Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Most countries offer the Pill over-the-counter






NEW YORK (Reuters Health) – Unlike women in the U.S., Canada and much of Europe, most women in the world can access the birth control pill without a prescription, according to a new study.


As medical organizations and other groups push to ease the prescription requirements for the Pill in the U.S. and elsewhere, “we can start to use this information to… get a sense of the safety of women having access to this method where no prescription is required,” said Kari White, who studies birth control at the University of Alabama in Birmingham.






The Pill is generally considered safe, said White, who was not involved in the new work, and some studies have shown that, without a doctor’s input, women can accurately screen themselves for risk factors to steer away from using the Pill if it’s not appropriate for them.


Earlier this year, the American College of Obstetricians and Gynecologists, a leading group of women’s doctors, endorsed the idea of making the birth control pill available without a prescription (see Reuters Health report of November 20, 2012 here: http://reut.rs/UH0Zz9).


In a survey of government health officials, pharmaceutical companies, family planning groups, medical providers and other experts in 147 countries Dr. Daniel Grossman, of Ibis Reproductive Health in Oakland, California, and his colleagues found that women in the U.S. and 44 other countries need a prescription to get birth control pills.


The group reported in the medical journal Contraception that while another 56 countries had laws requiring prescriptions, in practice women could access the contraception over-the-counter.


Thirty-five countries legally allowed access to oral contraceptives over-the-counter, and 11 countries allowed over-the-counter access as long as the woman is screened to ensure that she is a good candidate.


“The patterns we saw were interesting,” said Grossman. “Higher income countries – western Europe, Australia, Japan and North America – generally require a prescription.”


Grossman told Reuters Health he couldn’t explain why these patterns have emerged.


“Perhaps in places like China and India that have pills available over-the-counter formally without a prescription might be consistent with strong national family planning programs,” he speculated.


Dr. Ward Cates, of FHI 360, a research organization in Durham, North Carolina, said the lack of a prescription requirement might also reflect a general approach to making health care more accessible in countries where it is less available.


In some countries, “healthcare tends to be more fragmented and healthcare oversight tends to be more fragmented. Therefore the availability of products tends to percolate to outlets that tend to be more accessible to the public,” said Cates, who was not part of the study.


Grossman said it will be useful for countries looking to ease restrictions on birth control access to look to the experiences of these countries.


“Will this information about the availability of pills being over-the-counter in other countries influence policy here? Probably not,” Grossman told Reuters Health.


“But I do think it helps to put it in perspective that this is not something revolutionary.”


SOURCE: http://bit.ly/S51BnH Contraception, online December 10, 2012.


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Eleven Ways to Avoid Answering a Question: A Year in Review






When my grandfather was alive, each of his children and grandchildren was responsible for reporting to him about the world in which they worked. He loved knowledge; he always had. As the only scientist in the family, I was in charge of “science.” This never quite seemed fair and yet I did what I could until the day he asked me to explain dark matter. I am a broadly trained scientist. I have worked on bacteria, birds, plants, insects and a great deal else. But, when pressed, late in the evening, dark matter was beyond my comfort zone. I faltered. Sometimes with my grandfather, faltering could be propped up with grandstanding, but on this particular day there was no such doing. He knew I was guessing. His shoulders slumped and he announced softly, “I don’t think I am ever going to learn everything.” My ignorance was the BS that broke the camel’s back.


