Chinese state media on Thursday reported that women in the country have about 13 million abortions annually, the AP/Houston Chronicle reports. According to the China Daily newspaper, the actual number likely is much higher because the 13 million includes abortions performed in hospitals but not unreported procedures performed in rural clinics. Most of the abortions were among single young women who experts say know little about contraception. The paper also said that about 10 million pills for medical abortion are sold annually in the country.

China imposed strict population controls in the 1970s that prohibit most couples from having more than one child. For married women, sterilization and the use of intrauterine devices are widely promoted and subsidized. However, Chinese policies typically do not address the needs of unmarried women, even as national attitudes have become more accepting of sex outside of marriage, the AP/Chronicle reports. According to the newspaper, about 62% of the abortions were among unmarried women ages 20 to 29. The Chinese report called the number of abortions “an unfortunate situation” but did not indicate whether the procedures are increasing or decreasing from year to year. National Population and Family Planning Commission official Wu Shangchun is quoted in the report as saying that almost half of the women seeking abortion had used no form of contraception. Wu also said that reducing abortions is a national challenge that requires significant effort. Peking University professor Li Ying said that sex education in China must be improved at the university level and that Chinese parents must do more to teach children about sex (AP/Houston Chronicle, 7/30).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens 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.

A federal vaccine advisory panel scheduled to meet Wednesday likely will recommend that pregnant women be among the first groups to receive the H1N1 influenza vaccine if a limited number of doses are available, the AP/Atlanta JournalConstitution reports. The Centers for Disease Control and Prevention usually accepts the recommendations of the panel, called the Advisory Committee on Immunization Practices. According to the AP/JournalConstitution, health care workers are expected to be the No. 1 priority for receiving the vaccine.

For more than 10 years, the panel has recommended that pregnant women get vaccinated for seasonal flu, which can be a threat even to those who are young and healthy. CDC data show that pregnant women, who make up 1% of the U.S. population, have accounted for 6% of H1N1 flu deaths in the country since April, when the pandemic began.

British and Swiss health officials have recommended that women consider delaying pregnancies if possible. Most health officials have said that advice oversteps the available evidence, but they have agreed that pregnant women face significant risk from the H1N1 flu. A recent World Health Organization report stated that pregnant women appear to be “at increased risk for severe [H1N1] disease, potentially resulting in spontaneous abortion and/or death, especially during the second and third trimesters of pregnancy.” However, WHO has not yet recommended that pregnant women get priority vaccinations. Kevin Ault, an obstetrician at Emory University, said that pregnant women are especially vulnerable because of changes in the lungs and immune system that make it more difficult to overcome respiratory infections (Stobbe, AP/Atlanta JournalConstitution, 7/28).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens 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.

The Government of Japan will sign a new agreement with UNICEF tomorrow, making available $5.6 million (¥ 533 million or SDG 13.5 million) in support of health programmes that will benefit up to 5 million people in the coming year.

The contribution will be used to fund a number of lifesaving health activities in both north and Southern Sudan including

Provision of vaccines for routine immunization activities as well as polio and measles immunization campaigns.
Provision of solar refrigerators for vaccine storage facilities
Provision of malaria diagnosis and testing equipment and drugs
Provision of primary health centre kits containing essential drugs and medicines for 12 months
Provision of longlasting insecticidetreated bed nets to protect against malaria
Training of health workers and local vaccinators.

Announcing the contribution, His Excellency Yuichi Ishii, Ambassador of Japan to Sudan underlined the commitment of his country to fighting infectious diseases throughout Sudan.

“Improving quality of and access to basic health services is one of the priority areas for Japans assistance to Sudan. Infectious disease prevention for children is Japans major contribution to the health sector in Sudan and the Government of Japan has been supporting this programme since 2000 and will extensively support the continued efforts by UNICEF and the Government of the Sudan in preventing infectious diseases in Sudan,” Ambassador Ishii said.

