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Heena Patel

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SWHR’s 27th Annual Gala: The State of Women’s Health

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FOR IMMEDIATE RELEASE:
February 2, 2017

CONTACT:
Heena Patel, Communications Director
202-223-8224
heena@swhr.org

Celebratory event honors visionary women on Wednesday, March 22 in Washington DC

WASHINGTON, DC (February 2, 2017) – The Society for Women’s Health Research (SWHR®), widely recognized as the thought-leader in promoting research on biological differences in disease, will host its 27th Annual Gala: The State of Women’s Health on Wednesday, March 22, 2017, at the Ritz-Carlton Hotel in Washington, DC.

SWHR’s Gala will host more than 400 attendees, including members of Congress; researchers and clinicians; advocacy groups and disease awareness organizations; professional, scientific and medical associations; and individuals interested in the advancement of women’s health.

This year’s gala honorees will be presented the Women’s Health Visionary Award and include:

  • Myrna Blyth, Senior Vice President and Editorial Director of AARP Media, overseeing AARP The Magazine, AARP Bulletin, AARP Studios, AARP Book Division, and the AARP Website;
  • Susan Collins, Senator from Maine, who chairs the Senate Select Committee on Aging and the Transportation, Housing, and Urban Development Appropriations Subcommittee, and also serves on the Intelligence Committee, as well as the Committee on Health, Education, Labor and Pensions; and
  • Mary Lake Polan, MD, PhD, MPH, Clinical Professor, Department of Obstetrics and Gynecology and Reproductive Sciences at Yale University School of Medicine.

“The Society for Women’s Health Research is delighted to honor Myrna Blyth, Senator Susan Collins, and Dr. Mary Lake Polan for their lifetime of exemplary leadership and commitment to professional excellence,” said Amy M. Miller, PhD, SWHR president and CEO. “These extraordinary visionaries are powerful role models who have made unique contributions in advancing women’s health.”

SWHR will also host its Second Annual Gala Symposium on March 22, 2017, which will convene some of the best minds in health policy. The symposium will feature a series of presentations on the existing challenges and important advances needed to improve the health of women of all ages. Based on this discussion, SWHR will identify strategic next steps to addressing some of the most important policy issues related to women’s health.

From its inception, SWHR has worked to further women’s health and the study of biological sex differences and continues to raise awareness of the impact of sex differences on diseases and treatment. All event proceeds will benefit SWHR’s science, advocacy, and educational programs, which ensure that women’s health remains a national priority.

Media are invited to attend the gala. To request a complimentary seat, email your name and news organization to communications@swhr.org.

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About SWHR

The Society for Women’s Health Research (SWHR®) is a national non-profit based in Washington D.C. that is widely recognized as the thought leader in promoting research on biological differences in disease and is dedicated to transforming women’s health through science, advocacy, and education. Founded in 1990 by a group of physicians, medical researchers and health advocates, SWHR aims to bring attention to the variety of diseases and conditions that disproportionately or predominately affect women.

For more information, visit http://www.SWHR.org. Follow on Twitter at https://twitter.com/SWHR.

 

 

 

 

 

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SWHR Calls on the New Administration to Safeguard Women’s Health

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The Society for Women’s Health Research (SWHR®) offers support to both the President Trump administration and Congress and will actively build on the progress made in advancing women’s health in the U.S. and worldwide.

Approximately 157 million women live in this country; accounting for 50.8 percent of the U.S. population. For more than 25 years, our organization has brought attention to the variety of diseases and conditions that disproportionately or predominately impact women, and we are dedicated to transforming women’s health through science, advocacy, and education. With a new administration in the White House, it is crucial now more than ever to remember why women’s health is important and why it must remain a high priority on the national agenda.

For a century or more, the U.S. has paved the way in scientific research and medicine. Our leadership must continue. As an organization, SWHR looks forward to working with the incoming administration and Congress on championing continued research and funding of the study of sex and ethnic differences in the prevention, diagnosis, and treatment of disease; expanding access to healthcare coverage for preventive care services, including well-woman visits; ensuring proper mental health services and screenings by healthcare providers; and other important health policy issues that disproportionally affect women. Accelerating our progress in understanding the science of sex differences will benefit the health and longevity of both women and men.

Our tireless advocacy efforts for over a quarter-of-a-century have resulted in the passage of notable legislation, including the Women’s Health Office Act that mandated the offices on women’s health within the Department of Health and Human Services, and the authorization for offices and positions of women’s health among five federal agencies, including the Office on Women’s Health, the Office of the Director of the Centers for Disease Control and Prevention, and the Office of the Commissioner of the Food and Drug Administration. We anticipate the new administration will continue to appropriately staff and fund the offices on women’s health.

