The Joint Commission, which accredits hospitals, this spring will begin requiring hospitals to report all elective deliveries to a public database. Hospitals will also have to report gestational age at induction and c-sections for first-time births, which can be linked with failed inductions. "We believe this will be a very important driver of improvement in prenatal care," Mark Chassin, the organization's president, said (Neergaard, AP/Google News, 10/27).
Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2009 The Advisory Board Company. All rights reserved.
суббота, 26 ноября 2011 г.
Hospitals Tighten Rules For Elective Inductions, C-Sections Ahead Of New Joint Commission Reporting Requirements
In anticipation of new quality reporting requirements that will take effect in the spring, some hospitals are tightening rules for elective inductions and caesarean sections, the AP/Google News reports. National guidelines from the American College of Obstetricians and Gynecologists discourage elective deliveries prior to 39 weeks' gestation, but many physicians and hospitals allow inductions and scheduled c-sections at 37 weeks, according to the AP/Google News. According to the Centers for Disease Control and Prevention, one in five pregnancies is induced, double the rate in 1990. There is little data on the percentage of inductions that are elective, though a Hospital Corporation of America study of nearly 18,000 births at its 27 hospitals placed the figure at 10% of all births before 39 weeks. Recent research shows that infants born prior to 39 weeks face a higher risk of breathing disorders and other problems than those who remain in the womb longer.
суббота, 19 ноября 2011 г.
Novo Nordisk Launches Vagifem(R) 10??g , The Lowest Dose Of Local Oestrogen Available For Post-Menopausal Women With Vaginal Atrophy
Almost half (45%) of post-menopausal women suffer or have suffered from vaginal atrophy,
manifested as vaginal discomfort, increased tendency of infection, and pain during sexual
intercourse1. But only a fraction actually receives the most appropriate treatment for the
underlying cause - oestrogen deficiency. One reason is concern about the risk of excessive
oestrogen exposure. With most recent treatment guidelines there is a move towards
advocating the use of lower dose oestrogens to treat vaginal atrophy2.
This trend has led to a new product being introduced by Novo Nordisk. The company, which
markets a 25??g oestrogen vaginal tablet, has just launched the first ultra low dose local
oestrogen - it contains just 10??g of oestrogen. This helps meet the changing needs of patients
and healthcare professionals for products that limit oestrogen exposure but still provide
symptom relief. Clinical data demonstrates that the 10??g product relieves symptoms3, yet
notably, circulating oestrogen remains within normal post-menopausal levels4.
Esben Bruun Mortensen, Director of Biopharm, Novo Nordisk Limited, commented on the
launch, saying 'vaginal atrophy is a big issue for women, affecting around 40% of them at any
one time. It has negative consequences for sexual intimacy and self-esteem. Some women
mistakenly attribute symptoms to other conditions such as thrush or bladder infections, and
use treatments such as lubricants and moisturisers in an attempt to help them cope with their
symptoms. This fails to treat the underlying cause. Others are reluctant to take an oral
hormone replacement therapy (HRT) or patch because of concerns about excessive oestrogen
exposure. The arrival of the first ultra low dose 10??g local oestrogen provides a step forward
for patients and healthcare professionals. It provides effective local oestrogen replacement
directly into the vagina, whilst minimising oestrogen exposure, in line with the latest expert
guidelines'.
Notes:
Vaginal atrophy
Vaginal atrophy (VA) sometimes known as 'Atrophic vaginitis', is the thinning and inflammation
of the vaginal walls due to a decline in oestrogen caused by the menopause. Symptoms
include vaginal dryness, vaginal discomfort due to inflammation, itching, increased tendency of
infection and pain during sexual intercourse.
Development of Vagifem® 10??g
Vagifem® 10??g was approved by the European Member States on 18 January 2010. Its
approval was based on a randomised, placebo-controlled 52-week multicentre trial,3 which
found statistically significant improvements in VA symptoms with the 10??g preparation versus
placebo, including:
- Vaginal Maturation Index and Value, starting from wk 2 (p
manifested as vaginal discomfort, increased tendency of infection, and pain during sexual
intercourse1. But only a fraction actually receives the most appropriate treatment for the
underlying cause - oestrogen deficiency. One reason is concern about the risk of excessive
oestrogen exposure. With most recent treatment guidelines there is a move towards
advocating the use of lower dose oestrogens to treat vaginal atrophy2.