In part because of my grandfather I have always felt a responsibility to answer questions people ask about science. This year, I decided I would make this responsibility more conscious. I would try to focus much of my writing on answering questions that came up in my daily life, questions that I am responsible for because I am a scientist. It was a sort of New Year’s resolution. My other resolution was to write shorter articles.1–Sitting around enjoying a glass of wine with my family and our friends Ari Lit and Michelle Trautwein, Ari asked, Hey dude, why do we drink alcohol? Do monkeys drink alcohol? This led me to think about the big story of alcohol and, in as much, to write a whole series about our complex relationship with the yeasts that, as waste, produce our favorite drinks. It ended up becoming a forty thousand word online series, about alcohol, civilization and yeast. So much for the resolution to write short articles. Also, I forgot to check on the monkeys.2–My favorite questions tend to come from kids and earnest parents. This year at my daughter’s school, every third student and then every other students and then, jeez, almost every student seemed to have lice. Parents asked me, “what should we do about lice?” This was a follow-up to an article I had written years prior in response to a similar query. I was able to tell the story of how the louse problem (or success, depending on your perspective) came to be, over the last million years. But I failed to really answer what a parent should do if their kid gets lice. It turns out parents whose kids have lice don’t want to hear about ancient hominids and their lice. Go figure.Image 1. Picture of the louse species, Pthirus pubis, descended from an interaction between a human ancestor and a gorilla ancestor and that is all I am saying. Photo courtesy of the CDC. 3-In the last chapter of my book The Wild Life of Our Bodies I argue for a more serious gardening of nature in the places we live. Reading this, someone wondered about the ways in which we garden evolution itself. She emailed asking, Could we favor the evolution of good species in our houses? I wasn’t sure and am still not, but the question prompted me to reconsider the ways in which we have gardened evolution historically. I wrote the Garden of Our Neglect about this history. I then started to consider how we might favor the presence (if not evolution) of beneficial species on our bodies and in our homes. This led me to propose the Ecological Theory of Disease and to write Letting Biodiversity Get Under Our Skin, and How Clean Living is Bad for You. I also wrote an article about what our body might be doing to favor beneficial species in Your Appendix Could Save Your Life. None of these articles really told anyone which species to plant much less engender in their invisible gardens of indoor life.4-Another night with friends, we sat around talking about paleo diets. Ari asked who we should count as our ancestors, which ancestors should we consider if we were to eat ancestral diets? This debate inspired the piece Were Our Ancient Ancestors Vegetarians and then How to Eat Like a Chimpanzee. Later when Ari tried an essentially all nut and fruit super-fiber diet I found myself writing about the Hidden Truth about Calories. With these articles, I learned about diet, but I also learned that people can get very angry when it comes to discussing food. I never really answered Ari’s question.5-At one evening talk associated with the Museum of Life and Science in Durham, NC, someone asked me why her armpits smell sweet when she lives in the desert. She asked me that question in Durham, not in a desert, so I felt compelled to take her word for it rather than sniff around the story, but I did begin to wonder about what we do and don’t know about the microbial smells produced on our bodies and those of, for example, dogs, so I wrote Why Sick People Smell Bad. The article was fun, but I still don’t know why the woman had sweet pits; perhaps it is just her nature.6-My daughter (who sometimes seems to channel the pure inquisitivness of my grandfather) asked me “Why are our bodies warm and not cold?” This is the kind of question she asks so as to avoid going to bed. It led me to write the article How Killer Fungus May Have Made us Hot Blooded. The article offers a partial, possible, speculative answer to her question, which is her favorite kind of answer because it means she can stay up later as she asks follow-up questions.7–My son has started asking, “papa, who took your hair?” I told him, as I told my daughter when she was smaller, that the squirrels took it for their nest. This just seemed to make him afraid of squirrels so I decided to figure out the real answer, the result was a story in New Scientist (unfortunately pay-walled) about the mystery of baldness and its evolution. Balding, it turns out, is fascinating, but why we bald is still largely unresolved. Back to the squirrels.8–I sometimes introduce talks about social insects by mentioning the similarities between insect and human societies and the idea that insect societies can allow us to learn about our own. In response (and during election season), someone recently asked “who would the ants vote for?” The closest I could get to an answer was to discuss how other animals (mostly honey bees) choose their leaders. I figured out that we know far less about leaders in other societies, including those of ants, than I had thought.9–Piotr Naskrecki visited my house and found, in my basement, a species of camel cricket apparently native to Japan. He also found, to my wife’s dismay, two species of “interesting roaches.” This spurred me to ask other people about their camel crickets, which caused me to have to answer how a Japanese camel cricket has come to take over our basements? I don’t really have an answer yet, though if you check out the website there are ways for you to help me find one.10–For a number of years now, people have been offering me story ideas. “Man, you should totally write about…” Its often difficult to follow up on such ideas, but this year I tried. When my family and I were living in Parma, Italy Donato Grosso asked me if I knew about the species of crab living under Rome. “That,” he said, “would be a good story.” It was. It became “new species of crab living in Rome.” A visit to Girona, Spain where a friend had built a niche in his house for animals to colonize got me wondering about the niches in our cities that we have built for wild species. Pera said, “you should write about it.” I did, in the form of a story about the most common bird in the world, the house sparrow. There were no questions here, but even without a question to answer I seem to have written something slightly different from what Donato or Pera might have imagined.11-Finally, I have started to try to answer the question I have heard most often throughout my career, including from my grandfather, “what do I do about the ants in my kitchen?” Answering this question has required figuring out what the heck is going on with ants in kitchens and backyards and so I wrote one article about a backyard discovery made by English majors, another about a discovery made by an eight year old and another still about how little we seem to know about the most common ant species in eastern North America. I also recruited Eleanor Spicer to write Dr. Eleanor’s Book of Common Ants. None of these answered the question about what to do about the ants in your kitchen, though maybe the distraction bought me some time.Image 2. Camponotus pennsylvannicus, a common backyard (and occasionally kitchen) ant. Photo by Alex (the great) Wild.In short, although I’ve written something like 200,000 words this year, very few seem to have directly answered the questions I was asked. So much for my New Year’s resolution, though maybe part of the problem is that we still know so little about so many fields that it is nearly impossible to make it to the end of a story without encountering the unknown. Perhaps I can try to write shorter answers, answers short enough that I don’t get to what we don’t know. History is not on my side. I seem incapable of writing short articles (one of my shortest articles this year was repeatedly described as “long form”). Also, I come from a long history of “long form” people. My grandfather’s stories went long and, well, his father was apparently worse. When asked to comment on the history of the Episcopal church in his town, Greenville, Mississippi, my great grandfather wrote that he could not write about the history of the Episcopal church in Greenville without commenting on the history of the Episcopal church more generally. And he could not, he said, write about the Lutheran church in general without commenting upon the history of religion. And so he began. My people. It seems we start at the very beginning and answer a question similar too but not identical too the one we were asked. In this light, if my granddad were still around, I’d tell him now that, yes, I can explain dark matter now, but before I do I need to explain the big bang, which, ironically is what I do in my first article of 2013. So stay tuned and send me your questions. But don’t be surprised if, in commenting upon the history of your question, I need to comment on a broader church, the history of life or even the universe.Go ahead and post your science questions you think should be answered in 2013 here…   






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Factbox: U.S. “fiscal cliff,” tax impact of no deal






WASHINGTON (Reuters) – Higher federal taxes for millions of businesses and individuals will become law on Tuesday unless Congress acts to stop them. These taxes, worth $ 500 billion, comprise the bulk of what is known as the “fiscal cliff” problem.


The following shows the probable impact on taxpayers if Congress does not act on Monday, or does not come back later and undo these tax increases, based on data from the nonpartisan Tax Policy Center.






INDIVIDUAL TAXES


If midnight passes with no deal, lower individual tax rates enacted in 2001 on a temporary basis under former President George W. Bush will expire on December 31.


The income tax brackets will rise to 15, 28, 31, 36, and 39.6 percent from the current 10, 15, 25, 28, 33 and 35 percent for nearly 160 million taxpayers.


The poorest fifth of taxpayers, about 40 million households, will see an average tax increase of about $ 412.


The most affluent fifth, about 23 million taxpayers, will typically pay about $ 14,173 more in income tax.


The wealthiest 1 percent, about 1.1 million taxpayers, will see an average tax hike of about $ 120,000.


PAYROLL TAX


About 160 million workers will pay higher Social Security payroll taxes. The rate goes up to 6.2 percent on January 31 when the current, temporary 4.2 percent rate expires. The lower rate was extended in 2012 to give workers a little extra in their paychecks as a way to boost the economy. Unlike some of the other tax measures, there appears to be little interest from Republicans or Democrats in continuing the lower rate.


INVESTMENT TAXES


The capital gains tax rate will rise to 20 percent from 15 percent for most taxpayers who have income from gains on their investments. The tax rate on dividends will rise to the top income tax rate, 39.6 percent, from the current 15 percent dividend tax rate.


ESTATE TAX


The estate tax will rise to 55 percent from 35 percent. The value of assets exempted also drops to $ 1 million per person from its current $ 5 million per person.


ALTERNATIVE MINIMUM TAX


About 27 million Americans could be required to pay the alternative minimum tax (AMT), a tax that initially was intended to make sure the wealthy paid some tax. The AMT fix that Congress has enacted annually had resulted in only 4 million Americans paying the AMT.


