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Needle Exchange Program In Humboldt County, Calif., Forced To End; Officials Hoping For Federal Help
Health officials in Humboldt County, Calif., "will be watching closely" the debate expected to ensue over legislation introduced last week containing "a provision that would scrap the federal funding ban on needle exchange programs that has been in place for years," the Eureka Times-Standard reports. According to the Times-Standard, "This month, Open Door Community Health Centers" clinics in Arcata and Eureka quietly stopped administering the needle exchange program they have operated for almost a decade." Open Door Community Health Centers Chief Operating Officer Cheyenne Spetzler, said, "The footprint of the program just kept getting bigger." In addition, grant funding was often limited to covering the costs of the needles and not the costs of administering the programs, Spetzler said. County Department of Health and Human Services Programs Director Barbara LaHaie said the county is currently seeking alternatives to continue the program. However, "Without a reliable funding stream, that may prove difficult," the article states (Greenson, 7/13).
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Study Examines Trends In Gallbladder Cancer Over Four Decades
Overall prognosis for gallbladder cancer appears to be improving, although many patients still have incurable disease and poor survival rates, according to a report in the May issue ofArchives of Surgery, one of the JAMA/Archives journals.
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GOP Sens. Say Sotomayor Filibuster Possible But Unlikely, Obama Defends Judge's Past Comments
Several Republican senators in appearances on various talk shows on Sunday said that they do not expect the GOP to attempt a filibuster to block the Supreme Court nomination of Judge Sonia Sotomayor, although none ruled the idea out, the Washington Post reports. Sen. Kay Bailey Hutchison (R-Texas) said that she does not think the "need for filibuster will be there unless we have not had a chance to look at the record fully," adding that the Senate "need[s] to look at the record fully" and in an "expeditious way." Sen. Jeff Sessions (R-Ala.), the ranking member on the Senate Judiciary Committee, on NBC"s "Meet the Press" said that Sotomayor"s 17-year career as a federal judge is "very strong in her favor" and "the kind of background you would look for" in a Supreme Court justice. However, Sessions added that he and other Republican senators are concerned over a remark Sotomayor made in 2001 at a conference on Hispanics in the judiciary. According to the Post, Sotomayor was discussing how her Puerto Rican heritage has influenced her role as a judge when she said, "I would hope that a wise Latina woman with the richness of her experience would, more often than not, reach a better conclusion than a white male who hasn"t lived that life." Sessions said the remark "goes against the heart of the great American heritage of an independent judge" (Barnes, Washington Post, 6/1). Judiciary Committee member John Cornyn (R-Texas), appearing on ABC"s "This Week," said that senators "need to know ... whether she"s going to be a justice for all of us or just a justice for a few of us" (Wallsten, Los Angeles Times, 6/1).Sen. Charles Schumer (D-N.Y.) -- Sotomayor"s sponsor through the confirmation process -- said on "This Week" that she is "virtually filibuster-proof when people learn her record and her story." He added that Sotomayor is "legally excellent" and "not a far-left-wing judge" (Barnes, Washington Post, 6/1). White House Defends Sotomayor"s Comments White House Press Secretary Robert Gibbs said that he thinks Sotomayor would "say that her word choice in 2001 was poor, that she was simply making the point that personal experiences are relevant to the process of judging." In an interview with NBC News that will air this week, President Obama also defended Sotomayor, saying that "if you look in the entire sweep of the essay that she wrote, what"s clear is that she was simply saying her life experiences will give her information about the struggles and hardships that people are going through" (Eggen/Kane, Washington Post, 5/30). Obama also stood by his decision to nominate Sotomayor in his weekly radio and Internet address on Saturday. Obama said that he is "certain that she is the right choice" and that her record as a federal judge "makes clear that she is fair, unbiased and dedicated to the rule of law." While he said he expects "rigorous evaluation" of Sotomayor, Obama said his "hope is that we can avoid the political posturing and ideological brinkmanship that has bogged down this process, and Congress, in the past" (AP/USA Today, 6/1). First Meetings With Senators Expected This WeekAccording to the AP/Chicago Tribune, Sotomayor is scheduled to hold her first meetings with senators this week, beginning on Tuesday with Sessions and Democratic Sens. Harry Reid (Nev.) and Judiciary Committee Chair Patrick Leahy (Vt.). Gibbs said a meeting with Senate Minority Leader Mitch McConnnell (R-Ky.) also is possible, adding that he is hopeful there will be other meetings scheduled throughout the week (AP/Chicago Tribune, 5/31).The Wall Street Journal reports that the formal Senate confirmation hearings are not expected to begin for several weeks. The White House would like the Senate to confirm Sotomayor before the August recess so she will be on the bench for the court"s next term, which begins in October. Although some GOP senators say this might not be enough time to fully examine her record, Sotomayor is expected to be confirmed, the Journal reports (Bendavid, Wall Street Journal, 6/1).
Public Health