This trend has led to a new product being introduced by Novo Nordisk. The company, which
markets a 25??g oestrogen vaginal tablet, has just launched the first ultra low dose local
oestrogen - it contains just 10??g of oestrogen. This helps meet the changing needs of patients
and healthcare professionals for products that limit oestrogen exposure but still provide
symptom relief. Clinical data demonstrates that the 10??g product relieves symptoms3, yet
notably, circulating oestrogen remains within normal post-menopausal levels4.
Esben Bruun Mortensen, Director of Biopharm, Novo Nordisk Limited, commented on the
launch, saying 'vaginal atrophy is a big issue for women, affecting around 40% of them at any
one time. It has negative consequences for sexual intimacy and self-esteem. Some women
mistakenly attribute symptoms to other conditions such as thrush or bladder infections, and
use treatments such as lubricants and moisturisers in an attempt to help them cope with their
symptoms. This fails to treat the underlying cause. Others are reluctant to take an oral
hormone replacement therapy (HRT) or patch because of concerns about excessive oestrogen
exposure. The arrival of the first ultra low dose 10??g local oestrogen provides a step forward
for patients and healthcare professionals. It provides effective local oestrogen replacement
directly into the vagina, whilst minimising oestrogen exposure, in line with the latest expert
guidelines'.
Notes:
Vaginal atrophy
Vaginal atrophy (VA) sometimes known as 'Atrophic vaginitis', is the thinning and inflammation
of the vaginal walls due to a decline in oestrogen caused by the menopause. Symptoms
include vaginal dryness, vaginal discomfort due to inflammation, itching, increased tendency of
infection and pain during sexual intercourse.
Development of Vagifem® 10??g
Vagifem® 10??g was approved by the European Member States on 18 January 2010. Its
approval was based on a randomised, placebo-controlled 52-week multicentre trial,3 which
found statistically significant improvements in VA symptoms with the 10??g preparation versus
placebo, including:
- Vaginal Maturation Index and Value, starting from wk 2 (p
суббота, 12 ноября 2011 г.
Lack Of Information Fuels Cancer Screening Fears According To Review Covering Nearly 6,000 Women
Fear plays a major role in whether women decide to go for cancer screening or not, but healthcare providers underestimate how much women need to know and wrongly assume that they will ask for information if they want it.
Those are the two key findings from a study published in the June issue of the UK-based Journal of Advanced Nursing.
US researchers Dr Kelly Ackerson and Dr Stephanie Preston reviewed 19 studies that between them explored the attitudes of 5,991 women to breast and cervical cancer screening. The studies, which covered the period 1994 to 2008, included women of all ages, from 14 year-old teenagers to women in their eighties.
"Our review showed that fear could motivate women to either seek screening or to avoid screening" says nurse researcher Dr Ackerson, an Assistant Professor at Western Michigan University, USA.
"Some women complied because they feared the disease and saw screening as routine care, but other women feared medical examinations, healthcare providers, tests and procedures and didn't seek screening if their health was good.
"Lack of information was a big barrier. It was clear from our review that very few women understood that cervical smear testing aims to identify abnormal cells before they become malignant and that breast screening can detect cancer in the early stages when treatment is most effective.
"The review also highlighted that many women had misconceptions about breast and cervical cancer and who was at risk. For example, some women felt they did not need breast or cervical screening after a certain age and some believed that they could not develop cervical cancer if they weren't in a current sexual relationship.
"Women who did not have a family history of cancer were also less likely to think they were at risk. Because there has been a lot of publicity about the role that family history can play in breast cancer, many women assumed wrongly that the same family patterns can apply to cervical cancer."
Figures from the USA and UK show that there is a big gap between the number of women invited for screening and the number who actually attend.
In 2007 the Centers for Disease Control and Prevention in America estimated that 25 per cent of women aged 40 plus had not had breast screening in the last two years and 16 per cent aged 18 and over had not had a cervical smear in the last three years.
Cancer Research UK figures for the same year suggest that 4.4 million women were invited for cervical smears but only 3.6 million (82 per cent) attended.
Breast cancer rates are similar in both countries, despite differently funded healthcare systems and screening criteria, but a lower percentage of UK women die from cervical cancer.
The researchers have come up with three key recommendations as a result of their review:
Nurses should promote screening by educating women of the benefits of breast and cervical screening even when they do not ask for information.
Initiatives aimed at increasing uptake rates should focus on women's fears about the procedure or a possible positive result.
Public health messages need to specifically target women who do have access to healthcare but fail to undergo routine testing.
"Nurses have a key role to play in addressing the fears and lack of knowledge that women have when it comes to screening for breast and cervical cancer" concludes Dr Ackerson.