SWHR is hopeful the Trump administration will make the promotion of women’s health a prominent component in its national agenda, and that Congress will appropriately fund a federal research agenda that is inclusive of women’s health and sex differences research, which will ultimately improve the lives of all Americans.

ABOUT SWHR

The Society for Women’s Health Research (SWHR®) is a national non-profit based in Washington D.C. that is widely recognized as the thought leader in promoting research on biological differences in disease and is dedicated to transforming women’s health through science, advocacy, and education. Founded in 1990 by a group of physicians, medical researchers and health advocates, SWHR aims to bring attention to the variety of diseases and conditions that disproportionately or predominately affect women.

For more information, visit www.SWHR.org. Follow on Twitter at https://twitter.com/SWHR.

 

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Sexual and Gender Minorities: The Silent Majority in the World of Mental Health

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By Natalia Gurevich, SWHR Communications Intern

This past year mental health has been at the forefront of national coverage, especially with the recent presidential election, where both nominees acknowledged mental health as an issue of public health concern. For one group in particular, sexual and gender minorities, mental health is an issue compounded by additional stressors that can occur daily. Sexual and gender minorities are affected by more discrimination and stigma throughout their lives than the general population [1]. As a result, mental health issues also disproportionately affect this group [1].

Sexual and gender minorities are a group whose sexual identity, orientation, or practices differ from the majority of the population [2]. Sexual and gender minorities usually comprise of lesbian, gay, bisexual, and transgender (LGBT) individuals [2]. The term sexual and gender minority is fairly new, and is currently used by the National Institutes of Health, which established the Sexual & Gender Minority Research Office in September 2015. While many studies and groups still use LGBT or LGBTQ, for the purposes of inclusion and for this post, SWHR will use the term sexual and gender minority.

The population is probably slightly larger than reported, but those who publicly identify as a sexual and gender minority only make up about 3.4 percent of the U.S. population [3]. However, for this small minority group, suicide is one of the leading causes of death among those aged 10–24 years. Sexual and gender minority youth contemplate or attempt suicide 4 times more frequently than the general population [1].

Sexual and gender minorities are also more affected by disorders, like depression and substance abuse. Most of these disorders affect sexual and gender minority adolescents at a higher rate than their cis gender, heterosexual peers [4]. A lot of internalized disorders (mental health) and external disorders (drug and alcohol addiction) that begin to develop in teenage years often manifest themselves into deeper issues continuing into adulthood [5]. Therefore, many researchers focus on adolescence in sexual and gender minorities in an effort to better understand the root cause of mental health issues within this group.

A study published in 2008 by the Journal of Child Psychology and Psychiatry, found that stress was the main compounding factor [4] to higher rates of mental health issues in sexual and gender minorities compared to the rest of the population. Chronic stress leads to dysregulated emotions and sexual and gender minorities face multiple stressors during adolescence, including peer victimization, and in some cases, physical assault and rejection from their family [4]. Coping with these extraneous stressors, along with various other issues facing adolescents in general, potentially keep sexual minorities from developing emotional maturity and adaptability relative to their heterosexual peers [4], which can extend into adulthood.

Another study published in 2010 by the American Journal of Public Health found that three categories for discrimination—gender, race/ethnicity, and sexual orientation—were often compounded together, and when combined, led to higher rates of substance abuse [6], particularly in adulthood. An estimated 20-30 percent of sexual and gender minorities abuse substances, compared to about 9 percent of the general population [1].

Substance abuse is an external disorder that often goes hand-in-hand with internal disorders. Because sexual minorities face discrimination and social stigma on a higher basis than other subpopulations, daily stressors often increase their risk for anxiety, depression, panic attacks, suicidal ideation, psychological distress, body image disturbance, and eating disorders [2]. While the president-elect has spoken on mental health in the past, he has yet to announce a formal platform on the issue [7]. SWHR hopes that the new administration will recognize the current issues surrounding mental health and develop new policies to combat this public health concern.

Education and awareness on sexual and gender minorities and mental health should be addressed as early as possible in adolescents and continue into adulthood. If you are a member of the sexual and gender minority community or even if you are not, talk to your healthcare provider if you have any questions relating to mental health.

At SWHR, we believe that mental health is an important issue that affects members of every community, either personally or through a loved one. Everyone is entitled to receive the proper care and support they deserve, regardless of sexual orientation, gender, or race/ethnicity. Sexual and gender minorities belong to a group greatly affected by mental health issues, but are vastly underrepresented in research. All the mental health implications will remain relatively unknown without more research and education on this minority group. Learn more about SWHR and the work we do on mental health here.