Mr. Kenichi Shishido, Resident Representative of Japan International Cooperation Agency (JICA) Sudan Office, commented that “In 2008 JICA started a Mother Nile Project, a threeyear project of $2.5 million, focusing on the empowerment of village midwives (VMWs) in Sennar State. This unique project supports the “One Village One VMW” policy of the Federal Ministry of Health, in the areas of policymaking training and management of maternity health services.”

Acknowledging the importance of Japans continued support to health programmes in Sudan, acting UNICEF Representative Per Engebak said “This contribution is another tangible demonstration of Japans commitment to tackling preventable diseases in Sudan, and to give children the best chance of a healthy start to life.”

“While we have seen notable reductions in the incidence of infectious diseases in Sudan for example in Southern Sudan, the number of measles cases fell from 671 in 2007 to 383 in 2008 the reemergence of polio in the last two years has reminded us that we cannot afford to relax in the fight against infectious diseases,” he added.

Sudan has recorded significant progress in protecting childrens health since prior to the signing of the Comprehensive Peace Agreement; underfive mortality rates in Sudan fell from 156 deaths per 1,000 live births prior to 2005 to 112 according to the 2006 Sudan Household Health Survey.

However, to reach the Millennium Development Goal target of an underfive mortality rate of 62 deaths per 1,000 live births, continued efforts to improve child survival and development are required.

In 2008, UNICEF and its partners including the Government of National Unity, the Government of Southern Sudan and the World Health Organization took further steps towards that goal through the Sudan Accelerated Child Survival Initiative and other health activities that saw almost 9 million children immunized against polio, more than 3 million immunized against measles, and 1 million children vaccinated against diphtheria, tetanus and whooping cough, while nearly 2.5 million insecticidetreated bed nets to protect against malaria were distributed to families across Sudan.

“Consolidation of peace” is one of the main pillars of Japans foreign policy to Africa. It is, therefore, a basic principle of Japans assistance to Sudan, which is a highpriority country in Africa for Japans peace building programme. Since signing of the Comprehensive Peace Agreement, the Government of Japan has been committed to accelerating consolidation of peace in Sudan and its grant assistance to Sudan since 2005 amounts to approximately $390 million.

“The current debate over government funding for abortion in the health care plan is a reminder of how we have failed poor women,” Frances Kissling writes in a Salon opinion piece. According to Kissling, the 32yearold Hyde Amendment, which prohibits federal funding for abortion services, has played a large role in denying impoverished women access to the procedure. “Restoring those funds has not been a top priority for prochoice advocates, who sadly concluded that because the public does not care about poor women and is actually hostile to poor women who have sex and become pregnant, it would be futile to put too much capital into reversing Hyde,” Kissling writes.

However, “we have an opportunity to make amends” by reversing the Hyde Amendment and restoring federal funding for abortion services, according to Kissling. “But the portents are not promising,” she writes, adding that a group of “prolife” Democrats in the House in a recent letter to House Speaker Nancy Pelosi (DCalif.) “laid down the first major antiabortion challenge to health care reform.” In addition, the Obama administration “has refused to rule out including abortion in the health care package, but President Obama is already signaling that the status quo on abortion is likely to endure,” Kissling writes.

“The longer it takes to pass a plan, the more momentum against including coverage for abortion and possibly contraception will build,” Kissling writes, adding that “there is a good chance there will be limits on government funding for abortions in the health care package, if not outright exclusion.” A compromise being considered by the House Energy and Commerce Committee would not prohibit or require private insurers offering government plans from covering abortions but would prohibit the use of federal funds to pay for them. “Whether this would result in a reduction of coverage in such plans is unclear, but it is possible,” she continues.

“The timing is critical. The need is great, and growing,” Kissling writes, adding, “If abortion services are excluded from the health care reform package, the number of women who will not be able to afford abortions is bound to rise and the number of unwanted children will increase.” Kissling concludes, “One hears over and over again that we all agree that the health care system is broken; the status quo is not acceptable. The status quo on coverage for abortion is especially unacceptable” (Kissling, Salon, 7/27).