UNEMPLOYMENT BENEFITS


About 2.1 million long-term unemployed Americans will see their extended jobless benefits cut off as of January 1, according to the National Employment Law Project, an advocacy groups.


EXTENSIONS OF TAX BREAKS


A mix of tax breaks for individuals and businesses worth tens of billions of dollars annually, including the research and development tax credit for business, will lapse. These include deductions for payments of state and local taxes and tax benefits for college tuition.


MEDICARE PAYMENTS TO DOCTORS


Doctors treating elderly and disabled patients who make up the Medicare population will see a double-digit cut to in rates paid by the federal government health care program. Medicare patients could have a tougher time finding doctors who will treat them.


(Editing by Fred Barbash and Jackie Frank)


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‘Bumping’ Your Way to Safer Sex With a Smartphone App






Reported by Dr. Lauren Browne:


Let’s face it.  Teens have sex.  Parents may choose to ignore it, and teens may choose to deny it, but almost 50 percent of American high school students are having sex, according to the U.S. Centers for Disease Control. And each year, millions of those sexually active teens contract sexually transmitted diseases such as chlamydia, gonorrhea, syphilis, herpes and HIV.






Now one doctor hopes to curb the spread of STDs in this tech savvy group with a smartphone app that lets users “bump” their STD status.


It’s called ‘safe bumping,’” said Dr. Michael Nusbaum, the New Jersey developer of MedXSafe, a feature of the new app called MedXCom.  “If you happen to be out at a bar or a fraternity house or wherever, and you meet someone, you can then bump phones and exchange contact information and STD status.”


The app’s special feature, according to Nussbaum, encourages dating singles to go to the doctor for regular STD checks.  Those who screen negative can ask their doctors to document their STD-free status on the app, allowing users to share the information with whomever they choose.


An alarming 19 million new sexually transmitted infections occur each year, and rates of chlamydia and gonorrhea are on the rise, according to a new report released this month by the CDC.  More than 1.4 million chlamydia infections were reported in 2011, up 8 percent from the previous year.  Cases of gonorrhea were up by 4 percent, marking the second consecutive year of increases.


Nearly half of all infections occur in young people, between the ages of 15 to 24, a group that can be particularly devastated by the associated health effects.


“[Some] undetected and untreated STDs can increase a person’s risk for HIV and cause other serious health consequences, such as infertility,” said Mary McFarlane, an acting chief in the Division of STD Prevention at the CDC.  Harnessing modern social networking technology to prevent these infections may appeal to a younger tech-savvy generation.


MedXSafe is just one of several Internet-based programs devoted to easing confidential STD-status sharing between sexual partners.  Services like Qpid.me, whose slogan is Spread the Love, Nothing Else and U Should Know, designed by a former college student and his girlfriend, also allow their users to check on a partner’s STD status.


But could these services offer a false sense of security to teens who believe that, with a simple phone bump, they have the green light to have unprotected sex?


“It can take months for HIV to show up on a test,” said Renee Williams, executive director of SAFE, a nonprofit organization dedicated to abstinence education.  “So you can test negative today, go out on Friday night and have sex, and then get retested later and find out that you had HIV all along.”


The app does nothing to prevent unplanned pregnancy, and may even encourage high-risk behaviors that young people might otherwise not have been tempted to try, said Williams.


Nor is the app likely to be completely reliable, said Dr. J. Joseph Speidel, director of communication at the Bixby Center for Global Reproductive Health.


“Does it come with a condom?” asked Dr. Richard Besser, ABC’s chief health and medical editor, who’s also a pediatrician and former acting director at the CDC.


But the app’s creator said it does promote regular STD testing and encourages potential partners to openly discuss safe sex practices.


“We’re recognizing that this behavior is going to take place no matter what we do or what we say,” said Nusbaum.  “I have friends that are nuns and I’ve run this by them, and they also agree that it’s promoting safer behaviors.”


Although each program promises to keep health information strictly confidential, none are immune from cyber attacks.


But such attacks would not expose any users who have an STD, according to Nusbaum.  MedXSafe does not allow doctors to upload information about any tests that come back positive, including HIV.  A user with an infection is simply treated for the STD and then retested.  And that user is only confirmed STD-free via the app once subsequent test results come back negative.


Still, it is too early to tell whether these services will become popular with teens.  Lingering social stigma surrounding STDs might make potential partners reluctant to mention such an app when out at a party.


“It’s a big personal step to bring up using such an app,” said Noah Bloom, creator of a smartphone app called Jiber, which uses the same “bump” technology to electronically connect new friends.  “Who really wants anything in the way of getting lucky?”


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Conditional approval for Minn. health exchange






ST. PAUL, Minn. (AP) — U.S. Health and Human Services Secretary Kathleen Sebelius says Minnesota has reached a milestone in its effort to establish a health insurance exchange.


Sebelius notified Gov. Mark Dayton Thursday that the state has been granted conditional approval to operate its health insurance marketplace in 2014.






Nine other states and the District of Columbia have been given similar approval. Sebelius says the Centers for Medicare & Medicaid Services granted approval based on the state’s progress to date and its expected progress. The approval is contingent on the state’s ability to comply with regulations and meet the anticipated progress, among other things.


The health insurance marketplace will give more than a million state residents and small businesses an easy way to compare and buy private health insurance plans, using subsidies if they qualify.


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How Can Professional Santas Avoid the Flu?






A lot of kids must sit on Santa’s lap before he can hop in his sleigh on Christmas Eve, but Santa has to be extra careful during flu season if he wants to stay healthy into the New Year.


John Sullivan, a professional Santa Claus in Chicago, said he never turns down a child, even if the child’s nose is runny.






“I’ll see him. I’ll talk to him,” Sullivan said. “That’s just a risk that frankly comes with the job … Santa can’t go around wearing a surgical mask!”


Since children actually exhale more flu virus than adults because their immune systems are immature, Santa and other people who work with children are at greater risk for coming down with the flu, said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University in Tennessee.


“Of course, Santa is leaning over the child and listening carefully. He’s in the breathing zone of all these children,” Schaffner said. “They come into very close contact with a myriad of children, and children are the great distributor of respiratory viruses.”


Not only do children exhale more of the virus in each breath than adults do, but they also exhale it longer: 24 hours before they start feeling sick until after they feel better.


