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CHICAGO (AP) — Days before heading to her fourth World Cup, Megan Rapinoe announced Saturday she’ll retire at the end of the National Women’s Soccer League season.
“It is with a deep sense of peace & gratitude that I have decided this will be my final season playing this beautiful game,” the Olympic gold medalist and two-time World Cup champion said.
The U.S. team is aiming for a third consecutive title when the Women’s World Cup kicks off on July 20 in Australia and New Zealand.
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SAN LUIS LA HERRADURA, El Salvador, Jul 04 (IPS) – Using a few dry sticks as fuel, Margarita Ramos of El Salvador lit the fire in her wood stove and set about frying two fish, occasionally fanning the flame, aware that the smoke she inhaled could affect her health.
“I know that the smoke can damage my lungs, because that’s what I’ve heard on the news, but what can I do?” Ramos told IPS, standing next to her stove in the courtyard of her home in El Zapote, a village of 51 families in the coastal municipality of San Luis La Herradura, in the southern Salvadoran department of La Paz.
Firewood, the fuel of the poor
“I cook with firewood out of necessity, because I don’t always have a job or money to buy gas,” added Ramos, 44, referring to liquefied gas, a petroleum derivative used for cooking in 90.6 percent of Salvadoran homes, according to official data.
This is the situation faced by many women in El Salvador and other parts of the world, especially in the countryside, where dire economic conditions as well as ingrained habits and traditions lead families to cook with firewood, with negative repercussions on their health.
The World Health Organization (WHO) estimated that in 2019 approximately 18 percent of global deaths were due to chronic obstructive pulmonary disease and 23 percent to acute respiratory infections.
Ambient pollution, including wood smoke, plays a decisive role in respiratory diseases, especially among rural women, who do the cooking in line with the roles of patriarchal culture.
Back in 2004 the WHO warned that about 1.6 million people were dying annually from charcoal and wood smoke used in cooking stoves in many developing countries.
In El Salvador, 29,365 cases of acute respiratory infections per 100,000 inhabitants were reported in 2022, well above the 19,000 reported in 2021. Pneumonia reached 365 cases per 100,000 inhabitants in the same period, and the case fatality rate stood at 13.6 percent, up from 11.4 percent the previous year.
Ramos showed IPS the gas stove she has inside her house, with a cylinder that lasts approximately 40 days.
But when the gas runs out and she can’t afford to refill the cylinder, she has to cook with her wood stove. In her courtyard she has a table in a makeshift shed, where she keeps the wood and a metal structure that holds her pots and pans.
Official figures indicate that 5.9 percent of households in this Central American country use firewood for cooking.
However, in rural areas the proportion rises to 12.9 percent, while 84.4 percent cook with gas and the rest use electricity and other systems.
Ramos, 44, has no steady job and as a single mother, scrambles to provide for the needs of her two children.
Twice a week she cleans upscale apartments at a resort near her home, in Los Blancos, a well-known beach on El Salvador’s Pacific coast, also in La Paz. When she does well she cleans two a day, earning 24 dollars.
Sometimes she also washes other families’ clothes.
“Right now I have run out of gas, I have to use firewood,” she said. A cylinder of liquefied gas costs between 12 and 14 dollars.
She generally collects firewood on the banks of the estuary, from the branches of mangrove trees, since hers and other poor families live in a shantytown located between the Pacific Ocean and the Jaltepeque estuary, one of the country’s main wetlands.
Poverty affects 26.6 percent of the population at the national level in this small Central American country of 6.7 million inhabitants, according to official figures. But in rural areas the proportion rises to 29.6 percent, and of these, 10.8 percent live in extreme poverty.
Cutting costs with firewood
Meanwhile in San Salvador, the country’s capital, Cecilia Menjívar runs her small tortilla-making business partly by using firewood, which she collects from tree branches around the Los Héroes community where she lives.
She also uses wood left over from construction sites and sometimes buys it as well, at a cost of one dollar for about three “rajas” or axe-cut tree branches.
Tortillas are round flat bread made from corn dough, which are baked on metal plates generally heated with the flame from liquefied gas.
But Menjívar does not use gas to cook the 68 kg of corn she uses daily to run her business, as she can’t afford it.
“That’s why we prefer firewood. We don’t like it, first of all because of the damage to our health, and also because our clothes are impregnated with the smell of smoke and the walls of the house too, they look dirty,” Menjívar, 58, told IPS.
“We do it to save on the cost, which would be very high, and we wouldn’t make any profit,” she added, while behind her the 68 kg of corn for the day rattled in a boiling pot, black from the wood smoke.
Tortillas are part of the staple diet of the Salvadoran population. Most households cook their food on gas stoves, but they don’t make their own tortillas, because it is a complex and time-consuming process.
That is why so many women, like Menjívar, go into the tortilla business to meet the high level of demand, cooking the corn on wood stoves, usually located in the open air in their courtyards.
But during the May to November rainy season, they cook the corn inside the house, in a back room.
Because of the amount of corn and the size of the pot, the improvised wood stove made of wood and a metal structure has to be set on the floor.
The tortilla business has shrunk, she added, due to the increase in the cost of corn, which climbed from 15 dollars per quintal (45 kg) to 32 dollars.
“With this business we earn enough to buy our food and other basic things, but not for other expenses,” she said.