Reprinted with kind permission from nationalpartnership.org. You can view the entire Daily Womens Health Policy Report, search the archives, or sign up for email delivery here. The Daily Womens 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.

Ovarian cancer kills approximately 15,000 women in the United States every year, and more than 140,000 women worldwide. Most deaths from ovarian cancer are caused by tumors of the serous histological type, which are rarely diagnosed before the cancer has spread.

In order to better understand the early natural history and to guide rational design of an early detection strategy for these cancers, Patrick Brown and colleagues from Stanford University developed models for the growth, progression, and detection of these cancers, in order to define what properties a biomarkerbased screening test would require in order to be clinically useful.

Funding This work was funded by the Canary Foundation and the Howard Hughes Medical Institute. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests
The authors have declared that no competing interests exist.

Citation
“The Preclinical Natural History of Serous Ovarian Cancer Defining the Target for Early Detection.”
Brown PO, Palmer C (2009)
PLoS Med 6(7) e1000114. doi10.1371/journal.pmed.1000114

People with diabetes who live in less affluent neighborhoods are more likely to experience delays in treatment for hyperglycemia, according to a study published in the August issue of Diabetes Care. However, the researchers found, neighborhood income was only one factor in determining how quickly appropriate care was received.

People who were less adherent to medication, had A1C levels (a measure of how well blood glucose is controlled over time) lower than 9 percent, who had higher prescription drug copayments and who had not been to a doctor recently were also more likely to experience delays in receiving care for sustained hyperglycemia (high blood sugar levels), the study found.

“Findings highlight that no one person or thing is to blame when care quality falls short,” the researchers concluded. “Instead, receipt of quality care results from a complex system of factors. Although the decision to intensify diabetic medication is one usually associated with physicians, to be effective, interventions targeting improvements in pharmacological management should consider a broad array of factors. These include the financial barriers patients may face, the importance of access to routine visits, and possible psychological barriers to appropriate care.”

Hyperglycemia was measured using the A1C test, which looks at average blood glucose levels over a 23 month period. A person without diabetes would measure roughly 5 percent on the A1C test. The American Diabetes Association recommends that the goal for most people with diabetes be to keep A1C levels at or below 7 percent. The higher the A1C level, the higher the risk for diabetesrelated complications. Sustained hyperglycemia greatly increases the risk for diabetesrelated complications, such as nerve damage, amputations, blindness and stroke.

The study, led by researchers at the Henry Ford Health System, Center for Health Services Research in Detroit, found that 41 percent of people with sustained hyperglycemia failed to get appropriate care within six months; 25 percent failed to get care within a year; and 11 percent failed to get appropriate care for as much as two years. Once blood glucose levels exceeded 9 percent on the A1C test, however, patients were more likely to receive treatment, the study showed.

Diabetes Care, published by the American Diabetes Association, is the leading peerreviewed journal of clinical research into one of the nations leading causes of death by disease. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure, and nontraumatic amputations.

Source

The British Psychological Society has welcomed the publication, of New Horizons, the governments new plan for the development of mental health services.

Dr John Hanna, director of the Policy Unit of the Societys Division of Clinical Psychology says

“New Horizons promises to be the National Service Framework (NSF) the next 10year plan for mental health.

“We welcome in particular its vision of fostering wellbeing rather than just treating mental ill health. We also welcome the use it makes of health economics and the developing evidence base about which treatments for mental health problems are most effective.

“That evidence base shows that applied psychology has reached a position of parity with medicine, although that is not yet reflected in service delivery. We therefore disagree with the implication that the NSF has been fully implemented, particularly the NSF Standard 1 of preserving and enhancing mental willbeing as well as preventing and detecting emergent psychological distress.

“Nevertheless, we look forward to tangible policy proposals that, alongside effective commissioning and investment, will make New Horizons vision a reality.”