“It is likely because children are experiencing these viruses probably for the first time, and that their immune systems are not trained to combat the viruses and shut down the virus production mechanism quickly,” Schaffner said.


Schaffner said it’s important for professional Santa performers like Sullivan to get their flu shots, keep up their fluids and get enough sleep and exercise during the holiday season so that their bodies can fight the flu if they come in contact with it.


Sullivan has been Santa Claus every holiday season for more than two decades, and he never misses a flu shot, he said. He started in malls and now does private events at homes, offices and daycares.


“A lot of times when you pick up a baby, you can feel in their lungs that there’s congestion,” he said. “I’ll tell the parent the baby has cold … Frankly, if I’m Santa, I never reject a child.”


He said he’s gotten mild colds, but nothing serious, and he’s always mindful to avoid getting other people sick if he’s not feeling well.


Near Orlando, Greg Thompson runs The Santa Company, which has seven Santas, including Thompson himself, who has been dressing as Santa since he was 14. (“I’d discovered Santa’s secret, so I decided I wanted to be him.”) That first year, Thompson was 129 lbs., so his grandmother helped him stuff a pillow under his puffy jacket to complete the costume.


Although Thompson’s size may have been a problem, the flu wasn’t, he said. In fact, The Santa Company hasn’t had anyone call out sick since it was founded in 1999.


“We have not had it happen yet – knock on wood – but if someone were to come in and say, ‘Greg, I’m just sick and I can’t come in,’ we’d make sure to have a Santa for him,” Thompson said. “We’re more concerned about people bringing their kids to us. If a kid is obviously sick, you can look at him and tell, sometimes.”


Of the 80 appearances The Santa Company does each year, Thompson does about a quarter of them. When a child approaches Thompson-as-Santa with a runny nose and red eyes, Thompson said he will ask the child to sit down in front of him instead of on his lap.


“I’ll be happy to speak with him,” he said.


Thompson added that his Santas always wear clean gloves as part of the classic red suit with white trim, and they cough only into their elbows.


But Schaffner said gloves can quickly become contaminated, and probably don’t offer much protection against the virus as Santa touches a child and strokes his beard or touches his nose. Even surgeons are taught to wash their hands after they remove gloves, he said.


“They are at risk. There’s no doubt about it,” Schaffner said. “But maybe Santa’s beard and mustache can act like a filter and keep the virus out,” he joked with a laugh.


Santa is magical, after all.


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Merck, GE to collaborate on Alzheimer’s drug development






(Reuters) – Merck & Co and General Electric Co‘s healthcare unit have agreed to collaborate on an experimental drug for Alzheimer’s disease, the companies said on Tuesday.


GE Healthcare will supply Flutemetamol, an investigational imaging agent, to Merck for use with its experimental Alzheimer’s disease drug MK-8931.






The companies hope GE’s imaging agent will help identify patients who might benefit from a therapy such as Merck’s, which targets beta amyloid, a protein that can clump together and form plaques in the brain. Such plaques have been found in the brains of patients with Alzheimer’s disease.


MK-8931 is Merck’s lead Alzheimer’s drug candidate and is designed to modify progression of the disease as well as improve symptoms. Alzheimer’s robs patients of their memory and can cause other cognitive disturbances.


Based on promising results from an early-stage clinical trial of MK-8931, Merck plans to move forward with a larger trial, called EPOCH, at multiple sites around the world.


Flutemetamol is a positron emission tomography (PET) imaging agent that has been able, in clinical trials, to detect beta amyloid in the brain.


GE Healthcare will supply Flutemetamol to help select patients for clinical trials and evaluate the agent as a companion diagnostic tool. Financial and other terms of the agreement between the companies were not disclosed.


(Reporting By Toni Clarke; editing by John Wallace)


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S.Africa’s Mandela had gallstones removed, recovering: government






JOHANNESBURG (Reuters) – Nelson Mandela, the 94-year-old former South African president and Nobel Peace laureate hospitalised with a lung infection, has successfully undergone a procedure to have gallstones removed, the government said on Saturday.


“The former president underwent a procedure via endoscopy to have gallstones removed. The procedure was successful and Madiba is recovering,” President Jacob Zuma‘s office said in a statement, using Mandela’s clan name.






South Africa‘s first black president, who came to power in historic all-race elections in 1994 after decades struggling against apartheid, remains a symbol of resistance to racism and injustice at home and around the world.


Mandela was admitted to a Pretoria hospital on Saturday a week ago after being flown from his home village of Qunu in a remote, rural part of the Eastern Cape province.


Tests revealed a recurrence of a lung infection and that he had developed gallstones, the government statement said.


The medical team had decided to treat the lung infection before attending to the gallstones, it said.


Mandela spent 27 years in apartheid prisons, including 18 years on the windswept Robben Island off the coast of Cape Town.


He was released in 1990 and went on to use his unparalleled prestige to push for reconciliation between whites and blacks as the bedrock of the post-apartheid “Rainbow Nation”.


He stepped down in 1999 after one term in office and has been largely removed from public life for the last decade.


Mandela spent time in a Johannesburg hospital in 2011 with a respiratory condition, and again in February this year because of abdominal pains. He was released the following day after a keyhole examination showed there was nothing serious.


He has since spent most of his time in Qunu.


His fragile health prevents him from making any public appearances in South Africa, although he has continued to receive high-profile domestic and international visitors, including former U.S. President Bill Clinton in July.


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Hillary Clinton recovering after sustaining concussion: spokesman






WASHINGTON (Reuters) – U.S. Secretary of State Hillary Clinton is recovering after sustaining a concussion, a State Department spokesman said on Saturday.


“While suffering from a stomach virus, Secretary Clinton became dehydrated and fainted, sustaining a concussion,” Clinton spokesman Philippe Reines said in a statement.






“She has been recovering at home and will continue to be monitored regularly by her doctors. At their recommendation, she will continue to work from home next week, staying in regular contact with department and other officials. She is looking forward to being back in the office soon,” Reines added.


Clinton fell ill with a stomach virus last weekend and was forced to cancel a planned trip to the Middle East and North Africa.


(Reporting by Andrew Quinn; Editing by Will Dunham)


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FDA OKs Ariad’s drug for two rare blood cancers






(Reuters) – The U.S. Food and Drug Administration said on Friday it approved Ariad Pharmaceuticals Inc‘s drug to treat two rare types of blood cancer, three months ahead of the review date.


