According to the Journal Star, the Freedom of Conscience Act (LB461) would require hospitals and clinics to accommodate an employee's beliefs and related practices regarding abortion care unless a patient would face death without the employee's assistance. The protections also would apply to experiments or procedures that destroy human embryos, cells or tissue.
In addition, the bill would prohibit providers and health plans from restricting patient's end-of-life care decisions.
Under the bill, plaintiffs and defendants involved in civil lawsuits regarding religious or moral discrimination would be entitled to compensation for attorney's fees. The bill would affect employers' actions regarding "admission, hiring, firing, tenure, privileges or status," the Journal Star reports (Young/O'Hanlon, Lincoln Journal Star, 1/14).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families.
© 2010 National Partnership for Women & Families. All rights reserved.
четверг, 29 марта 2012 г.
Neb. Bill Would Expand 'Conscience' Protections For Health Workers, Patients
On Friday, Nebraska Sen. Pete Pirsch (R) introduced a bill (LB461) that would expand protections for health workers and patients who have moral or religious objections to abortion, certain end-of-life care decisions and procedures that involve the destruction of embryos, the Lincoln Journal Star reports.
четверг, 22 марта 2012 г.
Survey: Doctors Need More Knowledge About Exercise And Pregnancy
Research conducted by the President of the American College of Sports Medicine and colleagues shows many doctors aren't sure what to tell their pregnant patients about exercise.
ACSM President James Pivarnik, Ph.D., FACSM, and colleagues Patricia Bauer, Ph.D., and Cliff Broman, Ph.D., surveyed 93 M.D.s, D.O.s (doctors of osteopathy) and Certified Nurse Midwives about their knowledge of exercise recommendations for pregnant women. Although nearly all respondents - 99 percent - believed exercise was good for their expecting patients, 60 percent of M.D.s and 86 percent of D.O.s weren't familiar with pregnancy exercise guidelines. The results of the survey were published in the Journal of Women's Health.
"Study after study has shown exercise to be beneficial for both mother and baby, but some doctors seem reluctant to trust that body of evidence," said Pivarnik, author of a 2006 ACSM Roundtable Consensus Statement on the Impact of Physical Activity during Pregnancy and Postpartum on Chronic Disease Risk. The Roundtable Statement discussed how exercise during pregnancy decreased mothers' risk of preeclampsia, gestational diabetes, low back pain and more.
This decreased risk of chronic diseases and conditions is consistent with the Exercise is MedicineTM / program, which promotes exercise as a standard part of health care for all people.
Despite updated comprehensive pregnancy guidelines from the American College of Obstetricians and Gynecologists, Pivarnik and colleagues study showed antiquated beliefs among some doctors. Many still believed pregnant women shouldn't push their heart rates beyond 140 beats per minute - a guideline that hasn't been used since 1985.
Pivarnik recommends all health care providers familiarize themselves with current pregnancy exercise guidelines, which are included in the 2008 Physical Activity Guidelines for Americans. Overall recommendations can be tailored to the specific patient's needs. He also encourages health care providers to include more information about physical activity and its benefits in maternity education materials given to patients.
Source
The American College of Sports Medicine
ACSM President James Pivarnik, Ph.D., FACSM, and colleagues Patricia Bauer, Ph.D., and Cliff Broman, Ph.D., surveyed 93 M.D.s, D.O.s (doctors of osteopathy) and Certified Nurse Midwives about their knowledge of exercise recommendations for pregnant women. Although nearly all respondents - 99 percent - believed exercise was good for their expecting patients, 60 percent of M.D.s and 86 percent of D.O.s weren't familiar with pregnancy exercise guidelines. The results of the survey were published in the Journal of Women's Health.
"Study after study has shown exercise to be beneficial for both mother and baby, but some doctors seem reluctant to trust that body of evidence," said Pivarnik, author of a 2006 ACSM Roundtable Consensus Statement on the Impact of Physical Activity during Pregnancy and Postpartum on Chronic Disease Risk. The Roundtable Statement discussed how exercise during pregnancy decreased mothers' risk of preeclampsia, gestational diabetes, low back pain and more.