"They need to help women understand both the risks and benefits of screening so that they can make informed choices about whether or not they want to be tested."
Notes:
A decision theory perspective on why women do or do not decide to have cancer screening: systematic review. Ackerson K and Preston S. Journal of Advanced Nursing. 65.6, 1130-1140. (June 2009).
Source:
Annette Whibley
Wiley-Blackwell
Those are the two key findings from a study published in the June issue of the UK-based Journal of Advanced Nursing.
US researchers Dr Kelly Ackerson and Dr Stephanie Preston reviewed 19 studies that between them explored the attitudes of 5,991 women to breast and cervical cancer screening. The studies, which covered the period 1994 to 2008, included women of all ages, from 14 year-old teenagers to women in their eighties.
"Our review showed that fear could motivate women to either seek screening or to avoid screening" says nurse researcher Dr Ackerson, an Assistant Professor at Western Michigan University, USA.
"Some women complied because they feared the disease and saw screening as routine care, but other women feared medical examinations, healthcare providers, tests and procedures and didn't seek screening if their health was good.
"Lack of information was a big barrier. It was clear from our review that very few women understood that cervical smear testing aims to identify abnormal cells before they become malignant and that breast screening can detect cancer in the early stages when treatment is most effective.
"The review also highlighted that many women had misconceptions about breast and cervical cancer and who was at risk. For example, some women felt they did not need breast or cervical screening after a certain age and some believed that they could not develop cervical cancer if they weren't in a current sexual relationship.
"Women who did not have a family history of cancer were also less likely to think they were at risk. Because there has been a lot of publicity about the role that family history can play in breast cancer, many women assumed wrongly that the same family patterns can apply to cervical cancer."
Figures from the USA and UK show that there is a big gap between the number of women invited for screening and the number who actually attend.
In 2007 the Centers for Disease Control and Prevention in America estimated that 25 per cent of women aged 40 plus had not had breast screening in the last two years and 16 per cent aged 18 and over had not had a cervical smear in the last three years.
Cancer Research UK figures for the same year suggest that 4.4 million women were invited for cervical smears but only 3.6 million (82 per cent) attended.
Breast cancer rates are similar in both countries, despite differently funded healthcare systems and screening criteria, but a lower percentage of UK women die from cervical cancer.
The researchers have come up with three key recommendations as a result of their review:
Nurses should promote screening by educating women of the benefits of breast and cervical screening even when they do not ask for information.
Initiatives aimed at increasing uptake rates should focus on women's fears about the procedure or a possible positive result.
Public health messages need to specifically target women who do have access to healthcare but fail to undergo routine testing.
"Nurses have a key role to play in addressing the fears and lack of knowledge that women have when it comes to screening for breast and cervical cancer" concludes Dr Ackerson.
"They need to help women understand both the risks and benefits of screening so that they can make informed choices about whether or not they want to be tested."
Notes:
A decision theory perspective on why women do or do not decide to have cancer screening: systematic review. Ackerson K and Preston S. Journal of Advanced Nursing. 65.6, 1130-1140. (June 2009).
Source:
Annette Whibley
Wiley-Blackwell
суббота, 5 ноября 2011 г.
Indian Government Drops Requirement For Female Government Workers To Disclose Information About Menstrual Cycle, Maternity Leave
The Indian government on Thursday announced that it has removed questions about female workers' menstrual cycles and maternity leaves from government appraisal forms due to "the sensitivity of the issue," an unnamed official from the Ministry for Personnel, Public Grievances and Pensions said, AFP/Yahoo! News reports. The new appraisal forms, which were introduced in March, required women to disclose details about their menstrual history, most recent maternity leave, Pap tests and mammograms (AFP/Yahoo! News, 4/12). According to the AP/Raleigh News & Observer, all civil servants in the country undergo routine health screenings, but the results are not supposed to go in appraisals. Seema Vyas, joint secretary for general administration in the Indian state Maharashtra, said the new rule was "insensitive" (AP/Raleigh News & Observer, 4/12). Satyanand Mishra, head of the personnel department, said the questions in the All-India Services Performance Appraisal Rules 2007 were based on advice from the Ministry of Health and Family Welfare (Ghoge, Hindustan Times, 4/11). K. Ramchandran, a spokesperson for the health ministry, said a committee had developed the rule. Nearly 10% of India's 4,000 federal government workers are women, the AP/News & Observer reports (AP/Raleigh News & Observer, 4/12). The unnamed official said that a new "notification deleting those female-specific clauses will be issued shortly" (AFP/Yahoo! News, 4/12).
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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