Iclusig was approved to treat chronic myeloid leukemia and Philadelphia chromosome positive acute lymphoblastic leukemia.






The drug, generically known as ponatinib, is being granted an orphan product status, intended for drugs that aim to treat rare diseases.


The FDA said that Iclusig was approved under its accelerated approval program, which provides patients earlier access to promising new drugs while the company conducts additional studies.


Orphan drug designation is granted by the health regulator to drugs or biologics that treat a condition affecting less than 200,000 Americans.


The status grants the drugmaker a marketing exclusivity of seven years in the United States, upon approval.


Iclusig, which blocks certain proteins that stimulate the development of cancer cells, was to be reviewed by the FDA on March 27. (http://link.reuters.com/vut64t)


(Reporting By Vrinda Manocha in Bangalore; Editing by Maju Samuel)


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Hugo Chavez’s battle against cancer






(Reuters) – Venezuela‘s President Hugo Chavez is in delicate condition after his latest cancer surgery, the government said on Wednesday in a somber assessment that could presage an end to his 14-year rule.


Following is a chronology of the 58-year-old socialist leader’s fight for his health:






JUNE 30, 2011


* A pale-looking Chavez addresses the nation by television from Cuba, where he says doctors operated on him to remove a cancerous tumor from his pelvis.


JULY 4, 2011


* The president makes a surprise return to Venezuela ahead of the country’s Independence Day celebrations.


JULY 17, 2011


* Chavez returns to Cuba to begin a course of chemotherapy.


SEPT. 22, 2011


* Finishes his fourth and final course of chemotherapy.


OCT. 20, 2011


* Following tests in Havana, Chavez declares himself free from his cancer, and his doctors say he is completely cured.


DEC. 2, 2011


* Hosts a regional summit, minus representatives from the United States, in Caracas.


DEC. 20, 2011


* Attends a Mercosur summit in Uruguay, Chavez’s first political trip overseas since his illness was diagnosed.


FEB. 21, 2012


* Chavez says he will undergo another operation after a lesion was found in the same area where he had the tumor.


FEB. 28, 2012


* The president undergoes surgery in Cuba.


MARCH 4, 2012


* Chavez says he will undergo radiation treatment in Cuba.


MARCH 16, 2012


* President returns to Venezuela after his latest operation.


MARCH 25, 2012


* Chavez returns to Havana to begin his first cycle of radiation therapy.


APRIL 5, 2012


* The president cries during Roman Catholic Mass, calls on God “not to take him yet” because he has more to do for Venezuela.


APRIL 14, 2012


* Chavez returns to Cuba for more radiation treatment, missing the Summit of the Americas in Colombia.


OCT. 7, 2012


* Chavez easily wins re-election at presidential poll.


NOV. 27, 2012


* The president says he will return to Cuba for treatment including hyperbaric oxygenation, which can be used to treat the side effects of radiation therapy.


DEC. 7, 2012


* Flies home to Venezuela in the pre-dawn hours, joking, “Where’s the party?”


DEC. 8, 2012


* Chavez says doctors in Cuba found a recurrence of malignant cells in his pelvic area and that he must undergo another operation within days.


DEC. 11, 2012


* Chavez undergoes operation of more than six hours, which the government says was completed “correctly and successfully.”


DEC. 12, 2012


* Vice President Nicolas Maduro says the surgery was “complex, difficult and delicate,” and that the post-operation process will also be “complex and tough.”


(Reporting by Caracas newsroom; Editing by Xavier Briand)


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Head of $3B Texas cancer effort asks to resign






AUSTIN, Texas (AP) — The executive director of a troubled $ 3 billion cancer-fighting effort in Texas has submitted his resignation letter amid escalating scrutiny over the management of the nation’s second-biggest pot of cancer research dollars.


The Cancer Prevention and Research Institute of Texas made Bill Gimson‘s resignation letter public on Tuesday. Gimson has led the state agency since it launched in 2009 but fell under mounting criticism over the recent disclosure that an $ 11 million award to a private company was never reviewed.






Gimson wrote that he had been “placed in a situation where I can no longer feel effective.”


The agency’s board must still approve his request to resign.


Only the National Institutes of Health doles out more cancer research dollars than CPRIT.


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Seeing Through the Fog of ‘Chemo-Brain’






Two weeks ago, Diem Brown, contestant of the Real World/Road Rules Challenge, shared on her PEOPLE.com blog her frustration with her chemo-brain, after having received chemotherapy over the Thanksgiving holiday for recently diagnosed ovarian cancer.


She writes, “Stressed out, overwhelmed and soooo annoyed that your mind isn’t working as it should. This, my friends, is an example of chemo brain!”






Unfortunately, as a surgeon, I have witnessed too many patients get the diagnosis of cancer. If they can transcend the initial shock, there is a desperation to understand what their lives will be like as cancer patients, and what the odds are that they will be cancer survivors.


But for many women, their fear of death is as strong as their fear of chemotherapy, the poison that along with hope, is inseparable from the Hollywood images of the sick, nauseated, thin and bald.


Diem refers to “chemo-brain”, also known as “chemo-fog”, a side effect of chemotherapy that causes problems with memory, information processing, and mood –- effects that can persistent for as many as 20 years after treatment has subsided.


Mental dullness or fatigue and an inability to focus characterized by difficulty organizing thoughts and keeping memories has also been described by patients who suffer from chemotherapy induced cognitive dysfunction.


For years, chemo-brain went largely unrecognized by health care professionals, and those who suffered from it were left without answers to their confusion.


Recently, through the Internet, web chatting and blogging, many women who suffered from chemo-brain realized they were not alone, and over the last few years, several studies have been done giving credit to the condition. But, as they say, you have to see it to believe it.


And now we can see it. In the process of presenting my own research discussing the use of imaging in breast cancer patients at this week’s San Antonio Breast Cancer Symposium, I stumbled across a presentation discussing how scientists are trying to clear the chemo-fog by imaging the brain.


Dr. Bernadine Cimprich from the University of Michigan, along with a group of scientists from the University of Washington and University of Toronto took the stage in San Antonio Friday to shed some light through the fog, and offer a strategy at prevention.


Since chemo-brain doesn’t affect all cancer patients to the same degree, they asked the question, are some patients who receive chemotherapy predisposed to developing the disease?


