Archive for February, 2008

February 29, 2008

Double Dose: Hormone Therapy Affects Mammogram Results; UN Meetings on Status of Women; African Lesbians Demand End to Criminalization of Homosexuality; A Dose of “Slow Medicine”

Planned Parenthood Stands to Lose State Funding: “The Virginia Senate voted Wednesday to cut off state funding to Planned Parenthood of Virginia because it offers abortions, an action that could endanger hundreds of thousands of dollars in state aid for women’s health-care program,” reports the Washington Post.

“The irony is, Planned Parenthood probably prevents more abortions than any other organization in the country,” said Sen. Janet D. Howell (D-Fairfax).

Online Rally for Paid Sick Days: Join in at EveryoneGetsSick.org a project of the National Partnership for Women & Families and the Healthy Families Act Coalition.

EveryoneGetsSick.org supports the Healthy Families Act, proposed federal legislation that would guarantee workers up to seven paid sick days per year to recover from an illness or care for a sick family member. (Radical stuff, eh?) Via Half-Changed World, which has more good links.

Hormone Therapy Impedes Cancer Tests: “Women who take hormones to ease the symptoms of menopause are more likely to have abnormal mammogram results – and, therefore, more breast biopsies – than women who don’t take the therapy, researchers found,” reports the San Francisco Chronicle, which also notes that “the tools used to diagnose breast cancer are less likely to catch malignant tumors in women taking hormone replacement therapy, despite the fact that they have a slightly increased risk of cancer.”

The findings were published in the Archives of Internal Medicine.

The Wrong Target: “Society (and thus law enforcement) needs to view any adult who sexually exploits a child as a villain, and the exploited child as a victim of that villainy,” writes New York Times columnist Bob Herbert. “If a 35-year-old pimp puts a 16-year-old girl on the street and a 30-year-old john pays to have sex with her, how is it reasonable that the girl is most often the point in that triangle that is targeted by law enforcement?”

Mark the Calendar: March is Women’s History Month and March 8 is International Women’s Day. And Feminist Peace Network is the go-site for information and events related to both.

UN Meetings on Status of Women: The 52nd Session of the Commission on the Status of Women is meeting in New York from Feb. 25 – March 7. Here’s a look at all the panels (PDF).

Zohra Moosa and Jane Gabriel are live blogging the sessions. Check out their reports at Open Democracy. Developments will also be posted at PeaceWomen, the website for the Women’s International League for Peace and Freedom.

Plus: “[N]ot one presidential candidate has chosen to highlight the profound threat that gender inequality is posing to the development, economic stability and future peace of our world,” writes Kavita Nandini Ramdas, president and CEO of the Global Fund for Women, in The Nation.

Africa’s Lesbians Demand Change: BBC News reports on efforts by the Coalition of African Lesbians to highlight discrimination across Africa and to get governments to stop treating homosexuality as a criminal offense. The Coalition organized a conference in Maputo, the capital of Mozambique, that was attended by 75 activists. According to the International Gay and Lesbian Association, homosexuality is outlawed in 38 African countries and is legal (or unmentioned in the statute book) in at least 13.

Postpartum Depression: A University of Iowa survey of 4,332 new mothers from four Iowa counties found that 40 percent of Iowa mothers with a household income less than $20,000 suffered from clinically significant postpartum depression. In contrast, only 13 percent of new mothers with a household income of $80,000 or more were considered clinically depressed, according to this release.

A second UI study on race and postpartum emotions found that African-American mothers are more likely than white mothers to experience depressed moods immediately after giving birth, while Latina mothers are less likely to experience depressed moods. The study’s authors are now working to help mothers suffering from postpartum depression by teaching caseworkers and nurses how to screen for depression and by implementing a new intervention program involving “listening visits.”

A Dose of Slow Medicine: “For the very elderly … most agree the usual tough love of modern medicine in all its hospital-based, medication-obsessed, high-tech impersonality may hurt more than it helps,” writes Abigail Zuber, M.D., in this look at “slow medicine” — described as “a family-centered, less expensive” alternative to modern, impersonal treatments — and review of the new book “My Mother, Your Mother: Embracing ‘Slow Medicine,’ the Compassionate Approach to Caring for Your Aging Loved Ones,” by Dennis McCullough, M.D.