References:

  1. https://www.nami.org/Find-Support/LGBTQ
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657897/
  3. http://www.gallup.com/poll/158066/special-report-adults-identify-lgbt.aspx
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881586/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976222/#B1
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937001/
  7. http://www.huffingtonpost.com/entry/this-election-vote-with-your-mind_us_580678f4e4b08ddf9ece1139

 

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SWHR Names Amy M. Miller, PhD New Chief Executive Officer

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Held Leading Post At Personalized Medicine Coalition

WASHINGTON, DC (November 22, 2016) – The Society for Women’s Health Research (SWHR®) announced the hiring of Amy M. Miller, PhD as its new Chief Executive Officer, effective January 3, 2017.

Dr. Miller leaves the Personalized Medicine Coalition (PMC), where she served as Executive Vice President, directing national programs and in particular working with innovators, scientists, providers and payors on policy issues impacting personalized medicine.

“We welcome Amy to lead SWHR at a critical crossroads in women’s health research,” said SWHR Founder Florence Haseltine, PhD, MD. “While we celebrate the many achievements in women’s health policy advocacy to date, we must continue to press for unlocking the mysteries in sex differences and how men and women are different when it comes to cures, treatments and prevention. Amy understands that, and we’re excited to invite her to lead SWHR,” said Dr. Haseltine.

Before joining PMC, Miller worked in the office of the Director of the National Institute of Mental Health, where she served as a liaison among the scientific community, the legislative branch, and the consumers of mental health care and their families. A former American Association for the Advancement of Science Fellow, she also served as a domestic policy advisor to Senator Jay Rockefeller.

Dr. Miller began her career as a researcher at the National Institute of Child Health and Human Development. Miller received a BA from the University of New Orleans and holds a doctoral degree in human development from the University of Connecticut.

“The SWHR board of directors enthusiastically welcomes Dr. Miller to SWHR, and at the same time, thanks our interim CEO Larry Hausner for his effectiveness in leading SWHR in the past year,” said SWHR Chair John J. Seng.

SWHR leads the way in advocating for greater funding for women’s health research and for the study of biological differences that affect disease; promotes the inclusion of women and minorities in medical research; pushes for the analysis of research data for sex and ethnic differences; and informs women, health care providers, and policy makers about contemporary women’s health issues.

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ABOUT SWHR

The Society for Women’s Health Research (SWHR®) is a national non-profit based in Washington D.C. that is widely recognized as the thought leader in promoting research on biological differences in disease and is dedicated to transforming women’s health through science, advocacy, and education. Founded in 1990 by a group of physicians, medical researchers and health advocates, SWHR aims to bring attention to the variety of diseases and conditions that disproportionately or predominately affect women.

For more information, visit www.SWHR.org. Follow on Twitter at https://twitter.com/SWHR.

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One More Mom to Teenage Daughter Talk: The School Bathroom

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By Clare E. Close, MD, FAAP, SWHR Interdisciplinary Network on Urological Health in Women Member

It’s early morning and your teenage daughter runs out the door to school. Much will happen today that you may or may not hear about when you see her again tonight. It’s unlikely that you will hear anything about the school restrooms, yet during her day at school, your daughter is developing habits that can affect her bladder for her lifetime [1].

Three hours into the school day your daughter needs to urinate but doesn’t ask to leave her class because she can’t afford to miss information that will be on this week’s exam. Also this teacher gives extra credit to students who don’t ask for bathroom breaks. A minute later her urge to urinate is gone. During her short passing period to lunch she walks by the restroom, but is too busy texting her friend and doesn’t stop. She eats her lunch and heads to her next class. Suddenly she feels her bladder again. She heads to the bathroom but turns around because the floor looks dirty. Sitting down in class she crosses her legs and does not feel her bladder so much, which is good because her teacher does not allow bathroom breaks right after lunch.

Eight hours after leaving home, classes are over, and your daughter’s bladder feels so full that it hurts. She heads to the bathroom but the door is now locked to prevent afterschool vandalism. Arriving home she rushes into her bathroom but leaks on the way.

Scenarios like this may seem hyperbolic, but they are happening to teenagers every day. Because bladder health is rarely taught in middle or high school health studies, your daughter most likely has no idea that she should be taking better care of her bladder. Unless she has an obvious bladder problem such as infection, you also will probably never think about discussing your daughter’s bladder health.

We know children commonly hold their urine and stool in elementary school causing incontinence, bedwetting, and infection [2]. In middle school and high school there many more social, time, and academic pressures that keep adolescents from going to the bathroom [3]. Over time if your daughter holds her urine all day her bladder can become abnormal with a thick wall that can make her feel a sudden urge to go as well as make her leak urine. These problems can continue into your daughter’s adulthood [4]. To grow a healthy bladder your teenager should urinate every two to three hours and take time to relax and empty their bladder completely. Healthy eating and drinking plenty of water will help her have normal bowel movements, which are also important for a healthy bladder [5].