The Arthritis Foundation supports health care reform, which provides universal and affordable health care for the 46 million Americans living with arthritis.

American families, both insured and uninsured, are struggling with rising health care costs and the number of uninsured is rising. Due to the nature of chronic disease, people with arthritis struggle to pay for physician visits and for the increasing costs of multiple medications and other care that is necessary to properly manage their disease.

“Arthritis is the nations most common cause of disability, though many people are not aware that it is a very serious, painful and lifealtering disease,” said Amy Melnick, chief public policy officer for the Arthritis Foundation. “The burden of medical debt excessively falls on patients with chronic diseases, and studies show that outofpocket costs are rising faster for arthritis than for many other chronic conditions.”

In 2007, 28 percent of workingage adults with chronic conditions such as arthritis reported that their families had trouble paying medical bills. Of those, one in four went without needed care, half delayed needed care and 56 percent failed to get prescription medications, because of cost concerns. Prescription costs are hitting harder than ever due to reduced coverage, preexisting conditions and higher copays. These unmet needs put people with arthritis at greater risk for complications and permanent disability.

The Arthritis Foundation applauds the current proposals in Congress for the many provisions that would benefit all Americans, and particularly those affected by a chronic disease or disability, like arthritis. The provisions included for affordability; preventive services; the prohibitions of discrimination based on health status; the elimination of the annual or lifetime limits on coverage; requiring coverage of dependents up to 26 years of age; and the strategy to develop national quality and efficiency standards mirror the principles of the Arthritis Foundation and will greatly improve the American health care system. We support these goals and principles as outlined in the current proposed legislation.

“In our nation, the costs for individual health insurance premiums have risen nearly eight times faster than average incomes. With 45 million uninsured citizens, it is now more important than ever to find ways to make health care affordable and ensure greater access to care for all,” said Melnick.

Indeed, unwieldy medical bills contributed to 62 percent of all bankruptcies in 2007, according to a recent study (PDF) published in the American Journal of Medicine, and to half of all home foreclosures as revealed in a similar 2008 Harvard study.

The Arthritis Foundation wants health care reform this year that will improve the lives of people with arthritis and other chronic diseases. We strongly believe that legislative action is necessary to guarantee quality, affordable, essential health care for all Americans.

Botox is one of the many trade names for the neurotoxic protein called botulinum toxin that is produced by the bacterium Clostridium botulinum. In large doses, the protein causes botulism, a rare paralytic illness often linked to food poisoning.

However, the protein is used in cosmetic medicine to treat moderate to severe brow furrow (glabellar lines), uncontrolled blinking, lazy eye, wrinkles, and facial creases. These procedures use a small amount of diluted botulinum toxin that enables controlled weakening of muscles.

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Botulinum toxin is sold commercially under the brand names Botox, BTXA, Dysport, Myobloc, Neurobloc, Xeomin, Botox Cosmetic, and Vistabel. Botox widely used for noncosmetic medical proceduresIn addition to cosmetic use, Botox is used to treat cervical dystonia, writers cramp, excessive sweating, achalasia (an esophagus problem), chronic pain, neuropathy, and migraine headaches.

For people with overactive bladders, Botox can improve their quality of life, say researchers from Kings College London School of Medicine, London, England.