This decreased risk of chronic diseases and conditions is consistent with the Exercise is MedicineTM / program, which promotes exercise as a standard part of health care for all people.
Despite updated comprehensive pregnancy guidelines from the American College of Obstetricians and Gynecologists, Pivarnik and colleagues study showed antiquated beliefs among some doctors. Many still believed pregnant women shouldn't push their heart rates beyond 140 beats per minute - a guideline that hasn't been used since 1985.
Pivarnik recommends all health care providers familiarize themselves with current pregnancy exercise guidelines, which are included in the 2008 Physical Activity Guidelines for Americans. Overall recommendations can be tailored to the specific patient's needs. He also encourages health care providers to include more information about physical activity and its benefits in maternity education materials given to patients.
Source
The American College of Sports Medicine
четверг, 15 марта 2012 г.
Alcohol Abuse More Likely To Cause Brain Damage In Females
Alcoholism has traditionally been considered a male disease because there are many more alcoholic males than females.
But a new study by researchers at Oregon Health & Science University and the Portland Veterans Affairs Medical Center suggests that women are more prone to brain damage from alcohol abuse than men.
The study led by Kristine Wiren, Ph.D., associate professor of behavioral neuroscience and medicine, OHSU School of Medicine, and research biologist, PVAMC Research Service, found that female mice are more susceptible to neurotoxic effects of alcohol withdrawal, including significantly increased brain cell death, than male mice. It also found the gender difference exists whether the animals are prone to severe withdrawal due to a genetic predisposition, or resistant to it.
Wiren said she was surprised by the results.
"We designed the experiment to be able to identify gene expression differences between lines of mice that are genetically selected for severe alcohol withdrawal compared with mice that are resistant to alcohol withdrawal," Wiren said. "I thought there would be a difference between the genders, but I didn't think it would be the most important thing."
She added, "The withdrawal severity phenotypes do show some differences, but they're subtle."
The study appears in the online edition of the journal Neuropsychopharmacology.
Wiren and Joel Hashimoto, research associate of behavioral neuroscience at OHSU and the PVAMC Research Service, examined four groups of selectively bred mice: two female groups, including one prone to severe withdrawal and one resistant to severe withdrawal, and two similar male groups. Four control groups also were used.
Using DNA microarray or "gene chip" analysis, a laboratory process involving advanced robotics that allows large numbers of genes and their complex interactions to be observed, Wiren and Hashimoto examined 5,000 genes from the prefrontal cortex, the area of the brain implicated in complex planning, personality expression and social behavior, and is involved in withdrawal-related brain circuitry. They then identified a total of 295 alcohol-regulated genes for each mouse group.
"We're interested in that part of the brain because it's important in inhibitory control. Alcoholics are unable to display good inhibitory control," Wiren said.
After identifying the alcohol-regulated gene pathways, Wiren and Hashimoto were able to home in on the extent of cell death. Ten days after alcohol withdrawal, they examined cells in the lateral parietal cortex area, which is part of the network of brain regions, in addition to the prefrontal cortex, involved in inhibitory control, and identified live and dead cells with tissue stains.
"At this one time point, which is the peak for cell death, we clearly see females are showing enhanced brain damage compared to the males. So, if you're female, the cells are dying; if you're a male, the cells are not," Wiren said. "We don't know the behavioral consequences of that, though."
What's more, Wiren and Hashimoto discovered, male brains respond to alcohol withdrawal much differently, in a potentially reparative manner.
"What we found in males is that almost 50 percent of the (alcohol-regulated) genes are involved in the pathway for cleaning things up," Wiren said. The genes respond with "removal of damaged proteins. The females have all this apoptosis (cell death) going on, and the males instead may have repair going on."
Such brain damage may underlie debilitating cognitive dysfunction and motor deficits observed in some alcoholics, according to the study. In addition, disruption of inhibitory functions in the prefrontal cortex may contribute to excessive drinking and the self-sustaining nature of alcoholism.