Talking to your daughter about her bathroom habits may seem uncomfortable because of her desire for independence and privacy, but it is important to connect with her about issues of bathroom access, cleanliness, and safety. The school nurse may be the best person to reach out to if your daughter tells you about such problems. Her life-long bladder health may depend on it.

The Society for Women’s Health Research (SWHR®) launched its Interdisciplinary Network on Urological Health in Women in 2015 to promote bladder and urinary tract health across a woman’s lifespan. To learn more about the network or about urological health, visit swhr.org.

References

  1. Fitzgerald MP, Thom DH, Wassel-Fyr C, et al: Childhood urinary symptoms predict adult overactive bladder symptoms. J Urol 2006; 175: 989
  2. Sureshkumar P, Craig, JC, Roy LP, et al. Daytime urinary incontinence in primary school children: a population-based survey. J Pediatr 2000;137:814
  3. Bauer RM and Huebner W. Gender differences in bladder control: from babies to elderly. World J Urol 2013; 31(5): 1081-5
  4. Franco I. Pediatric overactive bladder syndrome pathophysiology and management. Paediatr Drugs 2007; 9: 379
  5. Burgers R, Liem O, Canon S, et al: Effect of rectal distention on lower urinary tract function in children. J Urol 2010; 184:1680

 

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A Little Leakage Goes a Long Way

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By Natalia Gurevich, SWHR Communications Intern

There have been many times when we have hated our bladders. For making us get up to use the bathroom in the middle of the night, or making us stop every hour on the otherwise fun family road trip. However, many of us take our bladder health for granted. Our bladders work hard, and sometimes they aren’t quite as effective as we would hope.  The majority of women, pregnant or not, have at some point in their lives dealt with incontinence, the unintentional loss of urine [1]. Urinary incontinence occurs more often in women than in men because of a variety of contributing factors: pregnancy, vaginal delivery, and menopause. Weak bladder muscles, overactive bladder muscles, and nerve damage may also cause urinary incontinence in women [1]. Incontinence is typically a minor and rare nuisance easily solved. But for some women, incontinence can be a chronic issue that significantly impacts their quality of life, depending on the type of incontinence and the cause.

There are several types of urinary incontinence in women, including stress urinary incontinence where urine leaks after pressure is put on the bladder (ex. coughing, sneezing laughing), urge incontinence where there is an urgent feeling of needing to urinate, overflow incontinence where the bladder is never empty, and mixed incontinence which is having two or more types of incontinence [5]. The most common type of mixed incontinence is stress and urge incontinence together [2, 5].

Female athletes, both amateur and professional often suffer from stress urinary incontinence (SUI), with a few exceptions [2]. Over 41 percent of young female athletes reported at least one episode of stress urinary incontinence during high impact activities [2]. Because female athletes spend time gaining muscle one would think the pelvic muscles would get stronger as a result, but actually the overuse of the pelvic muscles causes them to become weak and fatigue more easily [9].  In addition, approximately 25 percent of women under age 40 experience SUI during physical activity [2].

In 2002, a study published in the International Urogynecology Journal took a sample of 291 elite athletes and dancers, who were on average 23 years old [3]. The study showed a high prevalence of leakage within gymnastics, at 56 percent of participants suffering from incontinence, closely followed by ballet at 43 percent, and aerobics at 40 percent. Other sports like badminton, volleyball, handball, and basketball also had a high occurrence of women with incontinence [3].

Incontinence and other related urinary conditions are often viewed as harmless, but the results can be embarrassing and a constant source of worry and discomfort for the women affected, even leading to social isolation, marital distress, depression. Urinary incontinence is stigmatizing for many women. Almost 90 percent of women with a urinary incontinence don’t discuss it with their healthcare providers [2] and therefore do not get the proper support and treatment they need. And yet, the condition is so common among women, with seven to 37 percent of women between the ages of 20-39 reporting some degree of incontinence [6].

There are numerous treatments available for each type of urinary incontinence including medication, devices, surgery, discipline therapy, or Kegel exercises or pelvic floor exercises, which for the majority of women can be effective.

If you are a woman, and especially if you are an athlete, contact your healthcare provider if you have questions or concerns about your urological health. SWHR’s Interdisciplinary Network on Urologic Health in Women helps to raise awareness of the impact of bladder health on women’s well-being across the lifespan [2]. The network aims to identify and close the gaps in knowledge, research, policy and education and disseminate information and provide support to the general public [2]. Learn more about incontinence from SWHR’s new Urology Network Report here.

