Check also includes Keroack's complete presentation on the oxytocin topic. I'm sorry, but that thing looks like spam I get in my email, and is not the quality of work I expect to see from a supposed professional who stands to be in charge of family planning for the whole nation. Of course Keroack's anti-contraception stance, work with "crisis pregnancy centers," and abstinence-only agenda are the major concerns, but c'mon - The Drudge Report looks more professional than this.

    Related:
  • Previous post - In The News - scroll down for a bit about Keroack.
  • HHS Nominee Has Prescribed Birth Control - mention's Keroack's work for a group that opposes contraception - Washington Post
  • Bush Choice for Family Planning Post Criticized - Washington Post
  • Who is Eric Keroack? - Planned Parenthood
  • Abortion foe to lead on family planning - Boston Globe
  • Family Planning Farce - NYTimes editorial

    Thanks to Tyler for the heads up on this piece.
  • Reports on FDA Consideration of Birth Control

    The Washington Post is reporting outcomes of the FDA's consideration of newer low-dose birth control pills, although the details are not yet up on the FDA website. According to the article, "Food and Drug Administration advisers refused this week to recommend a set standard on how often next-generation pills would have to fail for them to be denied federal approval...Instead, the panel of outside experts recommended the agency keep an open mind to approving less-effective pills that could offer other important benefits, such as reduced risk of blood clots and stroke."

    This FDA briefing document provides background information on the meeting and concerns about lower-dose oral contraceptives.

    Shameless Self Promotion

    I thought a blog post was warranted to commemorate my first time as first author on a publication. The Journal of the Medical Library Association has recently added a case study feature, which presents a clinical question posed to the librarian by physicians and walks the reader through the process of developing an answer. The cases take an instructional tone, with "you" throughout, rather than a drier academic tone, as they are intended to instruct and encourage other librarians in assisting clinicians with their questions. This issue's case, Utilizing case reports to build awareness of rare complications in critical care, is freely available online, and presents an investigation as to whether a patient with an ileostomy could have a C. difficile infection affecting the small intestine. My co-authors are another medical librarian and a trauma doctor, both of whom are outstanding at what they do. I want to specifically thank co-author Jerome for the amazing amount of work she contributed to the case.

    The case study feature is curated by fellow blogger BeckyJ, and has its own accompanying blog, JMLA Case Studies in Health Sciences Librarianship. Links to background reading and further discussion of the case will be added to the blog in the coming days.

    Citation: Walden RR, Jerome RN, Miller RS. Utilizing case reports to build awareness of rare complications in critical care. J Med Libr Assoc. 2007 Jan;95(1):3-8. [Full Text]

    Full disclosure: I also serve as Editorial Assistant for the JMLA, and as a contributing author to the Case Studies blog.

    Technorati Tags: ; ; ; ; ; ;
    MeSH Tags: Clostridium difficile; Clostridium Infections; Ileostomy

    Wednesday, January 24, 2007

    More Crazy Football Fans

    The Bears must have an appeal with which I am unfamiliar. Remember the woman who elected to be induced early so her husband could see the Bears/Saints game? Another woman is hoping to auction off ad space on her pregnant belly in order to see the Bears in the Super Bowl. Jennifer Gordon and her husband already have lodging and flights for the game, but no tickets. Says Jennifer, who will be 36 weeks pregnant at the time of the game, regarding the possibility of going into labor during the game, "Hopefully, it'd be an easy labor, because I'll be distracted watching the game."

    The ad on Craigslist - "Beautiful, stretch-mark free belly can display your advertising message to millions of fans throughout the world...Belly sample ad pictures available upon request."

    Jacksonville Women's Access to Emergency Contraception

    A study published in the journal Contraception reports findings when Jacksonville, FL pharmacies were contacted by women inquiring about emergency contraception availability. "Secret shoppers" contacted >100 pharmacies in Jacksonville, FL in person and via the phone. A list of all Jacksonville pharmacies was generated using the phone book and an online search, and pharmacies that were out of business or compounding-only were excluded.

    Four female OB/GYN residents served as secret shoppers and visited 54 of the pharmacies on various days and times at their convenience. Inquiries were made as to the availability of Plan B, and other options if it was not immediately available. The shoppers recorded their interactions and responses to their questions immediately upon leaving the pharmacies. Phone calls were also made to 131 pharmacies (48 of which were also visited in person). The researchers considered Plan B to be "available" if it could be provided that day or within 24 hours.