"The results suggest that females are more vulnerable to neurotoxic consequences of alcohol withdrawal," Wiren noted. "Everyone should be concerned about chronic alcohol consumption and severe intoxication, but females may be more vulnerable." This data is "consistent with some controversial human studies that suggest that females do develop more brain damage than male alcoholics."
Future studies, including one funded by the VA, will examine the role that hormones play in response to alcohol withdrawal, include the possibility that the male hormone androgen exacerbates cell death in males.
"What we're looking at now is the involvement of testosterone in mediating the cell death in females," Wiren said. "Not just in chronic conditions, but in acute (alcohol consumption) situations, testosterone levels drop in males. In females, they may rise."
Wiren also wants to look at a longer withdrawal time course. "Maybe males show damage at a different time point," she said. "Or it might have happened earlier and they're showing repair."
The study was funded by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health, and all work was performed at facilities provided by the PVAMC.
Source: Jonathan Modie
Oregon Health & Science University
But a new study by researchers at Oregon Health & Science University and the Portland Veterans Affairs Medical Center suggests that women are more prone to brain damage from alcohol abuse than men.
The study led by Kristine Wiren, Ph.D., associate professor of behavioral neuroscience and medicine, OHSU School of Medicine, and research biologist, PVAMC Research Service, found that female mice are more susceptible to neurotoxic effects of alcohol withdrawal, including significantly increased brain cell death, than male mice. It also found the gender difference exists whether the animals are prone to severe withdrawal due to a genetic predisposition, or resistant to it.
Wiren said she was surprised by the results.
"We designed the experiment to be able to identify gene expression differences between lines of mice that are genetically selected for severe alcohol withdrawal compared with mice that are resistant to alcohol withdrawal," Wiren said. "I thought there would be a difference between the genders, but I didn't think it would be the most important thing."
She added, "The withdrawal severity phenotypes do show some differences, but they're subtle."
The study appears in the online edition of the journal Neuropsychopharmacology.
Wiren and Joel Hashimoto, research associate of behavioral neuroscience at OHSU and the PVAMC Research Service, examined four groups of selectively bred mice: two female groups, including one prone to severe withdrawal and one resistant to severe withdrawal, and two similar male groups. Four control groups also were used.
Using DNA microarray or "gene chip" analysis, a laboratory process involving advanced robotics that allows large numbers of genes and their complex interactions to be observed, Wiren and Hashimoto examined 5,000 genes from the prefrontal cortex, the area of the brain implicated in complex planning, personality expression and social behavior, and is involved in withdrawal-related brain circuitry. They then identified a total of 295 alcohol-regulated genes for each mouse group.
"We're interested in that part of the brain because it's important in inhibitory control. Alcoholics are unable to display good inhibitory control," Wiren said.
After identifying the alcohol-regulated gene pathways, Wiren and Hashimoto were able to home in on the extent of cell death. Ten days after alcohol withdrawal, they examined cells in the lateral parietal cortex area, which is part of the network of brain regions, in addition to the prefrontal cortex, involved in inhibitory control, and identified live and dead cells with tissue stains.
"At this one time point, which is the peak for cell death, we clearly see females are showing enhanced brain damage compared to the males. So, if you're female, the cells are dying; if you're a male, the cells are not," Wiren said. "We don't know the behavioral consequences of that, though."
What's more, Wiren and Hashimoto discovered, male brains respond to alcohol withdrawal much differently, in a potentially reparative manner.
"What we found in males is that almost 50 percent of the (alcohol-regulated) genes are involved in the pathway for cleaning things up," Wiren said. The genes respond with "removal of damaged proteins. The females have all this apoptosis (cell death) going on, and the males instead may have repair going on."
Such brain damage may underlie debilitating cognitive dysfunction and motor deficits observed in some alcoholics, according to the study. In addition, disruption of inhibitory functions in the prefrontal cortex may contribute to excessive drinking and the self-sustaining nature of alcoholism.