References:

  1. http://www.medicinenet.com/urinary_incontinence_in_women/article.htm
  2. Liliana Losada et al., “Expert Panel Recommendations on Lower Urinary Tract Health of Women across their Lifespan.” Journal of Women’s Health. Epub ahead of print (2016).
  3. Thyssen et al., “Urinary incontinence in elite female athletes and dancers.” International Urogynecology Journal. 2002;13(1):15-7.
  4. Simeone et al., “Occurrence rates and predictors of lower urinary tract symptoms and incontinence in female athletes.”Urologia. 2010;77(2):139-46.
  5. https://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.html
  6. “Urinary Incontinence in Women.” National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). 2 Sept. 2010. <http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/>
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4327384/
  8. http://www.webmd.com/urinary-incontinence-oab/types-of-urinary-incontinence
  9. Jacome et al. “Prevalence and impact of urinary incontinence among female athletes.” International Journal of Gynecology & Obstetrics. 2011;114(1):60–63.
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Baby On Board With Military Maternity Leave Policy

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By Natalia Gurevich, SWHR Communications Intern

Veteran’s Day is a revered holiday that induces images of crisp uniforms, waving flags, and national pride. This Veteran’s Day, in addition to thanking all veterans for their service, SWHR has examined a national issue that has made some progress, but one we cannot be completely proud of  yet—maternity leave policy and subsequent health concerns for the average woman and for those serving in the armed forces.

Currently, all branches of the U.S. military provide a standard 12-week paid maternity leave. In January of this year, the Navy and Marine Corps slashed their maternity leave policies down from a generous 18 weeks to just 12 weeks [1]. This change was made in order to double the Army and Air Force’s previous six-week policies [2].

The current paid maternity leave policy for the military is generous compared to maternity leave policies offered by the majority of U.S. employers – most of whom do not offer paid maternity leave. However, compared to the rest of the developed world, the U.S. is sorely lacking in maternity benefits and care with private, federal, and public employers.

Only four states in the U.S. have instituted paid maternity leave laws: California, New Jersey, Massachusetts, and Rhode Island. California offers new mothers up to six weeks, at 55 percent of their salary. New Jersey offers six weeks and two-thirds of salary, while Rhode Island pays four weeks at 60 percent of salary [4]. In the United States, there is no federal mandate for maternity leave. However, the Family and Medical Leave Act (FMLA), which became law in 1993,  allows “qualified employees to take 12 weeks of unpaid, job-protected leave for specific family and medical reasons” [4]. Family planning, including having a baby, falls under this law, along with adoption and foster care of a child, caring for an immediate family member (spouse, child, or parent) suffering a serious health condition, or personal medical leave [8].

According to the Bureau of Labor Statistics, only 12 percent of Americans have access to paid parental leave and only five percent of low-wage earners receive paid maternity leave [4]. In contrast, women in the military have better care than the average woman in the workforce. Although women in the military only receive 12 weeks, the time is paid in full. U.S. Secretary of Defense Ashton Carter has also made supplemental changes for new mothers, including the installation of “mother’s rooms,” at military bases with more than 50 women, where women can go to breastfeed in privacy. In addition to family planning, Carter proposed to extend childcare facility hours to 14 hours a day on military bases, and is offering female and male soldiers the opportunity to freeze their eggs or sperm in case of an accident in combat.

While the U.S. military has a generous maternity leave policy compared to the rest of the country, the U.S. is one of only three countries in the world that doesn’t offer some standard form of paid maternity leave, along with Suriname and Papua New Guinea [5]. However, 12 weeks is the bare minimum, with several countries allowing 52 weeks or more of paid maternity leave [5]. Sweden and Norway offer a year of paid leave for the mother and the father, and research has shown that families are more productive in the workforce if they are given this length of time [6]. Mothers are also less likely to suffer from post-partum depression and anxiety if they are provided paid family leave [9]., Studies also show that paid family leave decreases chances of infant mortality, increases breastfeeding length and rates, and improves child development overall [9].

According to a 2011 study by California’s Center for Economic and Policy Research, after the state of California implemented paid leave, 91 percent of businesses said it had a positive effect on profitability or no effect at all [7]. Essentially, there were no disadvantages, and implementing paid leave encouraged those starting families to stay in the workforce. Many women who take paid leave wind up returning to work later, as opposed to leaving to become a stay-at-home mother[4].

The U.S. military provides a much needed maternity leave policy for our female armed service members. Women who serve now have a much needed sense of security for their family planning. However, the same courtesy should be extended to all women who work in the U.S., contributing to our economy and ultimately improving the standard of living. As a country, our maternity leave policies are severely lacking when compared to the rest of the world. The U.S. military’s maternity leave policy is a positive example of what other employers should follow.

SWHR believes women should have the comfort and support they need when and if they choose to start a family. This Veteran’s Day we commend the women who have served or are serving in our armed forces. We hope that all women in the workforce can one day benefit from a similar maternity leave policy as our female soldiers.