    Findings:
  • Of 54 visited pharmacies, Plan B was: available immediately at 21 (39%); available in <24 hours at 16 (29%); not available in <24 hours at 17 (31%).
  • Of 131 pharmacies successfully phoned, Plan B was: available immediately at 42 (32%); available in <24 hours at 33 (25%); not available in <24 hours at 58 (44%).
  • 48 pharmacies were both called and visited, and consistent responses were received from 34 (71%) of these. 29% of these pharmacies gave inconsistent responses, such as stating on the phone that Plan B was available, but stating in person that it was not.
  • 11 pharmacies suggested other stores more likely to carry Plan B. It is not clear whether pharmacy staff verified this prior to sending the "patient" away.
  • 9 chain pharmacies were represented in the sample. Target was the only chain pharmacy to have Plan B in stock in all (7) of its Jacksonville stores. KMart, Pavilion, and SavRite did not have Plan B in stock in any of their Jacksonville stores. CVS had Plan B in stock in only 2 of 20 stores. No chain pharmacy staff members reported company policy as the reason for not stocking the drug, and some did not know why it was not in stock.
  • "The reasons most commonly cited by pharmacists for not carrying Plan B were lack of demand and short expiration time. Three pharmacists cited personal beliefs as the reason for not carrying or dispensing Plan B. None of the pharmacists cited store policy as the reason for not carrying the medication."

    Citation: French AC, Kaunitz AM. Pharmacy access to emergency hormonal contraception in Jacksonville, FL: a secret shopper survey. Contraception. 2007 Feb;75(2):126-30. Abstract

    Technorati Tags: ; ; ;
    MeSH Tags: Contraception, Postcoital; Health Services Accessibility; Time Factors
  • FDA Releases Statement on Newer Birth Control Pills

    The Agency's release, in full:

    FOR IMMEDIATE RELEASE
    Statement
    January 23, 2007

    Media Inquiries:
    301-827-6242
    Consumer Inquiries:
    888-INFO-FDA

    FDA Statement on Effectiveness of Newer Birth Control Pills

    Recent wire service stories about today's meeting of the FDA Reproductive Health Drugs Advisory Committee have created misperceptions about the effectiveness of newer generation hormonal contraceptives.

    The stories inaccurately report that the products are significantly less effective at preventing pregnancy than those approved decades ago. In fact, the newer generation products are highly effective in preventing pregnancy.

    The stories also mistakenly state that FDA called the meeting to discuss the need for higher standards of efficacy for the newer products.

    In fact, as published in the Federal Register Notice announcing this meeting, the purpose of this two-day meeting is to discuss clinical trial designs that reflect the diversity of users of hormonal contraceptives, expectations for efficacy and safety, and user acceptability of the newer generation products, including cycle control.

    ####

    Monday, January 22, 2007

    Blogging for Choice

    I've tried to write this post for Blog for Choice Day on why I'm pro-choice multiple times, but I almost fail to see the utility when people exist who don't even support women in getting appropriate medical care during childbirth, largely because they'd prefer to make a political point. I could line up all the reasons I'm pro-choice in a lengthy essay, but it boils down to this -- I am pro-choice because I believe in women. I believe there are situations in a woman's life that I/the government cannot possibly manage for her, and I believe individual women are the ones responsible for making the best choices for themselves and their families. Not me, not a politician solely interested in rallying the faithful, not a pharmacist who refuses to fill a legal prescription, not an insurance plan that won't cover birth control, not a doctor pushing too many inductions and too many c-sections, not schools and parents who believe that ignorance=bliss and safety, not states who refuse to protect women from the tyranny of the majority, not the football game schedule, and not those who would refuse to present medically accurate information to women on a whole host of issues. Women. The individual woman in the individual situation. I trust her, and leave her to her choice.

    Blog for Choice Day - January 22, 2007

    Technorati Tags: ; ;
    MeSH Tags: Abortion, Induced; Reproductive Rights

    What Would You Have Them Do?

    Sometimes, when people complain about something, you have to stop and ask, "Well, what is the alternative?" Bear Creek Ledger points out a story from WATE (Knoxville tv news) addressing the fact that emergency rooms are required to treat women in labor and "The law also requires TennCare to reimburse hospitals for the emergency care they provide to people here illegally who would qualify for Medicaid as a U.S. citizen." Dr. Heather Moss, OB/GYN is "is even more frustrated because some of her tax money is paying for illegal immigrants to give birth and she is delivering their babies." The news station "found TennCare pays for approximately 60 immigrants a month. Most of those are for mothers in labor. That adds up to a cost of about $1.7 million, an average of nearly $15 million a year." Says Moss "I'm frustrated that someone can come here illegally and basically benefit from our welfare system. A system that was set up to help the poor citizens of the state of Tennessee," and she "plans to contact legislators in Washington, asking them to change the law."

    Says the author of Bear Creek Ledger, "Good luck on that! I don’t think Gov. Bredesen will be doing anything about that any time soon. I’d also bet that the number is a very low estimate." So I ask, what exactly would you have him do?