Chemo-brain has been studied before, but has been difficult to characterize because so many different types of drugs and regimens are used, and for the most part patient’s memory and cognition are not studied prior to starting cancer therapy.


To help shed some light on the subject, these researchers used functional magnetic resonance imaging, or fMRI – a technology that uses magnets to image the brain as it works.


By taking pictures of the brain before and after chemotherapy, they found that patients who suffered from this condition had inherently different function from those who did not before they had even received treatment.


“Brain imaging before treatment showed reduced function in frontal [brain] regions” says Dr. Cimprich, the precise regions that are needed to perform working memory and guide our day-to-day activities, such as remembering the shopping list, our finding our way home.


Identifying patients who may be predisposed to developing chemo-brain can help oncologists alter treatment strategies in efforts to reduce or eliminate the fog.


Who are the patients at highest risk? Dr. Cimprich’s team used surveys to evaluate pre-treatment cognitive function and found that fatigue is a major factor. He suggests that “early interventions targeting fatigue may improve cognitive function and reduce the distress of chemo-brain”.


While the small study involved 98 patients, only 29 of which received chemotherapy, it still lays ground to understand the true nature of chemo-brain, and as Dr. Cimprich emphasizes, identifying the problem early is crucial, because early cognitive problems can become worse over time.


In her blog, Diem suggests making lists as a way to overcome her chemo-brain. And while we all know that stressful times can side track our minds and dull our spirits, until science can give us better answers, research suggests that a deep breath and a little yoga may help do the job of lifting the fog on chemo-brain.


Dr. Christopher Tokin is a surgical resident at the University of California, San Diego School of Medicine and a resident alumnus of the ABC News Medical Unit.


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S.Africa’s Mandela admitted to hospital for tests












JOHANNESBURG (Reuters) – Former South African president Nelson Mandela was admitted to hospital on Saturday for medical tests, although the government said there was no cause for alarm.


A statement from President Jacob Zuma‘s office gave no details of the condition of the 94-year-old anti-apartheid leader.












Former President Mandela will receive medical attention from time to time which is consistent with his age,” the statement said.


President Zuma assures all that Madiba is doing well and there is no cause for alarm,” it added, referring to Mandela by his clan name.


Mandela, who became South Africa‘s first black president after the country’s first all-race elections in 1994, was admitted to hospital in February because of abdominal pain but released the following day after a keyhole examination showed there was nothing seriously wrong with him.


He has since spent most of his time in his ancestral home in Qunu, a village in the impoverished Eastern Cape province.


His frail health prevents him from making any public appearances in South Africa, although in the last few months he has continued to receive high-profile visitors, including former U.S. President Bill Clinton.


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Smokers celebrate as Wash. legalizes marijuana












SEATTLE (AP) — The crowds of happy people lighting joints under Seattle‘s Space Needle early Thursday morning with nary a police officer in sight bespoke the new reality: Marijuana is legal under Washington state law.


Hundreds gathered at Seattle Center for a New Year’s Eve-style countdown to 12 a.m., when the legalization measure passed by voters last month took effect. When the clock struck, they cheered and sparked up in unison.












A few dozen people gathered on a sidewalk outside the north Seattle headquarters of the annual Hempfest celebration and did the same, offering joints to reporters and blowing smoke into television news cameras.


“I feel like a kid in a candy store!” shouted Hempfest volunteer Darby Hageman. “It’s all becoming real now!”


Washington and Colorado became the first states to vote to decriminalize and regulate the possession of an ounce or less of marijuana by adults over 21. Both measures call for setting up state licensing schemes for pot growers, processors and retail stores. Colorado’s law is set to take effect by Jan. 5.


Technically, Washington’s new marijuana law still forbids smoking pot in public, which remains punishable by a fine, like drinking in public. But pot fans wanted a party, and Seattle police weren’t about to write them any tickets.


In another sweeping change for Washington, Gov. Chris Gregoire on Wednesday signed into law a measure that legalizes same-sex marriage. The state joins several others that allow gay and lesbian couples to wed.


The mood was festive in Seattle as dozens of gay and lesbian couples got in line to pick up marriage licenses at the King County auditor’s office early Thursday.


King County and Thurston County announced they would open their auditors’ offices shortly after midnight Wednesday to accommodate those who wanted to be among the first to get their licenses.


Kelly Middleton and her partner Amanda Dollente got in line at 4 p.m. Wednesday.


Hours later, as the line grew, volunteers distributed roses and a group of men and women serenaded the waiting line to the tune of “Chapel of Love.”


Because the state has a three-day waiting period, the earliest that weddings can take place is Sunday.


In dealing with marijuana, the Seattle Police Department told its 1,300 officers on Wednesday, just before legalization took hold, that until further notice they shall not issue citations for public marijuana use.


Officers will be advising people not to smoke in public, police spokesman Jonah Spangenthal-Lee wrote on the SPD Blotter. “The police department believes that, under state law, you may responsibly get baked, order some pizzas and enjoy a ‘Lord of the Rings’ marathon in the privacy of your own home, if you want to.”


He offered a catchy new directive referring to the film “The Big Lebowski,” popular with many marijuana fans: “The Dude abides, and says ‘take it inside!’”


“This is a big day because all our lives we’ve been living under the iron curtain of prohibition,” said Hempfest director Vivian McPeak. “The whole world sees that prohibition just took a body blow.”


Washington’s new law decriminalizes possession of up to an ounce for those over 21, but for now selling marijuana remains illegal. I-502 gives the state a year to come up with a system of state-licensed growers, processors and retail stores, with the marijuana taxed 25 percent at each stage. Analysts have estimated that a legal pot market could bring Washington hundreds of millions of dollars a year in new tax revenue for schools, health care and basic government functions.


But marijuana remains illegal under federal law. That means federal agents can still arrest people for it, and it’s banned from federal properties, including military bases and national parks.


The Justice Department has not said whether it will sue to try to block the regulatory schemes in Washington and Colorado from taking effect.


“The department’s responsibility to enforce the Controlled Substances Act remains unchanged,” said a statement issued Wednesday by the Seattle U.S. attorney’s office. “Neither states nor the executive branch can nullify a statute passed by Congress.”


The legal question is whether the establishment of a regulated marijuana market would “frustrate the purpose” of the federal pot prohibition, and many constitutional law scholars say it very likely would.