For more information about our work in women’s health, visit www.swhr.org.

References

  1. http://www.military.com/daily-news/2016/01/28/maternity-leave-slashed-for-sailors-marines.html
  2. http://www.govexec.com/pay-benefits/2016/01/female-service-members-will-get-12-weeks-paid-maternity-leave/125543/
  3. https://www.army.mil/article/163550/army_directive_2016_09_maternity_leave_policy
  4. http://www.techrepublic.com/article/10-things-you-need-to-know-about-maternity-leave-in-the-us/
  5. https://www.payscale.com/career-news/2013/05/these-9-countries-have-the-worlds-best-maternity-leave-policies-infographic-
  6. http://www.npr.org/2011/08/09/137062676/time-with-a-newborn-maternity-leave-policies-around-the-world
  7. http://cepr.net/documents/publications/paid-family-leave-1-2011.pdf
  8. https://www.dol.gov/general/topic/benefits-leave/fmla
  9. http://paidfamilyleave.org/pdf/NebwornFamilyLeave.pdf
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Zika: Do We Still Have To Worry? Yes.

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By Clarissa K. Wittenberg

A moment for reflection

The first shock of the Zika virus epidemic has passed, but the danger continues. On September 28, the U.S. Congress voted to pass a $1.1 billion package to respond to the Zika crisis after President Obama had asked for $1.9 billion back in February [1].

This delay occurred despite information from Brazil about Zika’s danger to pregnant women.  The births of babies with microcephaly and other birth defects should have galvanized legislators into action.  Even in July, when the Centers for Disease Control and Prevention (CDC) said that the virus was “silently and rapidly” spreading in Puerto Rico, funds were not forthcoming [2].  The delay caused public health experts to re-program funds to meet urgent needs and then when funding came, to play catch up – a strategy that tends to costs more than if funds had been available in the first place.  While the Southern U.S. has been hardest hit, many states have the people infected with Zika virus.

The paradox of a mild disease with potentially fatal consequences

Because the Zika virus is mild and many people never feel ill, they fail to take precautions. Four out of five infected people experience no symptoms [2]. Even for those who do feel ill, the symptoms are mild and include fever, rash, joint pain, and conjunctivitis (red eyes) and may go unnoticed. Condoms are recommended for all sexual acts if a sexual partner has traveled to an area where Zika is present, as either partner can infect the other. The virus has been found in the semen of infected men for as long as six or seven months [1].

In addition to semen, Zika can also be transmitted by blood, saliva or urine. The Food and Drug Administration (FDA) issued localized advisories to screen for Zika virus in the blood supply back in February, and issued a stronger advisory for universal testing of blood supplies in August [3].

Case counts

According to the CDC’s Zika map, as of October 26, 2016, there were 4,091cases with laboratory evidence of Zika virus infection in the United States, as well as 28,723 in U.S. territories.  In the U.S., there were 953 pregnant women with Zika and 2,027 pregnant women with Zika in U.S. territories.

Cases are divided into locally infected and infected through travel or intimate contact with travelers to areas with Zika outbreaks.  New York City, for instance, has a large Puerto Rican population and inexpensive airfares to the Island and so has many travel-related cases.  As of October 26, 2016, New York City had over 886 people with Zika virus, and a baby with microcephaly was born in New York in July 2016.

Evidence accumulating on a link between Zika and birth defects

At the early on-set of the breakout, it was assumed that Zika virus was linked to birth defects. However, evidence from Brazil and other countries now shows that if a pregnant woman becomes ill with Zika, it may cause severe birth defects in the fetus such as microcephaly, a devastating stunting of brain and skull [4]. Zika has also been linked to eye defects or hearing loss in a developing fetus, and impaired growth in infants [1]. There are disturbing reports that even babies seemingly normal at birth may develop problems as they grow. But the risk for neurological birth defects seems to be linked to a woman’s individual history of other infections.

For years, Zika seemed a rather mild virus without fetal damage.  Even now, when the birth defects are so alarming, The Washington Post  reported that while birth defects are linked to Zika, the fetal deformities predicted by models are fewer than expected except in northeast Brazil. It is suggested that dengue has not been seen in this area since 2003 and maybe women are lacking immunity to that virus, which is a similar virus spread by the same type of mosquito. The article also mentions “anecdotal evidence that more women have been quietly terminating pregnancies over worries that their babies might be deformed.” Research reports in September 2016 indicated that a previous or a co-infection with herpes simplex virus-2 (HSV-2) might enhance the breaching of the placental barrier that allows such birth defects.

There is much research still needed to be done on Zika infection.  Zika is similar to dengue fever, yellow fever and West Nile fever. For example, if an individual has previously had one of these illnesses, does it make the Zika virus more dangerous or provide some immunity?