    As I can imagine it, in changing the law, you could do one or both of two things: 1) not require emergency rooms to care for women in labor; 2) not provide reimbursement to hospitals for providing care to laboring women who are illegal immigrants. Would you have illegal women who cannot pay what the story estimates as $10,000 for an uncomplicated delivery turned away, to labor on their own, in their homes, with no support? Would you have ERs continue to be required provide care in emergency situations (including labor), but provide them no reimbursement, and count on the illegal immigrants to pay the bills? Do you realize that, assuming illegal immigrants even make minimum wage, $10,000 would take 48.5 40-hour weeks to earn? If the bills don't get paid, are you comfortable with what happens to the staffing, supplies, and morale at the ER you may need to visit one day? Should you or can you target only laboring women? In other words, are you thinking about the effects of a change, or just worried about "anchor babies?" Labor and delivery are hardly the only procedures for which emergency rooms and hospitals end up providing care (to non-citizens and citizens alike); Vanderbilt estimates that it provided $31 million in charity care in 2005, and $98.7 million in total uncompensated care. Do we want to add to that burden? If you change the law, it would likely address any emergency procedures, and the cascade effects for the healthcare system are difficult to imagine. And let's just assume that we haven't erected a magic pixie dust wall that will keep all illegal immigrants out of the country, and women will continue needing help and safety while birthing babies. It's easy to say, "Let's just cut them off, let's reduce the incentive for coming here." It's much harder to do that in a way that doesn't profoundly affect the healthcare system and society. So seriously, tell me what the solution is.

    Technorati Tags: ; ; ; ;
    MeSH Tags: Emergency Treatment; Emigration and Immigration; Parturition; Social Justice

    Sunday, January 21, 2007

    Dispatches from NAPW

    Planning Birth Around Football

    According to an AP report found on the FOX Sports website, Chicago school teacher Colleen Pavelka decided to have her labor induced a few days early so her husband could attend the Bears/Saints football game. The baby was apparently born healthy at 8lbs 9oz.

    There is a good deal of controversy surrounding labor induction (evidenced by the Mothering piece linked below). The rates of induction have risen, and it is thought to both not be routinely medically necessary and to increase the chances that a woman will need a cesarean section. Some research findings are conflicting on the c-section point. A 2005 piece in the Journal of Perinatal and Neonatal Nursing cites reports that "According to the National Center for Heath Statistics, in 2002 (the most recent year for which data are available), in the United States the rate of induction of labor was approximately 20.6%, a 129% increase since 1989, the first year these data were collected...While there are women and fetuses with medical or obstetric indications for whom labor induction is beneficial and appropriate, two thirds of labor inductions are for non-medical indications...Miscalculations in estimated date of birth or planned elective induction prior to 39 completed weeks of gestation increases risk of iatrogenic prematurity and admission to the neonatal intensive care unit. ...There is compelling evidence that elective induction of labor significantly increases the risk of cesarean birth, especially for nulliparous women."

    FamilyDoctor.org: Labor Induction
    American Pregnancy Association: Inducing Labor
    ACOC Patient Education Pamphlet: Labor Induction
    Lamaze International: Tips for Avoiding Labor Induction
    MayoClinic.com: Inducing labor: your questions answered
    Mothering Magazine: Let the Baby Decide: The Case Against Inducing Labor

    Update: Women's Bioethics Blog also has commentary on the story.

    Technorati Tags:
    MeSH Tags: Labor, Induced

    NYTimes Piece Profiles "Post-Abortion Syndrome" and its Adherents

    The New York Times Sunday Magazine contains a lengthy piece on "post-abortion syndrome", a concept of emotional trauma caused to women by abortion that is largely unsupported by medical research, and the anti-abortion activists who use the concept as a weapon against women's reproductive options. The article delves into the medical research, the history of the notion of "post-abortion syndrome," and the activists who support and refute the concept. It covers a wide range of relevant issues, and you should really just read it for yourself.

    The bottom line, in my opinion, is that women who need psychological help after abortion (whether related directly to the abortion or otherwise) should be able to get it without shame, and women who do not feel traumatized after abortion should not be made to feel defective or manipulated into blaming abortion for other problems. Women should receive medically accurate information from anti- and pro- forces alike. Let each woman feel her choice in her own way, rather than using some women's emotions to deny options to all women.

    Technorati Tags: ;
    MeSH Tags: Abortion, Induced/Psychology

    Saturday, January 20, 2007

    Obese, Less Educated Women May Get Reduced Chemotherapy Dose

    A study published in the Journal of Clinical Oncology suggests that breast cancer patients who are obese, have less income/education, or live in certain geographic regions are more likely to received a reduced (less than recommended) initial chemotherapy dose. The statistics are somewhat complicated, but here is a general summary of the study.

    Citation: Griggs JJ, Culakova E, Sorbero ME, van Ryn M, Poniewierski MS, Wolff DA, Crawford J, Dale DC, Lyman GH. Effect of patient socioeconomic status and body mass index on the quality of breast cancer adjuvant chemotherapy. J Clin Oncol. 2007 Jan 20;25(3):277-84. [Abstract]

    Who Was Included: >700 consecutive patients from multiple sites throughout the United States were included. To be eligible, they had to be >18 years old, have confirmed diagnosis of stages I, II, or III breast cancer, starting a new, standard chemotherapy regimen of at least 4 courses.

    What Was Done: Information on the patients and treatment was collected through patient interviews and review of medical records. Expected dose of chemotherapy drugs was calculated using standard published doses considering the patient's body-surface area (using height and weight). For each drug, planned/expected dose was compared with the actual dose the patient received. An actual dose that was 85% or less of the expected dose was considered reduced.