That leaves the political question of whether the administration wants to try to block the regulatory system, even though it would remain legal to possess up to an ounce of marijuana.


Alison Holcomb is the drug policy director of the American Civil Liberties Union of Washington and served as the campaign manager for New Approach Washington, which led the legalization drive. She said the voters clearly showed they’re done with marijuana prohibition.


“New Approach Washington sponsors and the ACLU look forward to working with state and federal officials and to ensure the law is fully and fairly implemented,” she said.


___


Johnson can be reached at https://twitter.com/GeneAPseattle


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Investigation under way into New Jersey train derailment, chemical leak












PHILADELPHIA (Reuters) – Federal transportation investigators have begun interviewing the crew of a train that was carrying hazardous materials when it derailed on a railroad bridge in New Jersey, officials said on Saturday.


National Transportation Safety Board Chairwoman Deborah Hersman said the agency would spend the next two weeks preparing a preliminary report on Friday’s accident in the industrial town of Paulsboro.












A bridge collapse derailed seven of the 82 Conrail freight train cars, and a tanker car that fell into Mantua Creek leaked vinyl chloride into the waterway, which feeds into the Delaware River near Philadelphia.


More than 12,000 gallons (45,425 liters) of the highly toxic and flammable industrial chemical vinyl chloride leaked from a gash in the tanker car’s side following the derailment on Friday morning.


Twenty-two people were examined at a nearby hospital, but air monitors in the area did not register any problem, officials have said. Exposure to vinyl chloride can cause a burning sensation in the eyes or respiratory discomfort.


Investigators were obtaining records from Conrail on inspections of the bridge over the Mantua Creek. They also examined a derailment on the bridge in 2009, as well as any possible impact on the bridge from the high winds and rising waters that accompanied superstorm Sandy.


“We are continuing to question the crew to get additional information,” Hersman said at a press briefing. “We still have some work to do.”


State Senator Steve Sweeney, whose district includes Paulsboro, told Reuters on Saturday that 106 residents who live close to the crash scene were evacuated from the area on Friday night in case any more of vinyl chloride escaped into the air or water.


“What it really was was just to be cautious,” Sweeney said. The residents will be out of their homes for several days, and are staying with friends and relatives or hotels, he said.


Conrail is jointly owned by rail operators CSX Corp and Norfolk Southern Corp.


(This story corrects name of town in second paragraph to Paulsboro, not Paulson)


(Editing by Paul Thomasch and Bill Trott)


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Health officials warn of spiraling HIV in Athens












ATHENS, Greece (AP) — Health officials warn that the Greek capital is seeing an alarming increase in new HIV infections, particularly among intravenous drug users, as the country struggles through a protracted financial crisis in which funding has been slashed for health care and drug treatment programs.


Officials said while there were about 10-14 new HIV infections per year among Athens drug users from 2008 to 2010, that number shot up to 206 new cases last year and 487 new cases by October this year — a 35-fold increase.












Epidemiology and preventive medicine professor Angelos Hatzakis described the situation as a “big and rapidly developing epidemic in Athens.”


Marc Sprenger, director of the European Center for Disease Prevention and Control, said the situation must be dealt with quickly to prevent it from spiraling further.


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Leyes no reducen la sobreutilización de costosas terapias del cáncer prostático












NUEVA YORK, 26 nov (Reuters Health) – Dos estudios coinciden


en que las leyes para prevenir el uso excesivo de servicios de












salud no impiden que los médicos sigan indicando terapias


costosas para el cáncer de próstata.


Los autores hallaron que los médicos utilizaban cirugías


robóticas y radioterapias especiales para tratar la enfermedad,


sin importar si en la región existían leyes que exigen una


autorización oficial previa para el uso de instalaciones y


nuevos equipos médicos.


“Las leyes de certificación de necesidad se diseñaron para


alinear la demanda pública con el uso de distintos servicios”,


dijo el doctor Bruce Jacobs, autor principal de uno de los


estudios, de University of Michigan, Ann Arbor.


El gobierno de Estados Unidos impulsó que los estados


implementaran las leyes en los 70 y los 80, pero dejó de hacerlo


un par de décadas después. Aun así, algunos estados siguen


utilizándolas para controlar los costos.


En cada estudio, los autores analizaron tratamientos del cáncer


de próstata, que es el más común en los varones estadounidenses.


La Sociedad Estadounidense del Cáncer estima que a uno de cada


seis hombres se le diagnosticará cáncer prostático, pero que la


mayoría no morirá por esa causa. Estudios previos habían


mostrado que este cáncer es de lento crecimiento y que la


mayoría de los pacientes se puede controlar con espera vigilada.


El equipo de Jacobs revisó si en los estados con normas


estrictas (los que exigen aprobación hasta para el uso de


equipos de bajo costo) se utilizaban menos cirugías robóticas


para extirpar la próstata que en los estados con leyes no tan


estrictas o sin leyes.


En The Journal of Urology, los autores escriben que tanto el


costo de esos robots como si la cirugía robótica supera o no a


la cirugía tradicional para extirpar la próstata deberían ser


“la meta ideal” de revisión donde se aplican esas leyes.


En septiembre, por ejemplo, uno de los estudios que había


cuestionado la utilidad de la cirugía robótica demostró que los


hombres operados con la técnica robótica tuvieron pocas


complicaciones, pero puso en tela de juicio la conveniencia de


sus efectos en el largo plazo y su costo.


Pero otro estudio más reciente mostró que la cirugía robótica


reducía las complicaciones, las reinternaciones y las muertes


por causas quirúrgicas que los métodos tradicionales, según


informó Intuitive Surgical, el fabricante del sistema quirúrgico


da Vinci.


“Eso es importante para el paciente y para reducir el gasto del


sistema de salud”, indicó por e-mail Angela Wonson, vocera de


Intuitive Surgical.


En el nuevo estudio, los autores hallaron un aumento del uso


de la cirugía robótica para extirparle la próstata a un grupo de


beneficiarios de Medicare, independientemente de si el estado


contaba con leyes estrictas, más blandas o ninguna ley. Además,


la posibilidad de que un cirujano utilizara robots no tenía


relación alguna con la vigencia de las normas.