Men with enlarged prostates benefit from Botox injections directly into the prostate, a study at University Medical College, Taiwan found.A possible treatment for some cases of depressionSome studies have indicated that Botox used for aesthetic purposes can help people with mental illness. A study published in Dermatologic Surgery found that treating clinically depressed patients with Botox on the frown lines of their faces actually got rid of their depression.How does Botox work? Botox works to relax the contraction of muscles by blocking nerve impulses. The result is muscles that can no longer contract, and so the wrinkles relax and soften. It usually takes two to four days to see cosmetic improvement and the effects tend to last from four to six months. Most patients require retreatment to remove wrinkles and lines as they begin to reappear, but after each injection the wrinkles return as less severe as the muscles are trained to relaxHow is Botox administered? Botox procedures do not require anesthesia and usually take just a few minutes to perform. The protein is injected into the muscle using a fine needle in order to minimize discomfort and maximize accuracy. It is recommended that patients avoid alcohol for about a week before the procedure. In order to minimize bruising, patients should stop using aspirin and antiinflammatory medications about two weeks before treatment. For cosmetic procedures, a study published in Dermatologic Therapy found that men need a higher dose of Botox than women.Is Botox better than a facelift?According to the American Society of Plastic Surgeons, whether Botox gives better results than a facelift (surgery) depends on the age of the patient. People in their 30s who have had limited exposure to sunlight usually show signs of aging in their eyes and temple area first, with crows feet and some bulging of the eyelid. As they have not lost much volume at this point, fillers or Botox usually smooth out the lines that people want to get rid of.

When people enter their 40s the middle of the face starts to shift as the cheeks lose some of their fat and laugh lines set in. The cheeks become deflated towards the end of the 4th decade, and the jowls start to sag. A combination of Botox as well as minimal lifting procedures will provide the best results.What are the side effects of Botox? The most common side effect of Botox injections is temporary bruising. Other possible side effects includeHeadache Respiratory infection Flu syndrome Blepharoptosis (drooping of the upper eyelid) NauseaIndigestion (heartburn) Doctors in the USA and the UK have reported that some patients “binge” on Botox to the point where their faces look frozen. They refer to the term “Wrinklerexia” when some Botoxdevotees become so obsessed with their wrinklefree image that they start seeing lines where there are none and binge on Botox to obtain a freezeframe face.

Updates on the impact of sexually transmitted diseases, infection risk from animals in the home and public settings, seasonal and H1N1 influenza, and foodborne diseases were presented today at a news conference at the National Press Club in Washington, D.C. The news conference was sponsored by the National Foundation for Infectious Diseases (NFID).

“Each year we face new and reemerging infectious diseases threats,” said Susan J. Rehm, M.D., NFID medical director and vice chair, Department of Infectious Disease, at the Cleveland Clinic. “Our goal as medical professionals is to ensure that we identify these threats in a timely manner and educate the public to minimize the overall impact on society.”

Influenza is currently the leading cause of vaccinepreventable death in the United States. Seasonal influenza causes an estimated 36,000 deaths and 200,000 hospitalizations in the United States. Most of the deaths occur in the elderly, but the hospitalization rate for children 2 years of age and younger is comparable to the hospitalization rate of the elderly. As of June 30, 2009 the Centers for Disease Control and Prevention had received 89 reports of influenzaassociated pediatric deaths with 67 being attributed to seasonal influenza and 22 pandemic influenza cases.

“Unfortunately, seasonal influenza immunization has never been a health priority for Americans,” said Carol J. Baker, executive director of the Texas Childrens Hospital Center for Vaccine Awareness and Research and professor of pediatrics, molecular virology and microbiology at Baylor College of Medicine in Houston. “Influenza is not easy to recognize and is often confused with less severe respiratory viral infectious such as the common cold.”

Novel H1N1 influenza virus, which was recognized in late April 2009, has caused a million cases of influenza worldwide and the age groups most affected are the young rather than the elderly. Cases of the pandemic (novel H1N1) influenza are expected to rise during this fall and winter.

“Seasonal influenza vaccine should be available soon. We should start immunizing as soon as the vaccine is available to prevent the seasonal influenza. In addition to vaccines, we should remember hand hygiene, cough etiquette and social distancing also helps to prevent the spread of both types of influenza,” said Dr. Baker.