February 27, 2008

Remembering Barbara Seaman

Barbara Seaman

We at OBOS are saddened to report that Barbara Seaman, co-founder of the National Women’s Health Network, noted feminist, women’s health activist, and author, died this morning. Seaman’s life and work leave much to be celebrated, as she was a tireless advocate for informed consent and exposing information on hormonal medications, including publication of the breakthrough 1969 book “The Doctors’ Case against the Pill,” which led to Congressional hearings on oral contraception and ultimately to the first safety warning on the drug.

Born in 1935 and an Oberlin College graduate and Sloan-Rockefeller Science Writing Fellowship winner at the Columbia University School of Journalism, Seaman authored and contributed to numerous additional works on women’s health topics during her career, including “The Greatest Experiment Ever Performed on Women: Exploding the Estrogen Myth,” “For Women Only!: Your Guide to Health Empowerment,” and “Women and the Crisis in Sex Hormones.” Seaman also edited a collection of essays by major figures from feminism and women’s health, “Body Politic: Dispatches from the Women’s Health Revolution.”

Gloria Steinem has high praise for Seaman, stating, “There is no single person on earth who has done more to advance women’s health, to make an intimate difference in millions of women’s lives, and to inform consumers so they can transform healthcare.”

OBOS’s own Judy Norsigian has also recognized Seaman’s impressive contributions: “Barbara has been a steady beacon and truth-teller in the women’s health movement for almost half a century. I consider myself so lucky to be among the hundreds of students and activists she has supported and guided over the years. She has helped Our Bodies Ourselves at so many critical junctures with both practical and philosophical issues, including her successful efforts to find a publisher — Seven Stories Press — for the 2000 edition of ‘Nuestros Cuerpos, Nuestras Vidas.’ ”

Profiles and Remembrances:

Update: Norma Swenson, one of the founders of Our Bodies Ourselves, has written a tribute to Barbara that we’ve posted at the OBOS website.


February 26, 2008

Our Bodies Ourselves: Pregnancy and Birth

cover of Our Bodies, Ourselves: Pregnancy and Birth

Announcing “It’s a BOOK!” doesn’t have the same ring as “It’s a girl!” or “It’s a boy!”

But we here at Our Bodies Ourselves are bursting with the pride of new parents. After a two-year gestation involving the work of many doctors, doulas, midwives, birth activists, nurses, educators and, of course, mothers, “Our Bodies, Ourselves: Pregnancy and Birth” has arrived.

The new book addresses the questions and needs of women during pregnancy, childbirth and the “fourth trimester” — early motherhood. Topics include: choosing a provider and birth setting; making decisions about prenatal testing; arranging for continuous labor support; exploring options for pain relief; recovering from birth; and adjusting to life as a new mother.

“Our Bodies, Ourselves: Pregnancy and Birth” also provides an overview of U.S. maternity care practices and examines why some aspects of the care most women receive are not based on the most reliable research on what is safe and effective.

Check out the hot advance praise from other authors and educators. The first review, from Library Journal Reviews, calls it “a superlative guide” and says, “The information goes beyond the usual pregnancy self-help material by placing childbearing and parenting within a psychosocial and political context …”

At the OBOS website you’ll find excerpts from the book plus additional online content and recommended links. There’s also information about parenting and information on childbearing loss.

In this Q&A, OBOS Executive Director Judy Norsigian answers questions about the state of pregnancy and childbirth today and explains why this book is needed:

This book challenges the status quo of maternity care when it is not serving the best interests of women, babies, and families. We present the best available evidence about the advantages and disadvantages of a range of practices, from epidurals to episiotomies. And we include the important warning that some common procedures are not consistently helpful to women in good health and might be better avoided in some cases, while other practices that have been shown to improve birth outcomes are not offered widely.

Over the next few months, Judy and other book contributors will attend book readings, signings, discussions and other events. The OBOS calendar lists the many cities on the book tour so far. Yours truly will join Judy in April at Women & Children First in Chicago.