"The results suggest that females are more vulnerable to neurotoxic consequences of alcohol withdrawal," Wiren noted. "Everyone should be concerned about chronic alcohol consumption and severe intoxication, but females may be more vulnerable." This data is "consistent with some controversial human studies that suggest that females do develop more brain damage than male alcoholics."
Future studies, including one funded by the VA, will examine the role that hormones play in response to alcohol withdrawal, include the possibility that the male hormone androgen exacerbates cell death in males.
"What we're looking at now is the involvement of testosterone in mediating the cell death in females," Wiren said. "Not just in chronic conditions, but in acute (alcohol consumption) situations, testosterone levels drop in males. In females, they may rise."
Wiren also wants to look at a longer withdrawal time course. "Maybe males show damage at a different time point," she said. "Or it might have happened earlier and they're showing repair."
The study was funded by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health, and all work was performed at facilities provided by the PVAMC.
Source: Jonathan Modie
Oregon Health & Science University
четверг, 8 марта 2012 г.
Newsweek Examines Fetal Rights Debate In Courts, Legislatures
Courts across the country are deliberating cases challenging state laws affording rights to fetuses and grappling with questions about fetal rights and the rights of pregnant woman, Newsweek reports.
The magazine highlights the case of Samantha Burton, a Florida woman who was forced by court order to remain in a hospital on bed rest while pregnant because her physician believed the fetus's life was at risk. Burton, who was 25 weeks pregnant at the time of the court order, miscarried three days later. She is now challenging the court order as unconstitutional. Burton's attorney, David Abrams, said she "literally became a ward of the state, incompetent to make her own medical decisions, simply because she was pregnant." The court order stated that Burton, who had sought a second opinion, was required to comply with her doctor's advice to "preserve the life and health of [her] unborn child."
Meanwhile, Vermont state senators are debating legislation that would allow crimes resulting in the death of a pregnant woman to be prosecuted as double homicide. The legislation was introduced by state Sen. Vincent Illuzzi (R), who supports abortion rights and says that his bill notes in three separate places that it is not meant to curb a woman's right to an abortion. Thirty-seven other states have so-called "feticide" laws, 19 of which apply to early pregnancy and the rest of which specify a certain point in gestation when fetal rights begin.
According to Newsweek, the debate over fetal rights "underscores a national schizophrenia in our thinking about pregnant women, how they ought to act, and whose interests they must consider." Supporters of fetal rights say the state has an obligation to intervene to protect the safety of a fetus, just as the government would for a neglected child. Opponents say the laws strip pregnant women of their own rights. Lynn Paltrow, executive director of National Advocates for Pregnant Women, said, "It makes me think we're still engaged with a fundamental question of whether, upon becoming pregnant, women are still full citizens."
Generally, courts -- including the Supreme Court -- have ruled against the state's ability to enforce fetal rights because fetuses are not recognized as people under federal law. However, the federal Unborn Victims of Violence Act, signed by President Bush in 2004, recognizes the "child in utero" as a legal victim if it is injured or killed during the commission of any of 68 federal violent crimes. Despite attempts by antiabortion-rights groups to pass state "personhood" laws that codify fetuses as people with legal rights, no state has done so (Kliff, Newsweek, 1/19).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2010 The Advisory Board Company. All rights reserved.
четверг, 1 марта 2012 г.
Conservative Groups Object To Surgeon General Nominee Holsinger Because Of Cloning, Stem Cell Research Statements
The Family Research Council and other conservative groups are "objecting strongly" to President Bush's nominee for surgeon general, James Holsinger, for previous statements he made in support of loosening regulations on cloning and human embryonic stem cell research, the Washington Times reports.
Tom McCluskey, vice president for government affairs at FRC, said that Holsinger at a Kentucky Legislature committee hearing in 2002 "testified in support of loosening regulations around cloning and embryonic stem cell research." He added that FRC is "not supportive of [Holsinger's] nomination right now" because "the surgeon general is such a strong bully pulpit position that we want to be sure" of his stance.