Additional topics discussed at the 14th Richard J. Duma/NFID Annual News Conference and Symposium on Infectious Diseases included

Sexually Transmitted Diseases Neither Gone Nor Forgotten David Martin, M.D., chief, section of Infectious Diseases and Harry E. Dascomb Professor of Medicine and Microbiology at Louisiana State University School of Medicine in New Orleans, discussed the most common reportable infectious diseases in the United States is Chlyamydia trachomatis. The number of reported cases is growing each year due to increased screening efforts. “Excellent C. trachomatis diagnostic tests are now available and can be performed on urine specimens. Treatment is inexpensive and safe. Therefore, theoretically, this common STD could be dramatically curtailed in the United States population if broadbased screening efforts were undertaken,” said Dr. Martin. Dr. Martin outlined the need to eliminate barriers associated with screening including lack of access to healthcare, health care provider reticence to address sexual health issues, limited budgets to support screening programs, insufficient treatment of exposed sex partners, and lack of knowledge on the part of young sexually active individuals about the true risk of unprotected sexual intercourse with multiple partners. Dr. Martin also provided updates on treatment options for gonorrhea, the increased incidence of syphilis and medical advances which lead to discoveries of new STDs.

Infection Risk from Animals in the Home and in Public Settings Larry K. Pickering, M.D., FAAP, senior advisor to the director of the National Center for Immunization and Respiratory Diseases of the Centers for Disease Control and Prevention, executive secretary of the Advisory Committee on Immunization Practices (ACIP) and professor of pediatrics in the department of pediatrics at Emory University School of Medicine outlined the risks associated with animal exposures to nontraditional pets in the home and to animals in public settings. “The majority of households in the United States own a pet, and exposure to animals in public settings (petting zoos, state fairs, pet stores, animal swap meets, carnivals, child care centers) results in millions of humananimal interaction each year. Many pet owners, people in the process of choosing a pet and people exposed to animals in public settings are not aware of the potential risk posed by certain animals, especially nontraditional pets such as rodents, reptiles and weasels,” stated Dr. Pickering. “Infections with organisms acquired from these animals can involve many organ systems including the gastrointestinal tract, skin, lungs, blood and central nervous system. Organisms which have been associated with outbreaks include Salmonella species, E. coli 0157H7, Campylobacter species, Cryptosporidum species, and lymphocytic choriomeningitis. Dr. Pickering discussed regulations and recommendations applicable to these exposures and defined measures which can minimize or prevent illness in children from exposure to these animals.

Foodborne Diseases The Continuing Challenges to Public Health Robert V. Tauxe, M.D., M.P.H., deputy director, Division of Foodborne Bacterial, and Mycotic Diseases at the Centers for Disease Control and Prevention (CDC) provided an overview on the prevention of foodborne diseases, how they can be prevented and the roles the CDC plays in detection and prevention. “Educating consumers and food handlers is important, but not sufficient,” said Dr. Tauxe. “Through studying various outbreaks we can learn how to prevent disease through targeted prevention strategies.”

Since 1996 the CDC has utilized a national surveillance network which allows for sharing of DNA fingerprint patterns, permitting rapid detection of clusters of strains from ill persons that have matching patterns. This system facilitates the detection and investigation of dispersed common sources of outbreaks. Each year 50,000 strains are reported to the surveillance system. In recent years the system has detected multistate outbreaks including E. coli, Salmonella, and Botulism.

About the News Conference and Symposium

The 14th Richard J. Duma/NFID Annual News Conference and Symposium on Infectious Diseases was supported, in part, by unrestricted educational grants to NFID from Cubist Pharmaceuticals, Inc.; Merck & Co., Inc; Roche; and Wyeth Pharmaceuticals.

This event is named for former NFID president and executive director Richard J. Duma, M.D, Ph.D., currently director of infectious diseases at Halifax Medical Center in Daytona Beach, Florida.

About the National Foundation for Infectious Diseases

The National Foundation for Infectious Diseases (NFID) is a nonprofit, taxexempt 501(c)(3) organization founded in 1973 and dedicated to educating the public and healthcare professionals about the causes, treatment and prevention of infectious diseases