    What Information Was Collected: age, region (northeast, central, west coast, or south), other health problems, level of education, marital status, occupation, employment status, type of insurance, zip code, height, weight, tumor characteristics, planned and actual chemotherapy received, dates of treatment. Zip code data was used to determine median househould income, racial and ethnic composition, % of individuals and households below the poverty level, and % of individuals with high school or Bachelor's degree.

    Findings: The authors found certain characteristics associated with getting a reduced chemotherapy dose. Patients who had a higher BMI (were heavy for their height) were more likely to get a reduced dose, as were patients in the South, patients living in areas with higher levels of poverty, and patients with less than a high school education. Patients who were severly obese were 4 times as likely to have a dose reduction compared to patients with a normal BMI. Patients in the southern region were 5.6 times more likely to have a reduced dose compared to those in the northeast. After adjusting for education level, lower median household income was no longer significant, but less education was associated with lower chemotherapy dose.

    The authors speculate that while an obese patient's BMI may suggest a higher chemotherapy dose, doctors may be hesitant to provide the larger dose because of concerns about toxicity. They point to physician concerns/preconceptions (such as whether lower income/education patients will adhere to the treatment) as another factor which may be influencing dosing decisions.

    The same researchers published a study in a 2005 issue of Archives of Internal medicine that reviewed patient records for obese patients and found first-cycle dose reductions (90% or less of standard published doses) in 9% of the healthy weight, 11% of the overweight, 20% of the obese, and 37% of the severely obese women.

  • University of Michigan Health System press release
  • MedlinePlus: Poorer, Less Education Women Get Less Chemo for Breast Cancer
  • American Cancer Society: Item from 2005 suggesting full dose of chemotherapy is safe for overweight breast cancer patients

    Technorati Tags: ; ; ; ;
    MeSH Tags: Breast Neoplasms; Chemotherapy, Adjuvant; Socioeconomic Factors
  • Postpartum Progress Blog

    Katherine Stone, advocate for postpartum mood disorder sufferers, has created the blog, "Postpartum Progress." Recents posts have highlighted opportunities for women to participate in research, upcoming events, support groups, and relevant legislation. This seems to be a good resource for women interested in better understanding and/or the issue and becoming more involved with advancing research and legislation related to PPD.

    Technorati Tags:
    MeSH Tags: Depression, Postpartum

    Legislation Watch

    New items of interest. Many of these will likely die in committee, but it's nice to see what health-related proposals have come up lately. As always, if something interests you, contact your Congressperson. The Thomas links have full-text (when available), cosponsor, and status.

    H. Con. Res. 39 - Honoring women's health advocate Cynthia Boles Dailard
    Thomas | Summary from GovTrack
    Introduced 1/19/07 by Rep. Louise Slaughter [D-NY]

    H. Con. Res. 35 - Supporting the goals and ideals of National Black HIV/AIDS Awareness Day
    Thomas | Summary from GovTrack
    Introduced 1/18/07 by Rep. Barbara Lee [D-CA]

    S. 322 - A bill to establish an Indian youth telemental health demonstration project
    Thomas | Summary from GovTrack
    Introduced 1/17/07 by Sen. Byron Dorgan [D-ND]

    H.R. 506 - To provide for innovation in health care through State initiatives that expand coverage and access
    Thomas | Summary from GovTrack
    Introduced 1/17/07 by Rep. Tammy Baldwin [D-WI]

    Previous Posts:
  • HR464 (emergency contraception provision); HR468 (grants for teen pregnancy prevention; SRes24/HConnRes30 (National Stalking Awareness Month); HR405 (residential substance abuse treatment); HR427 (Medicaid for legal immigrant children); S244 (ob/gyns/liability)
  • HR32 (female genital mutiliation, CEDAW, etc.); S21 (reducing abortion & unintended pregnancy); S28 (requiring generic drug use under Medicare Part D)
  • Saturday News Roundup (1/20/07)

    From Katie Allison Granju, Will Ferrell did his part to reduce breastfeeding stigma by carrying his wife's breast pump to the Golden Globes.

    Via the Kaiser Network:
  • FDA To Reconsider Standards for Reviewing Low-Dose Oral Contraceptives. The drug regulation agency is set to reconsider the acceptible failure rates as a result of pregnancy rates in recent studies.
  • GSK To Begin Trial Comparing its Experimental HPV Vaccine Cervarix to Merck's Gardasil. Gardasil is currently the only FDA-approved HPV vaccine.
  • Debate continues over the appointment of contaception-opponent, abstinence-only advocate Eric Keroack to the position of deptury assistant secretary of the Office of Population Affairs, an agency devoted to provision of family planning and reproductive health care. The Boston Glove recently ran commentary from Ellen Goodman on the issue. RHRealityCheck links to a New York Times opinion piece on Keroack, available to subscribers only.
  • From the "things you shouldn't have to legislate" files, a bill has been introduced "that would require Washington (state) schools to provide medically accurate sex education."
  • Increased breast density may be linked to increased risk of breast cancer.
  • The contraceptive sponge is back, and you may soon see more aggressive marketing of the device.