Those of you in the Boston area can celebrate with OBOS this week:

Wednesday, Feb. 27: OBOS Executive Director Judy Norsigian will host “Being Born in Massachusetts: Pushing for More Midwives,” a panel discussion on maternity care discussion policies at Suffolk University. Film clips from classic and recent films will be shown before the discussion. More info (PDF)

Thursday, Feb. 28: Join the book’s editors and contributors, and the OBOS board of directors and staff for a book release party at Harvard Vanguard Medical Associates at Kenmore Square. More info


February 25, 2008

Conference Evaluates Microbicides for HIV Prevention

Microbicides 2008, an international conference to discuss current research on microbicides, is happening this week in New Delhi, India. Microbicides are a hot topic in global HIV/AIDS prevention research, as they represent a woman-controlled, non-barrier method that do not require a partner’s cooperation.

An early report from the conference notes that tenofovir gel, a vaginal microbicide that incorporates an antiretroviral drug (such as those used in HIV treatment), has passed safety trials for daily use. The next step in research will be to study whether this gel is effective in reducing HIV infection. Another release from the conference provides preliminary safety findings on a rectal microbicide using an investigational drug.

One recent setback in microbicide research was the three-year Carraguard trial, which demonstrated the safety of the seaweed-derived product, but found that it did not significantly reduce HIV infection risk. However, it’s not unusual for drug research to suffer many disappointing trials before hitting on a product that truly works. The Population Council’s Peter Donaldson noted, “The trial has contributed significantly to the field’s body of knowledge regarding product development, trial design, and women’s and their partners’ willingness to use a vaginal gel consistently.”

Related information:


February 25, 2008

Legal Momentum Hosts Panel Discussion on Sex Ed

The Rayburn House Office Building on Tuesday will play host to sex, lies and stereotypes. And no one will get in trouble for it.

But there will be plenty of talk about the trouble with abstinence-only programs and the harm they cause to women and girls in particular. “Sex, Lies & Stereotypes” (PDF) is the name of a new report produced by Legal Momentum and the title of Tuesday’s panel discussion.

Based on recommendations arising from a September 2006 roundtable at Harvard Law School, the report argues for the need to limit federal funding for inaccurate and biased abstinence-only programs, both in both the United States and abroad. (Ann has excerpts here.)

Legal Momentum’s Julie Kay, author of the report, will discuss legislative priorities concerning sex-education programs. Also appearing are Jamila Taylor of the Center for Health and Gender Equity (CHANGE) and Jen Heitel Yakush of the Sexuality Information and Education Council of the United States (SIECUS). The honorary co-chair is Rep. Henry Waxman.


February 24, 2008

Double Dose: BCA Blasts Approval of Avastin; Short Maternity Leave for Women in the Military; Do Cellphones Affect Male Fertility?; More on Migraines; Debating “Juno”

Score One for the Patient: A breast cancer patient whose medical coverage was canceled by her insurer was awarded more than $9 million from her for-profit insurer, Health Net Inc., reports the L.A. Times. “The award issued by an arbitration judge was the first of its kind and prompted Health Net to announce it was scrapping its cancellation practices that are under fire from state regulators, patients and the Los Angeles city attorney.”

BCA Blasts Approval of Avastin: In a surprise move, the FDA approved the use of Avastin as a treatment for breast cancer. “The big question was whether it was enough for a drug temporarily to stop cancer from worsening — as Avastin had done in a clinical trial — or was it necessary for a drug to enable patients to live longer, which Avastin had failed to do. Oncologists and patient advocates were divided, in part because of the drug’s sometimes severe side effects,” writes Andrew Pollack.

“In the end, the agency found a compromise of sorts. It gave Avastin ‘accelerated’ approval, which allows drugs for life-threatening diseases to reach the market on the basis of less than ideal data, subject to further study.”

Breast Cancer Action blasted the decision. “The FDA has lowered the bar on the approval of breast cancer therapies. At a time when many questions are being raised about how the FDA approves drugs for market, today’s decision is a victory for drug companies, but not for patients,” BCA Executive Director Barbara A. Brenner said a statement posted at Prescription Access Legislation.

Short Maternity Leaves, Long Deployments: The Washington Post reports on the difficulty women in the military face if they want to have children and keep their jobs. Ann Scott Tyson writes:

The wars in Iraq and Afghanistan have placed severe strains on the Army, including longer deployments in which soldiers serve 15 months in the war zone, followed by 12 months at home. Under that system, a woman who wishes to have a child and remain with her unit must conceive soon after returning home so she can give birth, recover and prepare for her next overseas tour.