The importance of continuing antiviral research

At the start of the Zika crisis, the National Institute of Allergy and Infectious Diseases (NIAID) used the antiviral drug screening program already in place for other viruses such as dengue, West Nile, yellow fever, and Japanese encephalitis, to create an urgently needed test that might be valuable for potential antiviral activity against the Zika virus [6]. More than 60 antiviral compounds were examined and 15 had moderate to high activity and are undergoing more study. The already advanced dengue virus research is helping to speed research on Zika.

A new approach to anti-viral drugs may be needed

NIAID points out the various recent viral pandemics and suggests that development of broad-spectrum antiviral drugs might be needed rather than infection-specific drugs or vaccines.  The challenge of research on these drugs is heightened by the fact that every step must be carefully tested to ensure pregnant women aren’t given anything that can cause birth defects.  Concern about safety is not limited to infectious diseases, but is an issue in other conditions such as heart disease and cancer in women as well.  It is to be hoped that the urgency presented by Zika virus will help across the board to shape safer clinical trials and drug development for pregnant women.

A search for answers

In June 2016, NIAID, Eunice Kennedy Shriver National Institute of Child Health and Human  Development, National Institute of Environmental Health Sciences and the Brazilian Fundacao Oswaldo Cruz-Fiocruz launched the multi-country Zika in Infants and Pregnancy (ZIP) Trial.  A prospective observational trial that plans to enroll as many as 10,000 pregnant women at up to 15 sites and follow them throughout their pregnancies to determine if they become infected with Zika virus, and to learn the outcomes for mother and child [5].

Public health falls to the States: Is more Federal help needed in emergencies?

Zika testing and medical care is a state responsibility.  The CDC does provide information, special teams and emergency grants but not a comprehensive national program. And although the CDC was prepared, until funds were allocated, emergency team activities could not begin until a request from the state is received. Public health laboratories have had a surge in demands for the complex high intensity Zika tests so desperately needed by women causing long waits for results. Controversy at the CDC about the efficacy of specific Zika tests also caused delays. Funds for these tests must compete with spraying for mosquitoes, case finding, and help for women without health insurance and maternal and child health programs in Puerto Rico and other territories. The crisis is intensified, as often the most cases are seen in the poorest women in the poorest states.

Environmental issues are health issues.

Aedes aegypti mosquitos also can transmit yellow fever, dengue, and chikungunya viruses.
Today, crowded cities, areas with poor conditions, and international travel contribute to potential pandemics. Aedes aegypti is a difficult mosquito to eradicate, as it can remain dormant during dry spells and then hatch during a rainfall.  Delays in spraying were also caused by debates over safety and efficacy of mosquito eradication compounds this year in both Puerto Rico and Florida. Various strategies for genetic modification of mosquitoes are being tested.  For the best information on safe and effective mosquito control, consult the U.S. Environmental Agency at www.epa.gov.

Will warmer temperature bring more mosquitoes?

Temperatures have been rising in the contiguous states since 1901.  (Environmental Protection Agency, “Climate Change Indicators: U.S. and Global Temperatures”, Data source, NOAA, 2016.)  Mosquitoes thrive in hot areas, so a very sophisticated approach involving many specialists is needed to predict patterns of infections and disease. Trade and travel are now global.  Surveillance of disease patterns must meet this challenge and each nation will need to monitor signs of impeding pandemics. The World Health Organization now counts 67 nations with Zika virus infections. Our public health depends upon better health across the globe.

 

References

  1. http://www.npr.org/sections/health-shots/2016/09/28/495806979/congress-ends-spat-over-zika-funding-approves-1-1-billion
  2. https://www.cdc.gov/zika/
  3. http://www.fda.gov/%20EmergencyPreparedness/Counterterrorism/MedicalCountermeasures/MCMIssues/ucm485199.htm
  4. http://www.nytimes.com/interactive/2016/health/what-is-zika-virus.html?_r=0
  5. https://www.nih.gov/news-events/news-releases/nih-launches-large-study-pregnant-women-areas-affected-zika-virus
  6. https://oversight.house.gov/wp-content/uploads/2016/02/2016-02-24-NIH-Dr.-Fauci-Testimony.pdf

Resources

About the Author

Clarissa K. Wittenberg served as a senior communications officer at several NIH Institutes, and the Office of Global Health of the Secretary for Health and Human Services. She was a consultant to the Department of Psychiatry and Human Behavior, the University of Mississippi Medical Center on mental and overall health of underserved populations.  She was a member of a select volunteer health issues committee for the first Obama campaign.

palmer

SWHR Welcomes New Member to Urology Network

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By the Society for Women’s Health Research

The Society for Women’s Health Research (SWHR®) is pleased to welcome Mary Happel Palmer, RN, PhD, FAAN, AGSF, to the Interdisciplinary Network on Urological Health in Women. The network, created in 2015, aims to raise awareness of the impact of bladder health on women’s well-being across the lifespan.