    TikvaGirl also saw and appreciated the recent episodes of Scrubs addressing postpartum depression.

    Via Our Bodies, Our Blog, more on the difficulties of childbirth in Iraq (see previous posts 1 & 2)

    RHReality check takes on the coverage of sex and condoms in a recent episode of Desperate Housewives.

    Women's Bioethics Blog comments on a Virginia bill to require HPV vaccination (or parental opt-out) for girls attending middle school.

    CNN: Infant outcomes worse with planned C-section

    I'd be interested to know how this map of U.S. births to females 15-19 years old corresponds with sex ed and access to reproductive health, given that the highest rates are in the South (east and west).

    The Washington Post reports that Bush plans to propose tax incentives for private insurance during the State of the Union Address. The Post also has an update on mandatory HPV vaccination in Maryland.

    Technorati Tags: ; ; ; ; ; ; ; ; ; ; ; ; ;
    MeSH Tags: Breast Feeding; Breast Neoplasms; Contraception; Family Planning Services; Insurance, Health; Papillomavirus Vaccines; Pregnancy in Adolescence; Sex Education; Television; United States Dept. of Health and Human Services; United States Food and Drug Administration
  • CDC Launches Women's Health Exhibit

    The Centers for Disease Control and Prevention has launched a new exhibit, The Changing Face of Women's Health, which can be seen in full at the CDC in Atlanta, GA during Jan 22-Apr 6, 2007, and can be previewed via an online tour. The exhibit is organized into four thematic areas, addressing risk, control, detection, and prevention. The CDC has also provided numerous links to web resources on women's health topics.

    Before planning a tour, check out the CDC's information for visitors, directions, and group tour scheduling details.

    Thanks to BeckyJ for the tip.

    Technorati Tags: ; ; ;
    MeSH Tags: Centers for Disease Control and Prevention (U.S.); Exhibits; Women's Health

    American Cancer Society Issues New HPV Vaccine Guidelines

    The American Cancer Society released this press release regarding new ACS guidelines that purportedly recommend that girls should receive the HPV vaccine when they're 11-12 years old. The new guidelines were developed by an expert panel who reviewed existing published and unpublished data on HPV vaccines. The guidelines do not explicitly state that girls 11-12 years old receive the HPV vaccine, but discuss the barriers reaching adolescents for vaccination and the recommendation by many health organizations that adolescents receive a routine healthcare visit at 11-12, thus creating a time during which teens could receive booster and other vaccines, including the HPV vaccine.

    The core explicit recommendations of the guideline are as follows: unvaccinated and vaccinated women should continue Pap screenings; HPV testing prior to vaccination is not recommended; public health and policy efforts are needed to reduce disparities in HPV vaccine access; healthcare visits for specific problems such as minor illness and sports physicals and other nontraditional venues could be used to more widely distribute vaccine; educators, policy-makers, young girls and others need to be educated about cervical cancer detection and early prevention; ongoing research and surveillance is needed.

    Cervical cancer/HPV information from the guideline:
  • In 2006, an estimated 9,710 cases of invasive cervical cancer will be diagnosed in the United States, and an estimated 3,700 women will die from this disease.
  • Globally, cervical cancer is the second most common cause of cancer death in women, with an estimated 510,000 newly diagnosed cervical cancer cases and 288,000 deaths.11 In developing countries, cervical cancer is often the most common cancer in women.
  • The greatest burden of cervical cancer is found in underserved, resource-poor populations of women in whom at least 80% of all incident cervical cancer and related mortality occurs. The highest rates of cervical cancer have been observed in regions of Africa, Central and South America, and Micronesia, where age-standardized incidence rates exceeding 50 cases per 100,000 women per year have been observed.
  • In the U.S. -- Although disparities in incidence and mortality have decreased in recent years, cervical cancer incidence remains about 60% higher among black women (10.5/100,000) compared with white women (6.6/100,000), and cervical cancer mortality among black women is the highest (4.7/100,000) of any racial or ethnic group. Rates are particularly high among those African Americans living in the rural South (eg, the Mississippi Delta) and also in some urban areas (eg, Washington, DC)
  • Other US racial/ethnic/geographic groups experience cervical cancer incidence and mortality higher than the population average. These include (1) Hispanics living along the US-Mexico border areas; (2) White (non-Hispanic) women living in Appalachia, rural New York State, and Northern New England; (3) American Indian women living in the Northern Plains and Alaskan Natives; and (4) Vietnamese Americans. Cervical cancer incidence remains high among these groups because of limited resources and poor access to health care, which is further exacerbated by social and cultural barriers.
  • ...more than 50% of college-age women acquired an HPV infection within 4 years of first intercourse
  • Transmission by nonpenetrative genital contact is rare, but infection has been reported in women who did not have a history of penetrative intercourse
  • The lower age limit for vaccine efficacy studies of Gardasil is 16 years and for Cervarix is 15 years. As the vaccine is prophylactic, it is important to consider risk of prior infection, which is best estimated by prior sexual activity. In the United States, according to national survey data, 24% of females report being sexually active by age 15 years, 40% by age 16 years, and 70% by age 18 years. Seven percent of high school students (male and female) reported having initiated intercourse before aged 13 years, and 10% of sexually active ninth graders reported having had 4 or more lifetime sex partners...From a public health perspective, routine vaccination before sexual debut or shortly thereafter is important to achieve optimal effectiveness.
  • Efficacy trials in young men are ongoing, with results expected in 2007.
  • While data are limited, several examples cited below may provide some insight into the potential impact of HPV vaccination on behavior. National Survey of Family Growth data show that only 10% of male and 7% of female adolescents who have never had sex cite "don't want STD" as the main reason for not having sex.
  • The citation for the guidelines, published in an academic medical journal: Saslow D, Castle PE, Cox JT, Davey DD, Einstein MH, Ferris DG, Goldie SJ, Harper DM, Kinney W, Moscicki AB, Noller KL, Wheeler CM, Ades T, Andrews KS, Doroshenk MK, Kahn KG, Schmidt C, Shafey O, Smith RA, Partridge EE, Garcia F. American Cancer Society guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors. CA Canjcer J Clin. 2007 Jan-Feb;57(1):7-28 Free Full Text