Female soldiers interviewed over the past year say the tight schedule cuts short precious time for mother and infant to bond and breast-feed, forcing women to choose between their loyalty to their comrades — as well as their careers — and nurturing their families.

Vaccinating Boys for Girls’ Sake?: The New York Times looks at efforts to convince parents to vaccinate boys to prevent the spread of human papillomavirus, or HPV, which can lead to cervical cancer. HPV also causes anal and penile cancers, but these are much more rare. (Read our previous coverage of the HPV vaccine Gardasil here.)

One woman tells the NYT, “You don’t want to say it’s just the girls’ problem … But my sons won’t contract cervical cancer. And genital warts are treatable. I’m very skeptical. What risks will I expose them to?”

Another woman comments, “If there was a vaccine I could take that would get rid of prostate cancer, why wouldn’t I? … If there was a vaccine that sons could get that would get rid of breast cancer, most parents wouldn’t hesitate. But cervical cancer is the ‘sex cancer.’”

Do Cellphones Affect Male Fertility?: Some studies suggest as much, but the data is limited, writes Tara Parker-Pope, adding, “There are some global concerns about declining male fertility in industrialized countries, but issues like pollutants, exposure to chemicals and smoking are likely far more worrisome culprits than cellphones.”

The Studies Surrounding DHEA: The L.A. Times “Healthy Skeptic” column looks at the anti-aging claims of DHEA and finds it’s no fountain of youth.

More on Migraines (and Music): I’ve mentioned the group blog on migraines at The New York Times — be sure to check out Paula Kamen’s latest post on leaving the rabbit hole. Kamen, who suffers from chronic daily headaches, also appeared last week on WBUR’s “The Point”.

Jeff Tweedy hasn’t weighed in yet, but I did see Wilco Tuesday and Wednesday (braving cold and limited views) during the band’s five-night run in Chicago. Yeah, OK, that had nothing to do with women’s health, but I had to boast somewhere.

Debating “Juno”: Will “Juno” win best picture? Stay tuned. In the meantime, young birth mothers discuss what they liked and didn’t like about the film’s portrayal of adoption.


February 22, 2008

V-Bombs and Sex-Ed Fights: Vaginas in the News

“School Newspaper Drops a V-Bomb” reads the headline of this L.A. Times story about the confiscation of a high school student newspaper that featured a labeled diagram of a vagina on the front page of the Valentine’s Day issue.

The paper’s editor-in-chief, 15-year-old Richard Edmond, said he was trying to raise awareness of violence against women with a lead story about playwright Eve Ensler’s “Vagina Monologues.”

“I didn’t think it was going to be that big a deal,” Edmond said. “But they are really upset.”

Edmond said administrators did not explain to his satisfaction why this copy of Le Sabre was unfit for distribution. He said he was told by administrators: “This is not in the taste of the school; this is a high school, not Hollywood Boulevard.”

That didn’t jive so well with the students. The next day, Edmond and others went to school wearing homemade white, black and pink T-shirts reading “My vagina is obscene.” School officials sent home Edmond and two other protesters who refused to change their clothes.

My favorite quote has to be what Edmond told the Student Press Law Center: “My deans said, ‘We understand there’s violence against women, but we have to send you home because that’s our job. I don’t think there should be a ‘but.’”

* * *
This Chicago Tribune headline, meanwhile, promises more bang than the story delivers: “Sex-Ed Fight Began with Condom and Banana.”

No mess here; rather, it’s about a New Jersey peer-to-peer sex-ed course that has drawn the ire of some parents. Indeed, the original headline to the Philadelphia Inquirer story was a more subdued “Sex Ed Led by Teens is Dividing Parents.”

The program involves faculty-supervised juniors and seniors who conduct a series of five seminars attended by freshmen. The New Jersey Teen Prevention Education Program (Teen PEP) is sponsored by the N.J. Department of Health and Senior Services, HiTOPS Inc. (Health-Interested Teens Own Program on Sexuality) and the Princeton Center for Leadership Training.

Favorite quote:

“Students listen to each other anyway,” said Alex Van Kooy, 16, a Clearview peer educator. They talk about sex “in the halls and at the bus stop, and we’re just trying to give the correct information instead of rumors and whispers.”