“I am excited about being invited to be part of the Urology Network,” Dr. Palmer said. “For years I have conducted research and advocated for bladder health in women and in older adults. Being part of the interdisciplinary group enables me to continue and expand this work. I look forward to the day when women enjoy optimal bladder health every day of their lives.”

Dr. Palmer is the Helen W. and Thomas L. Umphlet Distinguished Professor in Aging in the University of North Carolina at Chapel Hill School of Nursing. She has conducted extensive interdisciplinary research on the prevalence, incidence, and risk factors for urinary incontinence in adults. Dr. Palmer has authored numerous papers and book chapters, and has written two award-winning books on urinary continence.

Dr. Palmer’s current research investigating the meaning of bladder health to women across the life span has confirmed that women engage in different behaviors dependent on the environment and their urinary symptoms.

“We are delighted to welcome Dr. Palmer onto this Network,” said Rebecca Nebel, PhD, Assistant Director of Scientific Programs at SWHR and Program Director of the Urology Network. “Her expertise in women’s bladder health adds even more value to an already impressive membership, and we are excited to see what new avenues the Network addresses with her addition.”

To learn more about SWHR’s Interdisciplinary Network on Urological Health in Women, visit our website.

University Communications

SWHR Cohosts Sex Differences Conference at University of Colorado

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By The Society for Women’s Health Research

From September 28 through 30, the Society for Women’s Health Research (SWHR®) cohosted the National Conference on Women’s Health Research with University of Colorado Anschutz Medical CampusCenter for Women’s Health Research (CWHR). The conference, titled “Sex Differences Across the Lifespan: A Focus on Metabolism,” convened some of the best minds in sex-difference research to share knowledge and ideas, while setting the stage for the next pivotal scientific research in cardiometabolic risk across the lifespan.

“Sex Differences Across the Lifespan: A Focus on Metabolism” brought together leading researchers from across the country in the areas of women’s health and sex differences to share and discuss their latest findings. The conference featured interactive sessions, poster presentations, focus groups, and keynote speakers. In addition to the scientific sessions, the conference included a breakfast presentation by leading women’s health researcher, Wendy Kohrt, PhD, and business leader Ginger Graham, MBA.

The SWHR cohort present at the conference included founder Florence P. Haseltine, PhD, Vice President of Scientific Affairs Monica M. Mallampalli, PhD, MSc, and Scientific Program Manager Aimee Gallagher, MPH, MS. Dr. Mallampalli also gave the conference’s opening remarks.

“SWHR was very proud to cohost this conference,” Dr. Mallampalli said. “The Society’s mission has long been to promote the field of sex-based biology, and in 2003, SWHR launched an Interdisciplinary Network on sex differences in metabolism. We were very happy to see the wealth of sex differences data presented at this conference and advances made in the field of metabolism.”

The conference highlighted critical next steps that must be taken as we work to advance sex differences research. Marjorie Jenkins, MD, of the Food & Drug Administration (FDA) Office of Women’s Health spoke about the FDA’s advances in drug testing in women. Jed Friedman, PhD, of CU Anschutz shared findings on how and why obesity might worsen the health and development of a pregnant mom’s baby. Sherita Hill-Golden, MD, of Johns Hopkins University discussed why women with diabetes are more likely to have cardiovascular complications than their male counterparts.

The conference was the CWHR’s inaugural event on the importance of sex differences research, with the next event set for 2018. By researching sex differences in disease, CWHR and SWHR believe patient treatments and outcomes can be improved for all – women and men alike.

For more information about SWHR, sex differences, and the work we do, visit our website at www.swhr.org.

ABOUT CWHR

The University of Colorado Anschutz Medical Campus’ Center for Women’s Health Research (CWHR) is dedicated to furthering the careers of scientists focused on women’s health research through seed grants and mentorship. CWHR delivers critical health information to women, families, doctors and community members, and believes in mentoring and investing in scientists who specialize in women’s health research. The seed grants CWHR provides contribute to amazing, life-changing discoveries and help legitimize scientists and their research projects so they can acquire ongoing funding. To learn more about CWHR, visit their website.

ABOUT SWHR

The Society for Women’s Health Research (SWHR ®) is a national non-profit based in Washington D.C. that is widely recognized as the thought-leader in promoting research on biological differences in disease and is dedicated to transforming women’s health through science, advocacy, and education. Founded in 1990 by a group of physicians, medical researchers and health advocates, SWHR aims to bring attention to the variety of diseases and conditions that disproportionately or predominately affect women. To learn more about SWHR, visit our website.

 

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