    Technorati Tags: ; ; ; ; ;
    MeSH Tags: American Cancer Society; Guidelines; Papillomaviridae; Papillomavirus Vaccines; Uterine Cervical Neoplasms

    Friday, January 19, 2007

    "Pregnant Girls Gone Wild?"

    Nice teaser headline there, MSNBC. Three pregnant teenagers (ages 15 & 16) living in the New Hope Maternity Home in American Fork, Utah allegedly hit the director with a frying pan, bound her with electrical cords, stuck a sock in her mouth, and took off in a stolen van, with the director's wallet, credit cards, and phone. The teens also apparently tied up another 17-year-old pregnant resident.
    Daily Herald (Utah paper) - 3 pregnant teens on the run

    As the maternity home is intended for "troubled" teens, I'll be interested to find out whether the girls ran away because they simply didn't want to be at the home, or whether there was some problem that made them want to escape the home.

    Lead in Your Vitamins?

    MSNBC is reporting that recent ConsumerLab tests of daily multivitamins identified problems with the ingredients, including unusual levels of lead in The Vitamin Shoppe Multivitamins Especially for Women. From the story:
  • Cntrum Silver, Member's Mark Complete Multi (distributed by Sam's Club), One A Day Women's and Flintstones Complete passed CL's tests.
  • The Vitamin Shoppe women's product contained 15.3 micrograms of lead per daily serving of two tablets, and contained "54 percent of the 200 milligrams of calcium stated on the label."
  • "Hero Nutritionals Yummi Bears, a multivitamin for children, had 216 percent of the labeled amount of vitamin A in the retinol form, delivering 5,400 International Units (IU) in a daily serving. That's substantially more than the upper tolerable level set by the Institute of Medicine of 2,000 IU for kids ages 1 to 3 and 3,000 IU for those 4 to 8."
  • "Eniva VIBE, a multivitamin liquid sold in packets, had only 54 percent of the claimed vitamin A."

    Unfortunately, the full ConsumerLab (remember, this is not the same as Consumer Reports) report is not available unless you subscribe on their website, so it is difficult to vet their claims. The CL site shouts, "Twelve multivitamins failed our tests! Find out which passed or failed now," which you have to pay ($10 for the single report) to do. No thanks - I don't appreciate it when companies try to scare me in order to take my money. However, this is not the first report to question vitamin quality. A Feb 2006 Consumer Reports piece mentions testing done in 2004 that found nearly half of 18 tested brands failed to contain the claimed amount of a least one nutrient and several did not dissolve adequately, although none of the vitamins in their tests contained heavy metals such as lead.
  • Tuesday, January 16, 2007

    More Legislation to Watch

    As with the bills and resolutions listed in the previous post, full-text and details may not yet be available for these newly introduced items. The GovTrack links will provide status updates; if you'd like to follow these bills, you can set up monitoring in GovTrack or check the Thomas pages individually when they become available. I'm going to make an effort to go back and update posts with links to additional information/text when it becomes available, and will link to all previous legislation-related posts from each new one, so you can easily link back and follow their progress.

    H.R. 464 - To provide for the provision by hospitals receiving Federal funds through the Medicare Program or Medicaid Program of emergency contraceptives to women who are survivors of sexual assault.
    Thomas | Summary Page from GovTrack
    Introduced 1/12/07 by Rep. Steven Rothman [D-NJ]. This bill would require the following of hospitals receiving Medicare/Medicaid:
    (1) The hospital promptly provides the woman with medically and factually accurate and unbiased written and oral information about emergency contraception, including information explaining that--

    (A) emergency contraception has been approved by the Food and Drug Administration as an over-the-counter medication for women ages 18 and over and is a safe and effective way to prevent pregnancy after unprotected intercourse or contraceptive failure if taken in a timely manner;

    (B) emergency contraception is more effective the sooner it is taken; and

    (C) emergency contraception does not cause an abortion and cannot interrupt an established pregnancy.