Echoing that point, columnist Michael Smerconish writes in a related piece that everything he needed to know about sex he learned playing street hockey.

“In those teenage years, sex came up just about everywhere,” writes Smerconish. “Playing sports. At the movies. Drinking a Frank’s soda. All over. Except home. And certainly not in any classroom.”

His column includes a number of great comments from Michael Porter, a high school English teacher who also serves as a Teen PEP adviser. Tongue in cheek, Porter says, “When I first started to hear some of the revolting things that were happening in Teen PEP workshops, I was ready to start protesting the group myself, until I remembered that I was in charge of it.”

All joking aside, Porter gets that talking about some subjects may be uncomfortable at first, but it’s far easier than dealing with a sexually transmitted disease or unplanned pregnancy.

“I am the father of a 15-year-old girl,” Porter said. “Believe me, I am terrified of the sexually saturated culture that she is surrounded by. I sincerely hope that she chooses to postpone sexual involvement for a long, long, long time. At the same time, as a second-best alternative, I want her to have the information to be safer, should she make a different choice.”


February 20, 2008

Bill Clinton Gets Riled Up About Abortion

At a campaign event in Steubenville, OH on Sunday, Bill Clinton was campaigning for Senator Clinton and was heckled by anti-choice students from the religious Franciscan University of Steubenville. Clinton responded thusly:

“We disagree with you. You want to criminalize women and their doctors and we disagree. I reduced abortion. Tell the truth! Tell the truth! If you were really pro-life, if you were really pro-life, you would want to put every doctor and every mother, as an accessory to murder, in prison, and you won’t say you wanna do that, because you know that you wouldn’t have a lick of political support. Now, the issue is, you can’t name me anybody presently in politics that did more to introduce policies that reduce the number of real abortions, instead of the hot air putting out to tear people up and make votes by dividing America. This is not your rally. I heard you.”

The video is available via YouTube.

OnTheIssues has summary information on the candidates’ positions on the topic: see pages on Clinton, Huckabee, McCain, and Obama.


February 20, 2008

Outrage Over FDA Crackdown on Biodentical Hormones? Not So Fast, says National Women’s Health Network

The Washington Post last week reported on an ad campaign protesting the FDA’s crackdown on pharmacies that manufacture and market biodentical hormones to treat symptoms of menopause. Sandra J. Boodman writes:

Last week the HOME (Hands Off My Estrogens!) Coalition, a group based in tiny Edinburg, Va., placed a full-page ad in five newspapers, including USA Today and the Wall Street Journal, accusing regulators of being hostile to “natural” hormonal medicines made according to a doctor’s prescription by a compounding pharmacy.

The ads urge women and their physicians to e-mail the White House and members of Congress asking them to protect patients’ access to medications they claim are “bio-identical” to those found in the body.

Hold the outrage. There is no scientific evidence that bioidentical hormones are safer than conventional hormone therapy drugs — and marketing claims that such drugs can restore youth and prevent or treat serious conditions such as cancer have long irked many in the medical community. As the Post story notes, “A key ingredient in these made-to-order drugs is estriol, a form of estrogen that the coalition claims is safe and protects against breast cancer — but that the FDA says is unapproved.”

Last month, the FDA sent letters to seven pharmacy operations that compound biodentical hormones, warning them that their claims about the safety and effectiveness of bioidentical hormone replacement therapy “are unsupported by medical evidence, and are considered false and misleading.”

While this upset the HOME Coalition, the National Women’s Health Network, along with physician groups such as the Endocrine Society, applauded the enforcement. The NWHN has long been concerned about the oversight of natural hormones — here’s a handy fact sheet on the subject — and two years ago the NWHN petitioned the FDA to stop companies from marketing estrogen-and-testosterone combination pills.

Marian Sadler of the NWHN critiques the Home ad over at Prescription Access Legislation. Sadler writes that the ad attempts to “make you feel that the HOME Coalition is looking out for women’s health and women’s rights, defending natural care from hostile attacks by drug companies and the FDA, and ‘speaking the truth,’” but it’s basically just a sales pitch for natural hormones. She continues:

Like hormones that are synthesized in a lab and sold by drug companies, natural hormones are powerful chemicals that affect many parts of the body. It is very important to understand that products are not necessarily safe just because they’re natural. The same questions we ask about drugs need to be answered for alternative therapies too.

