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Iowa Lawmakers Discuss Reform And Increased Coverage For Children
An overhaul of the U.S. health care system would probably help maintain improvements already made in Iowa, Gov. Chet Culver and other health advocates said Tuesday, according to the Des Moines Register.
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Need For Studies On People With Weakened Immune Systems: Vulnerability To Flu And Response To Vaccination
An article published in the August edition of The Lancet Infectious Diseases reports that additional research is required on the vulnerability to the new H1N1 flu strain of different immunosuppressed populations. The possible effectiveness and side-effects of future vaccines also need to be evaluated. The review is the work of Dr Ken M Kunisaki, Minneapolis VA Medical Center, USA, and University of Minnesota, USA, and Dr Edward N Janoff, Univeristy of Colorado Denver School of Medicine and Denver Veterans Affairs Medical Center, USA.
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Unjust Stigma, Lack Of Physician Training Hinder Market For IUDs, Opinion Piece Says
Intrauterine devices "seem like the perfect form of contraception: simple to use, long-lasting, reversible, hormone-free, economical," Slate columnist Kate Klonick writes. She asks, "So why are American women so late to this party? Perhaps the better question is: Why did they leave the party to begin with?"Klonick explains the benefits of IUDs, calling them a "foolproof method of birth control" and noting that they are 99% effective and "can last up to 10 years." Although IUDs can cost between $300 and $500, it is a one-time expense that is often covered by insurance, according to Klonick. She notes that although efficacy studies show that birth control pills, patches and vaginal rings can be "99% effective in a clinical setting, real-life compliancy -- like forgetting to take the pill at the same time every day -- reduces its success rate." Klonick adds that the availability of hormone-free IUDs makes them an "ideal" option for "women prone to some of the negative effects of hormonal birth control, like weight gain, mood swings, acne or high blood pressure."According to Klonick, IUDs were used by almost 10% of U.S. women taking birth control in the late 1970s but are now used by less than 2% of such women. She writes that Katharine O"Connell, a gynecologist at Columbia University who specializes in contraception, believes IUDs still carry a stigma "due to the erroneous belief that they"re highly dangerous" partly due to a number of deaths that occurred in the early 1970s tied to a specific brand of IUD known as the Dalkon Shield. Because of bad publicity surrounding the devices, "the U.S. pharmaceutical industry abandoned the research and manufacturing of IUDs in the mid-1980s, claiming the devices were no longer profitable," Klonick states. According to O"Connell, most experts now agree that the Dalkon Shield"s problems were related to its design, which made users more susceptible to infection, and a lack of testing for sexually transmitted infections before insertion.There are now two major brands of IUDs -- Mirena and ParaGard -- on the U.S. market, but physican training remains a problem, according to Klonick. She writes that studies show that premedical students are not educated regarding IUDs to the extent they are about oral contraceptive pills. O"Connell also noted that many medical schools limit classes on contraception to one lecture, which often omits IUDs. Klonick writes, "This lack of training can leave many doctors feeling uncomfortable recommending the once-controversial devices to their patients." She adds that many physicians who know how to insert and remove IUDs "still refuse to recommend it to childless patients because of the device"s checkered history." She concludes, "With Mirena advertising on television, the downturn in the economy forcing people to economize, and more women concerned about the long-term effects hormones have on their bodies, perhaps the IUD"s stigma will finally become a thing of the past" (Klonick, Slate, 7/29).
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The Influences Of Peers, Parents On Self Identity Confirmed By fMRI

Ask middle-school students if they are popular or make friends easily, they likely will depend on social comparisons with their peers for an answer. Such reliance on the perceived opinions of others, or reflected self-appraisals, has long been assumed, but new evidence supporting this claim has now been found in the teen brain. Using functional magnetic resonance imaging (fMRI), researchers looked at adolescent and young-adult brain activity related to both direct self-appraisals, such as "Do I think I"m smart?" and perceptions of others" opinions -- reflected self-appraisals: "Do I think my friend thinks I"m lonely?" During direct self-appraisals, researchers found that adolescents show more activity than adults in neural networks tied to self-perception (medial prefrontal and parietal cortices) and in areas linked to social cognition (dorsomedial prefrontal cortex, temporal-parietal junction and posterior superior temporal sulcus). The results, said lead author Jennifer H. Pfeifer, a psychology professor at the University of Oregon, suggest that adolescent self-perceptions depend heavily on others. The study is detailed in the July/August issue of the journal Child Development. Pfeifer briefly describes the research in a video at: http://www.youtube.com/watch?v=XRe1h3aEsI0. The findings even allowed researchers to extrapolate on which outside influences -- such as friends or parents -- drive particular self-appraisals. If a topic involves academics, moms got the nod, which translated into the brain tagging what teens believed mom though about these abilities as highly self-relevant, Pfeifer said. When it came to social skills, however, reflected self-appraisals from a best friend"s perspective mattered most at the neural level. "As you transition into junior high, peers gain a lot of influence over certain domains, especially in the social realm," Pfeifer said. "Parents manage to maintain this influence in the academic domain." Three highly active areas of current research in adolescent social development include family relations, peer relations and self-development, said Pfeifer, a former doctoral student at the University of California, Los Angeles, where the research was conducted. "At the intersection of these fields, we inquired to what extent are adolescent self-views relatively independent, versus being reliant on perceptions of how others view them, particularly peers and family members," she said. "Rather than just relying on self-reports, our study benefited from a relatively new technique, by examining the neural systems supporting self-perception and taking the perspective of others on the self." The study involved a dozen 11- to 13-year-old students (five girls, seven boys) middle school students and 12 adults (six males, six females) ranging in age from 23 to 30. Participants responded to some 40 questions while inside the scanner over two separate eight-minute sessions. The responses about academics, social abilities and the perspectives of various others allowed researchers to identify what areas of the brain were utilized. "It wasn"t a huge surprise to us that reflected self-appraisals elicited responses in the brain"s social cognition network for perspective taking and thinking about other people," said Pfeifer, who heads the UO"s Developmental Social Neuroscience Lab. "This includes dorsal aspects of the medial prefrontal cortex and also the temporal parietal junction in adolescents and adults. What was most remarkable, however, was that adolescents also used those regions when asked to think about themselves directly, but adults did not. "If we asked, "Do you think you are good at spelling?" teens till seemed -- by way of patterns of brain activity -- to be consulting what they thought other people"s perceptions of them were. This is evidence not contaminated by self reporting," she said. "Their perceptions of themselves really are more dependent on how they think others see them." The study was a follow up to research published in 2007 in the Journal of Cognitive Neuroscience. In that study, Pfeifer and colleagues at UCLA sought to identify neural systems supporting self-knowledge retrieval in younger children. Until that study opened the possibility of using fMRI, most research focused on explicit self reflection as revealed by children. "It will take additional studies to see how we can harness these findings," Pfeifer said. "We already know that peers really matter when it comes to a person"s social self-concept. These studies provide us with a new way to examine this topic. It"s a methodological advance that might help us think about kinds of interventions to improve self-esteem and who -- parents or peers -- might be best used in them." Co-authors of the study with Pfeifer were her UCLA colleagues Carrie L. Masten, Larissa A. Borofsky, Mirella Dapretto, Matthew D. Lieberman and Andrew J. Fuligni. Primary funding for the research came from the National Center for Research Res and the National Institutes of Health. Pfeifer also was supported by a National Research Service Award from the National Institute of Mental Health. Jim Barlow University of Oregon


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