    (2) The hospital promptly offers emergency contraception to the woman, and promptly provides such contraception to her at the hospital on her request.

    (3) The information provided pursuant to paragraph (1) is in clear and concise language, is readily comprehensible, and meets such conditions regarding the provision of the information in languages other than English as the Secretary may establish.

    (4) The services described in paragraphs (1) through (3) are not denied because of the inability of the woman or her family to pay for the services.
    In the findings of the legislation, it is estimated that "25,000 to 32,000 women become pregnant each year as a result of rape or incest."


    H.R. 468 - To make grants to carry out activities to prevent teen pregnancy in racial or ethnic minority or immigrant communities, and for other purposes.
    Thomas | Summary from GovTrack
    Introduced 1/12/07 by Rep. Hilda Solis [D-CA].

    S. Res. 24 - A resolution designating January 2007 as "National Stalking Awareness Month"
    Thomas | Summary from GovTrack
    Introduced 1/11/07 by Sen. Joseph Biden [D-DE].

    H. Conn. Res. 30 - Raising awareness and encouraging prevention of stalking by establishing January 2007 as "National Stalking Awareness Month"
    Text and Status from Thomas | Summary from GovTrack
    Introduced 1/11/07 by Rep. Ted Poe [R-TX].

    H.R. 405 - To amend the Public Health Service Act regarding residential treatment programs for pregnant and parenting women, a program to reduce substance abuse among nonviolent offenders, and for other purposes.
    Thomas | Summary from GovTrack
    Introduced 1/11/07 by Rep. Barbara Cubin [R-WY]

    H.R. 427 - To amend title XIX of the Social Security Act to assure coverage for legal immigrant children and pregnant women under the Medicaid Program and the State children's health insurance program (SCHIP).
    Thomas | Summary from GovTrack
    Introduced 1/11/07 by Rep. Edophus Towns [D-NY]

    S. 244 - A bill to improve women's access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the delivery of obstetrical and gynecological services.
    Text Not Available | Summary from GovTrack
    Introduced 1/10/07 by Sen. Judd Gregg [R-NH]

    Previous Posts:
  • HR32 (female genital mutiliation, CEDAW, etc.); S21 (reducing abortion & unintended pregnancy); S28 (requiring generic drug use under Medicare Part D)

    Technorati Tags: ; ; ; ; ; ; ; ; ; ;
    MeSH Tags: Contraception, Postcoital; Legislation; Malpractice; Medicaid; Residential Treatment; Substance-Related Disorders
  • Uterine Transplants

    The Washington Post ran a piece yesterday, First U.S. Uterine Transplant Planned. The article examines questions such as whether enough research and animal experimentation has been done to justify attempting the procedure in humans, and whether this is an option that should be available because the uterus is not necessary for life, unlike other commonly transplanted organs such as hearts and kidneys. The transplant would be considered temporary, allowing a woman to bear a child but is not intended as a lifetime replacement uterus, as the baby would be delivered via c-section and the uterus removed at that time. A November 2006 article from New Scientist reported that a physician at New York Downtown Hospital had been approved by its hospital review board for such a transplant, following "the first successful uterus transplant in a non-human primate" (a rhesus monkey) performed at the University of Pittsburgh. Scientists interviewed for that article were also skeptical that the procedure had been properly vetted through research.

    Personally, I can't imagine wanting to carry a baby so badly that I would undergo a transplant procedure. Pregnancy has its own set of risks; adding transplantation risks to the mix seems like a dangerous and unnecessary option.

    Click on the MeSH tag below to run a search for medical articles on uterine transplantation. Our Bodies, Our Blog also has coverage of the story.

    Technorati Tags: ;
    MeSH Tags: Uterus/transplantation

    Saturday, January 13, 2007

    Saturday News Roundup (1/13/07)

    Note: Where the news items below are based on published research, I have not yet had a chance to read the studies and vet the coverage of the findings. Reader beware.

    Via CDC's Morbidity and Mortality Weekly Report: Infant Deaths Associated with Cough and Cold Medications --- Two States, 2005

    via CNN:
  • CDC warns against giving toddlers, babies cold medicine, cough syrup
  • Survey: Many assume they can't control cancer risk
  • Women more likely to survive lung cancer
  • '100 hours': House passes stem-cell bill despite veto threat
  • Risk of death high for new ex-cons

    via Medpundit, the U.S. Department of Health and Human Services has established the National Clearinghouse for Long-Term Care Information

    The National Heart, Lung, and Blood Institute has introduced a "New Campaign on Little Known Fourth Leading Cause of Death In United States," chronic obstructive pulmonary disease.

    via the New York Times:
  • House Democrats Pass Bill on Medicare Drug Prices
  • Wal-Mart Says Health Plan is Covering More Workers
  • AIDS Drug to Protect Fetus Is Safe for Infected Mothers, Study Finds

    via 4women.gov, Health Tip: Symptoms of Ovarian Cysts

    Doulicia reports on bad press for doulas

    via Feministing:
  • January 22 is Blog for Choice Day
  • SD anti-choice law gets a rare rehearing

    Katie Allison Granju brings the bad news on people's perceptions of infant formula vs. breast milk.