Just as pharmaceutical companies promote drugs, there is a large industry that produces and sells alternative health care products. Whether they are recommended by a doctor, a nurse practitioner, a naturopath or the cashier at the health food store, women should be skeptical of products that claim they will extend life, reverse aging, restore youth or prevent disease without causing any adverse effects.

Plus: The “Our Bodies Ourselves: Menopause” features a section specifically on “Natural Products: Phytoestrogens and Bioidentical Hormones.”


February 18, 2008

More Findings on Healthcare Disparities

Several recently published studies have noted that racial disparities persist in healthcare, and have specifically looked at the divide in cancer diagnosis and care.

As noted in today’s New York Times, a study is being published in the journal Lancet Oncology that reportedly finds that “the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in late stages, often diminishing their chances of survival,” and that “blacks had a higher risk of late diagnosis, even after accounting for their disproportionately high rates of being uninsured and underinsured.” This study is not yet available to me via my subscription, but may be worth a read.

Another study published in the journal Cancer examines racial disparities in cancer therapy, attempting to determine whether racial gaps in care have narrowed from 1992 to 2002 in elderly adults with colorectal, breast, lung, or prostate cancer. The authors report that black patients were significantly less likely than white patients to receive radiation after lumpectomy, resection for lung cancer, adjuvant therapy for colon and rectal cancers, and definitive therapy for prostate cancer. Interestingly, there was no disparity found for adjuvant chemotherapy in breast cancer patients. Black patients were also significantly more likely to have Medicare coverage and to have had no visits to a physician prior to their cancer diagnosis. In general, there was no notable decrease in disparities over the 10-year period.

A third study, also in Cancer, looks at racial differences in cervical cancer survival in the Detroit area. The authors found that black women were more likely to be older at diagnosis, to be diagnosed at a later stage of disease, to have larger tumors, and to live in neighborhoods classified as “working poor” than white women. The authors conclude that race by itself does not have an impact on survival, but that the lower cervical cancer survival rate of black women may be due to socioeconomic factors that affect access to care.

Relatedly, the Agency for Healthcare Research and Quality publishes reports on the state of disparities in healthcare that encompass more than just black and white – the most recent, from 2006, is available here.


February 17, 2008

Double Dose: Finding the Fun in Big Pharma; MacGyver Meets Dr. Ruth; Sex, Lies & Stereotypes: The Truth About Sex Education; Chemical Exposure in Infants

Who’s On Pharma?: Prescription Access Legislation presents a comedy classic updated for the pharmaceutical industry … Check it out. And there’s lots more worth reading on PAL’s blog.

MacGyver Meets Dr. Ruth: Once you get beyond the freaked-out expression on the female avatar, what follows is a very interesting article about the efforts of Dr. Carla Pugh, a surgeon at the Northwestern University medical school who builds low-cost models of breasts and other body parts out of everyday items to help medical students get over their squeamishness. (For the “Who Knew?” files: “Lima beans, it turns out, are excellent facsimiles for tumor tissue,” writes Richard Morgan.)

“Just because you’re smart enough to get into medical school, you’re not smart enough to outwit the social restraints we all grow up with,” Pugh told the Times. “It’s not like med school students are gifted to the degree that they can touch a stranger’s genitals and look them in the eye and have a calm conversation without feeling weird about it.”

Sex, Lies & Stereotypes: That’s the title of a new report (PDF) released by Legal Momentum. Compiled by Julie F. Kay with Ashley Jackson, the report is based on recommendations arising from an expert roundtable Kay hosted on how abstinence-only programs harm women and girls.

Plus: Here’s a column by Courtland Milloy that I’ve kept around for a while on a comprehensive sex education program in place at a Washington, D.C. high school that goes above and beyond most programs.

“While students at the public charter elementary are learning basic skills, they are also being inoculated with heavy doses of self-respect, integrity, discipline, responsibility and teamwork. That’s where you’ll find the cure,” writes Milloy. “This holistic approach to education is known as the Carrera Adolescent Pregnancy Prevention Program, which was developed in 1984 by Michael Carrera of the New York-based Children’s Aid Society. Clearly, there is more to it than the name implies, and it might well be the gold standard for sex education in public schools.”