White House spokesperson Emily Lawrimore said that Holsinger's 2002 testimony against the ban on cloning was because "he felt that the penalties proposed in the bill were disproportionately severe on patients and researchers." She added that "[s]ince 2002, there have been significant advances in new techniques for potentially deriving pluripotent stem cells without cloning or destroying embryos. As such, Dr. Holsinger believes the president's cloning policy is appropriate" (Ward, Washington Times, 7/9).
Federal funding for embryonic stem cell research currently is allowed only for research using embryonic stem cell lines created on or before Aug. 9, 2001, under a policy announced by Bush on that date (Kaiser Daily Women's Health Policy Report, 6/20). According to Lawrimore, Holsinger would not help formulate stem cell or cloning policy. Holsinger's "main focus will be childhood obesity, so he will not be involved in determining policy related to stem cell research," Lawrimore said (Washington Times, 7/9).
Holsinger has served as secretary of the Kentucky Cabinet for Health and Family Services and as chancellor of the University of Kentucky Chandler Medical Center. He also had a 26-year career with the Department of Veterans Affairs and served for more than 30 years in the Army Reserve. The term of the previous surgeon general, Richard Carmona, expired last summer, and Bush nominated Holsinger in May. Some lawmakers and gay and lesbian advocacy groups have raised concern about his position on gay-rights issues (Kaiser Daily Health Policy Report, 6/11).
Sen. Edward Kennedy (D-Mass.) -- chair of the Senate Health, Education, Labor and Pensions Committee, which will hold a confirmation hearing for Holsinger on Thursday -- said he is "disappointed" with Bush's nomination because Holsinger is "an individual whose record appears to guarantee a polarizing and divisive nomination process." According to the Times, there "appears to be little overt support" for Holsinger among the HELP committee's 21 members (Washington Times, 7/9).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Tom McCluskey, vice president for government affairs at FRC, said that Holsinger at a Kentucky Legislature committee hearing in 2002 "testified in support of loosening regulations around cloning and embryonic stem cell research." He added that FRC is "not supportive of [Holsinger's] nomination right now" because "the surgeon general is such a strong bully pulpit position that we want to be sure" of his stance.
White House spokesperson Emily Lawrimore said that Holsinger's 2002 testimony against the ban on cloning was because "he felt that the penalties proposed in the bill were disproportionately severe on patients and researchers." She added that "[s]ince 2002, there have been significant advances in new techniques for potentially deriving pluripotent stem cells without cloning or destroying embryos. As such, Dr. Holsinger believes the president's cloning policy is appropriate" (Ward, Washington Times, 7/9).
Federal funding for embryonic stem cell research currently is allowed only for research using embryonic stem cell lines created on or before Aug. 9, 2001, under a policy announced by Bush on that date (Kaiser Daily Women's Health Policy Report, 6/20). According to Lawrimore, Holsinger would not help formulate stem cell or cloning policy. Holsinger's "main focus will be childhood obesity, so he will not be involved in determining policy related to stem cell research," Lawrimore said (Washington Times, 7/9).
Holsinger has served as secretary of the Kentucky Cabinet for Health and Family Services and as chancellor of the University of Kentucky Chandler Medical Center. He also had a 26-year career with the Department of Veterans Affairs and served for more than 30 years in the Army Reserve. The term of the previous surgeon general, Richard Carmona, expired last summer, and Bush nominated Holsinger in May. Some lawmakers and gay and lesbian advocacy groups have raised concern about his position on gay-rights issues (Kaiser Daily Health Policy Report, 6/11).
Sen. Edward Kennedy (D-Mass.) -- chair of the Senate Health, Education, Labor and Pensions Committee, which will hold a confirmation hearing for Holsinger on Thursday -- said he is "disappointed" with Bush's nomination because Holsinger is "an individual whose record appears to guarantee a polarizing and divisive nomination process." According to the Times, there "appears to be little overt support" for Holsinger among the HELP committee's 21 members (Washington Times, 7/9).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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