    RHRealityCheck on The L Word's portrayal of "crisis pregnancy centers."

    The Kaiser Network has made available a transcript, video and podcast of its recent Ask the Experts: HPV Vaccine webcast session.

    The Well-Timed Period on the demise of the placebo week.
  • Blogging Elsewhere

    I'm at NashvilleIsTalking, a Nashville-centric blog and aggregator run by local ABC affiliate WKRN, this weekend, mucking up the series of tubes. Come on over.

    Thursday, January 11, 2007

    Another Reason Scrubs is a Good Show

    Tonight's episode of NBC sitcom Scrubs featured a surprisingly straightforward depiction of postpartum depression, as well as breastfeeding and lactation consultants. The character Carla has recently had a baby; her husband notices that she seems depressed, while she struggles with her feelings and insists that she'll be fine. A friend of the couple who is also a mother eventually convinces Carla that she needs to seek help. Carla and her husband are also shown meeting with lactation consultants, with Carla appearing as though attempting to breastfeed. While the breastfeeding scene was played for laughs (it is a comedy, after all), the postpartum depression issue was portrayed as a serious concern, and neither of these two topics is a common sight on network television. Additionally, the Carla character is a long-time nurse, and her husband is a surgeon; depicting medical professionals dealing with these problems in a serious manner normalizes the issues in a way rarely seen in television or film.

    Last fall, CBS ran public service announcements on postpartum depression during the crime drama Cold Case.

    Technorati Tags: ; ; ; ; ;
    MeSH Tags: Breast Feeding; Depression, Postpartum; lactation consultants [keyword]; Television

    Tuesday, January 09, 2007

    MeSH 2007: Medical Terminology Updates

    This post is really for the librarians among you, and possibly those of you who are interested in words and their meaning. The National Library of Medicine has released their 2007 updates to the Medical Subject Headings (MeSH). MeSH geeks may click on the links for MeSH descriptor data, including definitions. Among the changes:

  • "Circumcision" has been replaced by "Circumcision, Male." In the past, there have been two terms, "Circumcision" and "Circumcision, Female," where "Circumcision" was used to refer to the procedure in males. The scope note for "Circumcision" says that gender is unspecified but usually male, and seems to have been typically used in practice to represent male circumcision. The "Circumcision, Female" term has remained. Thanks to NLM for clarifying the subject headings for searching purposes and no longer thinking that unqualified equals male, at least for this concept.

  • "Feminine Hygiene Products" and "Menstrual Hygiene Products" have been added. These are obviously not new concepts. In the past, the term "Tampons" represented both the menstrual product variety and the "plug other kinds of bleeding during surgery" variety; the scope note states, "They are variously used in surgery to plug the nose, vagina, etc., for the control of hemorrhage or the absorption of secretions." This created difficulties when searchers wanted to look specifically for things like the adverse effects of (menstrual) tampons. "Tampons" has been clarified to "Tampons, Surgical."

  • "Female Athlete Triad Syndrome" has been added; previous searches has to make combined use of Amenorrhea, Eating Disorders, and Osteoporosis or textwords to identify the concept.

  • Papillomavirus Vaccines has been added. This term will represent the new HPV vaccine.

  • Also in sex-specific terminology - The urogenital diseases terms have changed, and appear to be somewhat more consistent in the 2007 MeSH.
    Old MeSH:
  • Urologic and Male Genital Diseases [C12] --> Genital Diseases, Male [C12.294] + (with Urogenital Diseases at the same level)
  • Female Genital Diseases and Pregnancy Complications [C13] --> Genital Diseases, Female [C13.371] --> Urogenital Diseases
    New MeSH:
  • Female Urogenital Diseases and Pregnancy Complications [C13] --> Female Urogenital Diseases [C13.351] --> Genital Diseases, Female [C13.351.500]
  • Male Urogenital Diseases [C12] --> Genital Diseases, Male [C12.294]

    In the "I'm glad they added that!" department, these terms are new to 2007 MeSH: Adult Stem Cells; Dysuria; Explosive Agents; Infant, Extremely Low Birth Weight; Nocturia; Nocturnal Enuresis; Pain, Referred; Particulate Matter; Pneumonia, Ventilator-Associated; Respiratory Aspiration; Stockings, Compression; Surgical Tape; Trigger Finger Disorder; Urinary Bladder, Overactive; Urinary Incontinence, Urge; West Nile Virus Vaccines.

    2006 MeSH
    2007 MeSH
    New Descriptors - 2007
    Changed Descriptors - 2007
    Deleted Descriptors - 2007

    Technorati Tags: ; ; ; ; ;
    MeSH Tags: There's no way I'm listing all the MeSH terms again here.