Find out more about the Carrera Adolescent Pregnancy Prevention Program at StopTeenPregnancy.com.

Baby Care Products and Phthalate Exposure A study in the February issue of the journal Pediatrics points to baby care products as possible sources of infant phthalate exposure. Julie Deardorff has more on the study and why phthalates — chemicals found in plastics and personal care products — are a growing concern.

Plus: Check out Deardorff’s post about taking part in testing to determine her individual chemical concentration levels.

Medicine MIstakes: Here’s something worth thinking about before your next hospital visit. The first large-scale study of preventable prescription errors in community hospitals found that one in every 10 patients admitted to six Massachusetts community hospitals suffered serious and avoidable medication mistakes, reports the Boston Globe. The two nonprofit groups that conducted the study urged all hospitals in Massachusetts to install a computerized prescription ordering system.


February 15, 2008

In Their Heads: The New York Times Hosts a Blog on Migraines

As someone with a standing prescription for Maxalt, I have a particular interest in migraines. But even if you’ve never reached for an Excedrin, you’ll find the writing irresistible at The New York Times’ blog, Migraine: Perspectives on a Headache.

Whether it’s Oliver Sacks’ description of geometric hallucinations, Siri Hustvedt’s discussion of acceptance, or Paula Kamen’s summary of the rabbit hole she went down in search of a cure for her chronic daily headache (which is different than a migraine), the stories offer an engaging mix of memoir and analysis.

Future bloggers will include neurologist Klaus Podoll and, one of my favorite musicians, Jeff Tweedy, who went through rehab for a prescription to painkillers prescribed to help manage his migraines.

Plus: NPR’s Talk of the Nation on Tuesday hosted a discussion about migraines with Dr. Joel Saper, founder and director of the Michigan Head Pain and Neurological Institute.

Guests include NYT bloggers Siri Hustvedt and Paula Kamen, who notes that she is about to celebrate her 18th anniversary with her headache — the story of which is wonderfully chronicled in “All In My Head.” Journalist Neal Conan wishes Kamen a speedy divorce.


February 13, 2008

Quality of Breast Cancer Information on the Web

We’ve posted before about the problems of identifying good health information on the web, and provided some tips for doing so. A study released by the journal Cancer this week addresses this very topic, examining websites with breast cancer information that turn up among the top results in various search engines and examining them according to a set of quality criteria.

The researchers evaluated 343 websites on various breast cancer-related topics, and found varying levels of accuracy, including 41 false or misleading statements on 18 (5.2 percent) sites. Government (.gov) sites received a 100 percent accuracy rating, with organizational (.org) sites receiving a 98 percent accuracy, “Other” (such as state government and non-U.S. sites) scoring 94 percent, commercial (.com) sites scoring 93 percent, and educational (.edu) sites faring worst at 86 percent accurate.

The authors also found that the type of topic covered by the website made a difference with regards to factual accuracy. Websites covering complementary medicine were most likely to include at least one inaccurate statement, and were 15.6 times more likely to contain inaccurate information than sites not covering this topic. Websites addressing psychology, reconstruction, and risk factors were also likely to contain inaccurate information.

Unfortunately, the authors do not specify for readers which sites were most inaccurate or what the errors were, noting that this is because “online information changes rapidly, and specific webpages are likely to have changed by the time our review is published.” Inclusion of this information might have been a good public service for women seeking breast cancer information. I’m curious, for example, whether the inaccurate “risk factor” information was related to the long-debunked abortion association myth, but it’s not possible to know from the published paper.

While I don’t 100 percent agree with all of the authors’ “technical quality” criteria or their conclusions about those criteria, the bottom line remains the same. Readers ultimately need to weigh various criteria, focusing on the most important ones such as interest disclosures (especially financial concerns), authorship and credentials, sourcing, and dating, and simply be skeptical of information that doesn’t meet these criteria and doesn’t come from a reliably trusted source. The investigated breast cancer websites were judged to be fairly accurate overall, but it’s always important consider the quality of a site before relying on the information it provides.

Citation: Bernstam EV, Walji MF, Sagaram S, Sagaram D, Johnson CW, Meric-Bernstam F. Commonly cited website quality criteria are not effective at identifying inaccurate online information about breast cancer. Cancer. 2008 Feb 11; [Epub ahead of print].