During Pregnancy Obese Women Should Not Gain Weight, Study Suggests

For years, doctors and other health-care providers have managed pregnant patients according to guidelines issued by the American College of Obstetricians and Gynecologists (ACOG). In 1986, ACOG stated, "Regardless of how much women weigh before they become pregnant, gaining between 26-35 pounds during pregnancy can improve the outcome of pregnancy and reduce their chances of having the pregnancy end in fetal death." Until its revised guidelines were released yesterday, the Institute of Medicine (IOM) had recommended that overweight women should gain about 15 pounds during pregnancy. The current study was undertaken to test whether these guidelines make a difference in maternal-fetal outcomes among obese women. In the study, conducted at several hospitals, the researchers followed 232 obese pregnant women, all of whom had a body mass index (BMI) of 30 or greater. Half of the women followed conventional prenatal nutritional guidelines, which is essentially "eat to appetite" (control group). The other half were placed on a well-balanced, nutritionally monitored program, which included a daily food diary (study group). The average weight gain in the control group was 31 pounds, compared to 11 pounds in the study group. Twenty-three extremely obese patients lost weight during their pregnancy. The findings showed that there were no fetal deaths and no growth-restricted infants in the study group. Also, there were fewer babies weighing more than 10 pounds in the study group than in the control group. (A birth weight over 10 pounds poses significant hazards to both infants and mothers.) Moreover, women in the study group gained less weight, had fewer cesarean deliveries, were less likely to develop gestational diabetes, and retained less weight after they delivered than women in the control group. The researchers concluded that obese pregnant women may be placed on a healthy, well balanced, monitored nutritional program without adverse maternal-fetal outcomes. "Women who are obese when beginning a pregnancy are, by definition, unhealthy," says study leader Yvonne S. Thornton, MD, MPH, a clinical professor of obstetrics and gynecology and board-certified specialist in maternal-fetal medicine at New York Medical College. "To say that they should gain even more weight is counter-intuitive, and our study bears that out. Rather than focusing on numerical endpoints with respect to weight gain, we need to focus on making these women healthier by getting them to eat a well-balanced diet." The study grew out of Dr. Thornton"s personal experience with obesity and pregnancy. Despite being overweight, she gained a substantial amount of weight during her first pregnancy, exacerbating her life-long battle with obesity. During her second pregnancy, she followed a well-balanced diet and gained little weight, with no adverse consequences for mother or baby. Dr. Thornton observed the same pattern in her own clinical practice, leading her to question prevailing guidelines for weight gain during pregnancy. Adding to her skepticism was the fact that women who develop gestational diabetes are routinely put on diets that effectively limit weight gain, with no ill effects. "It is the mindset of our specialty, and our society, that we need to have round, chubby pregnant women in order make sure they are healthy," adds Dr. Thornton. "Pregnancy has become a license to eat. We talk about "eating for two," but it"s really more like eating for 1 and 1/20th." These attitudes have contributed to the obesity epidemic in the U.S., where 35 percent of women are considered obese, says the researcher. The situation is even worse among African-American women, four out of five of whom are overweight or obese. "Gaining weight during pregnancy contributes to obesity, and it makes it that much harder for overweight women to return to their normal weight after pregnancy," says Dr. Thornton. The IOM and the National Research Council (NRC) have undertaken a study to review and update the 1990 IOM recommendations for weight gain during pregnancy. The IOM-NRC findings, which support the findings in Dr. Thornton"s study, were released May 28. Dr. Thornton"s paper, "Perinatal Outcomes in Nutritionally Monitored Obese Pregnant Women: A Randomized Clinical Trial," was published in the June issue of the Journal of the National Medical Association. Her co-authors include Claudia Smarkola, PhD, Sharon M. Kopacz, MD, and Sabriya B. Ishoof, MD. Donna E. Moriarty, M.P.H. New York Medical College


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