Un segundo estudio, a cargo del doctor Ganesh Palapattu, jefe


de oncología urológica de University of Michigan, analizó si las


leyes limitaban el uso de la radioterapia de intensidad modulada


o IMRT, por su sigla en inglés, o si controlaba el aumento de


los costos de atención del cáncer prostático (la IMRT permite


que los médicos orienten la radiación al tumor sin dañar el


tejido sano que lo rodea).


El equipo escribe que la IMRT es costosa y que, hasta ahora, no


habría sido comparada con otros tratamientos del cáncer de


próstata en un estudio aleatorizado, que es el diseño de


preferencia en la investigación clínica.


Al comparar el costo de tratar a una persona con cáncer


prostático en los estados con leyes y los estados sin leyes, el


equipo observó que las leyes no parecían influir en el control


de los costos de los tratamientos.


Palapattu opinó que es tiempo de reevaluar las leyes.


FUENTE: The Journal of Urology, online 19 de noviembre del


2012.


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German research points way to faster flu vaccines












LONDON (Reuters) – An experimental vaccine based on a molecule related to DNA protects animals against influenza and may one day offer an ultra-rapid way to develop new shots for humans, German scientists reported on Sunday.


Assuming it also works in people, the new approach could allow commercial flu vaccines to be designed and manufactured in weeks rather than months.












Making vaccines quickly is critical in fighting flu, particularly during a pandemic when health authorities and drugmakers are in a race to keep up with mutating strains of virus.


Flu vaccines have traditionally been produced in chicken eggs, a tricky and lengthy process. More recently some firms have started using animal cell cultures, with Novartis on November 20 winning the first U.S. approval for such a product.


Both approaches, however, still involve virus cultivation, which can result in variable yields and production delays.


The new vaccine developed by Lothar Stitz of Friedrich-Loeffler-Institut and colleagues uses a quicker approach. It is made solely of messenger RNA (mRNA) – a single-stranded molecule that carries information telling cells which proteins to make.


“The only thing we need is the sequence of the relevant genes,” Stitz said. “It’s a new option and it doesn’t take long to do.”


His team vaccinated mice, ferrets and pigs with an mRNA vaccine and found that the immune response was similar or better than that found with conventional vaccines. What is more, the new vaccines showed high efficacy in very young and very old animals, which can be a problem with current flu shots.


Reporting their results in the journal Nature Biotechnology, the scientists calculated that a completed vaccine could be produced within six to eight weeks of the genetic code of a flu virus strain being published.


In contrast growing vaccines in fertilised chicken eggs can take up to six months, while using cell cultures may reduce that by up to eight to 10 weeks.


Another potential advantage of mRNA vaccines is the fact that they do not need to be refrigerated.


A human vaccine based on the research is still years away, since extensive clinical trials will be needed to test safety and efficacy, and the job of taking the work forward now rests with CureVac, a privately owned biotech company.


CureVac, backed by billionaire German investor and business software firm SAP’s co-founder Dietmar Hopp, is already developing a therapeutic mRNA vaccine for prostate cancer in human trials.


The firm also has a vaccine for lung cancer in development and is working on prophylactic vaccines against several unnamed infectious diseases in a collaboration with Sanofi.


Sanofi is a major supplier of flu vaccines, along with Novartis and GlaxoSmithKline.


(Editing by Greg Mahlich)


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Ireland opens new probe into death of woman denied abortion












DUBLIN (Reuters) – Ireland has opened a new investigation into the death of a woman denied an abortion of her dying fetus, as the government scrambled to stem criticism of its handling of an incident that polarized the overwhelmingly Catholic country.


Savita Halappanavar, a 31-year old dentist, was admitted to hospital in severe pain on October 21 and asked for a termination after doctors said her baby would not survive, according to husband Praveen, but in a country with some of the world’s most restrictive abortion laws, surgeons would not remove the fetus until its heartbeat stopped days later.












Husband Praveen Halappanavar, who believes the delay contributed to the blood poisoning that killed his wife on October 28, has said he would not cooperate with an investigation already launched by the country’s health service because he did not believe it would be neutral.


On Friday, the Health Information and Quality Authority (HIQA) watchdog, which is government-funded but independent of the state health service, said it had also launched an investigation after receiving information from the health service and University Hospital Galway, where Halappanavar died.


A solicitor acting on behalf of the husband said the new inquiry was unlikely to be enough to satisfy his client.


“My client has always made his position very clear … He wants a public inquiry. He has made it clear he wants to get to the truth of the matter, so I don’t think that the framework of HIQA will suffice,” Gerard O’Donnell, told RTE radio.


He added that the next step would be to consider an application to the European Court of Human Rights, which criticized Ireland’s abortion ban in 2010.


Halappanavar’s death has reopened a decades-long debate over whether the government should legislate to explicitly allow abortion when the life of the mother is at risk.


Irish law does not specify exactly when the threat to the life of the mother is high enough to justify a termination, leaving doctors to decide. Critics say this means doctors’ personal beliefs can play a role.


Though the influence of the Catholic Church over Irish politics has waned since the 1980s, successive governments have been loath to legislate on an issue they fear could alienate conservative voters.


CALL TO CLARIFY


Ireland’s abortion stance is enshrined in a 1983 constitutional amendment that intended to ban abortion in all circumstances. In 1992, when challenged in the “X-case” involving a 14-year-old rape victim, the Supreme Court ruled that abortion was permitted when the woman’s life was at risk, including from suicide.


But successive governments refused to make clear the circumstances under which a threat would make an abortion legal. After several challenges, the European Court of Human Rights ruled in 2010 that Ireland must clarify its position.


Prime Minister Enda Kenny, whose ruling Fine Gael party made an election pledge not to introduce new laws allowing abortion, said last week he would not be rushed into a decision on the issue.


The government was forced into an embarrassing u-turn this week when it removed three Galway-based consultants from the health service inquiry following criticism from Praveen Halappanavar.


The issue has raised tensions between Fine Gael and the more socially liberal Labour Party, its junior coalition partner, which has campaigned for a clarification of the country’s abortion rules.


The country’s president, Michael D. Higgins, a former member of the Labour Party, weighed into the debate this week when he said an investigation was needed that satisfied the dead woman’s family.


Opposition party Sinn Fein introduced a motion to parliament on Wednesday calling for parliament to legislate on abortion, but it was rejected.


“Successive governments over the past 20 years have failed in respect of legislation. That failure is in large measure due to fear or cowardice,” said Mary Lou McDonald, vice president of Sinn Fein.


(Editing by Will Waterman)


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