February 12, 2008

Skinny Trumps Healthy

Tara Parker-Pope has the skinny on “Skinny Bitch,” the hit diet book that has surprised some readers with its strict vegan coda (the Times reported on that aspect last year) and its harsh words for readers.

Parker-Pope points to this Salon story, in which Julie Klausner raises questions about the book’s castigatory language: “This book is a PETA pamphlet in chick-lit clothing and an innovative fusion of animal rights activism with punitive dieting tactics that prey on women’s insecurities about their bodies.” Klausner continues:

The relentless bullying peppered throughout the authors’ advice accounts for much of the book’s humor, including quips like “you need to exercise, you lazy shit,” “coffee is for pussies” and “don’t be a fat pig anymore.” It was a formerly anorexic friend of mine who nailed it when she read excerpts from the book. “When you have an eating disorder,” she told me, “that’s the voice you hear in your head all the time.”

Thanks to “Skinny Bitch,” women who hate their bodies no longer need rely on their own self-loathing to stoke the flames of what seems like motivation but is actually self-flagellation — penance for the sin of being too fat. Now dieters can have the convenience of a former model (Barnouin) and a former modeling agent (Freedman) putting their transgressions in the black-and-white terms of right and wrong. “If you eat crap,” they chirp, “you are crap.”

Get ready for more in-your-face advice: The authors have signed an additional two-book deal, on top of their follow-up cookbook, “Skinny Bitch in the Kitch.”

In a NYT story earlier this year on the cookbook, Kimberly Latham, a fashion publicist in New York, acknowledges that she “would never have read ‘The Omnivore’s Dilemma.’ I’m not even sure I know what an omnivore is. But I know what a skinny bitch is, and I know I want to be one.”

Debbie Rasmussen, the publisher of Bitch magazine and a vegan herself, provides a more rational analysis: “Obviously I’m in favor of assaults on the food industry … On the other hand, the constant equating of skinny and healthy is something I have a real problem with. And replacing junk food with vegan junk food is not my idea of how to change our unhealthy food culture.”

Plus: The Christian Science Monitor looks at the rise of self-help books, including “Skinny Bitch,” that criticize the reader.


February 11, 2008

CDC Releases Info on CMV Infection in Pregnancy, Health Effects of Domestic Violence

Two items in recent issues of the CDC’s freely available Morbidity and Mortality Weekly Report are particularly relevant to women’s health.

The first addresses OB/GYNs’ knowledge of cytomegalovirus risks during pregnancy. According to the agency, cytomegalovirus (CMV) is the most common congenital infection in the United States – they estimate that 8,000 children each year suffer permanent disabilities (such as hearing and vision loss and cognitive impairment) caused by CMV.

In March of 2007, the CDC surveyed 305 selected ACOG members about their knowledge of CMV infection prevention techniques and their related practices with obstetric patients. Ninety percent of the physicians reported knowing that hand-washing reduced infection risk, and 60 percent routinely recommended handwashing to their pregnant patients, but fewer knew that avoiding sharing utensils and avoiding children’s saliva could also reduce risk. Only 44 percent of the respondents had counseled pregnant patients about avoiding CMV infection, although more than 25 percent had diagnosed a case in the past five years.

The MMWR piece also refers to a 2006 study which found only about 22 percent of women surveyed had ever heard of CMV. For more information on the infection, see the CDC’s website, American Pregnancy Association*, and the March of Dimes.

Another recent MMWR piece looks at associations between intimate partner violence, poor health, and risky behaviors. Questions on these topics were asked as part of the 2005 Behavioral Risk Factor Surveillance System survey. The researchers found that those reporting any lifetime history of intimate partner violence reported significantly higher rates of activity limitations, use of “disability equipment,” arthritis, asthma, stroke, and other conditions, and were more likely to have health risk factors such as risky sexual behavior, smoking, and heavy drinking.

The editors note that the survey has limitations and cannot explain the cause of these associations, but suggest that “clinicians should consider assessing exposure to IPV (intimate partner violence) when patients have signs or symptoms of stress or other conditions that are consistent with IPV.”

*8/8/08 update: We just discovered that the American Pregnancy Association is funded by anti-choice activists, and the information on its website is biased in places by their perspective. For more information, see Exposed: American Pregnancy Association Hides Links to CPCs.