Chronic bronchitis and pneumonia
Menjívar said that she fell ill with pneumonia in 2022, and she did not rule out that the cause could have been precisely the smoke she has been inhaling for decades, although she pointed out that the doctors who treated her did not inquire about it.
“Since I was a little girl I have been exposed to smoke, because my mother also used to make tortillas using firewood,” she said. “When she couldn’t find dry branches, my mom would burn anything: old shoes, old clothes or paper.”
When she got pneumonia, she had to stop working for three months, and she had to leave the business in the hands of her teenage daughter.
Burning firewood releases toxic gases and polluting particles that end up causing ailments that in medical terminology are grouped together as chronic obstructive pulmonary disease, pulmonologist Carmen Elena Choto told IPS. These gases include carbon monoxide and nitrogen dioxide.
“We also see other harmful particles, there may even be hydrocarbons, because they not only burn wood, but also dry cow dung, corncobs, paper, anything to make the fire,” said the expert.
Damage to the bronchi, or chronic bronchitis, and to the alveoli in the lungs, or pulmonary emphysema, are some of the diseases associated with exposure to smoke, including tobacco smoke, she added.
“Due to the burning of biomass (firewood and other products), the most frequent disease is chronic bronchitis,” said Choto, and older women are the main victims.
People with bronchitis have a constant cough “or wheezing or shortness of breath because there is obstruction due to mucus plugs in the airway,” she said.
Patients, she added, feel tired and suffer from dyspnea or shortness of breath from low oxygen levels, which in severe cases requires hospital care.
Menjívar began to feel these symptoms after spending years making tortillas.
“I felt very tired, I suffered from hot flashes, I was short of breath, I felt like I was having a hard time breathing,” she said.
After she was diagnosed with pneumonia, Menjívar stopped working for three months.
“That’s why I try to stay farther away from the smoke now,” she said. “But the smoke spreads through the house.”
For her part, Ramos, in her coastal village, has put her stove in the yard outdoors, to reduce exposure to smoke. She worries that she could suffer from asthma, like her sister.
Eco-stoves, an alternative
One possible answer to reduce exposure to smoke, especially in rural areas, is the spread of eco-stoves, which due to their combustion mechanism are more efficient in producing energy and release less smoke.
These stoves have been around for decades in developing countries, including El Salvador, but they have not yet become widespread enough to make a difference, at least in this country.
There are socio-cultural aspects that hinder the expansion of the stoves and lead to the continued use of wood-burning stoves, environmentalist Ricardo Navarro, of the Salvadoran Center for Appropriate Technology, a local affiliate of the international organization Friends of the Earth, told IPS.
For example, he mentioned the practice by small farmers of placing corn or beans on bamboo or wooden platforms on top of wood stoves, so that the smoke prevents insects from eating the food.
“The problem is that sometimes we approach the issue as an energy or health problem, without considering these socio-cultural aspects,” Navarro said.
© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service
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This Thursday, the United States Supreme Court rejected affirmative action at colleges and universities around the nation, declaring that the race-conscious admissions programs at Harvard and the University of North Carolina were unlawful. Now on Friday, the Supreme Court decided to block the Biden administration’s student debt relief program and sided with a Christian web designer in Colorado who refuses to create websites to celebrate same-sex weddings out of religious objections. Despite their limited federal elected power, Conservatives have racked up more huge wins in the great political battles of the early 21st century.
Newswise is your source for expert commentary. Below is a roundup of recent expert pitches concerning the United States Supreme Court.
Sociologists Available to Discuss Affirmative Action Ruling in College Admissions
– American Sociological Association (ASA)
Law and diversity experts react to Supreme Court’s affirmative action decision
– Tulane University
Three important takeaways from SCOTUS decision in Groff v. DeJoy
– University of Georgia
SCOTUS decision on race-based admission: experts can comment
– Indiana University
U law expert available to comment on Supreme Court decision on affirmative action
– University of Utah
– University of Georgia
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Newswise — LA JOLLA, CALIF. – June 30, 2023 – A study led by researchers at Sanford Burnham Prebys has found that in young women, certain genetic mutations are associated with treatment-resistant breast cancer. These mutations are not linked to treatment-resistant breast cancer in older women. The findings, published in the journal Science Advances, could help improve precision medicine and suggest a brand-new way of classifying breast cancer.
“It’s well established that as you get older, you’re more likely to develop cancer. But we’re finding that this may not be true for all cancers depending on a person’s genetic makeup,” says senior author Svasti Haricharan, Ph.D., an assistant professor at Sanford Burnham Prebys. “There may be completely different mechanisms driving cancer in younger and older people, which requires adjusting our view of aging and cancer.”
The research primarily focused on ER+/HER2- breast cancer, which is one of the most common forms of the disease. It is usually treated with hormonal therapies, but for some patients, these treatments don’t work. About 20% of tumors resist treatment from the very beginning, and up to 40% develop resistance over time.
“Understanding how certain forms of breast cancer develop in a way that makes them eventually resist therapy can help us better classify the disease. It may also help clinicians adjust the treatment plans for patients who will likely experience resistance to standard treatments,” says Haricharan. “For scientists like myself, it can help guide research to develop new therapies to overcome these obstacles.”
The study included an extensive analysis of a large database of breast cancer patients. It revealed that in ER+/HER2- breast cancer patients, certain gene mutations had a strong correlation with response to treatment—and the effects were dependent on age. Some gene mutations were only linked with treatment-resistant breast cancer in younger women.
“This was a strange finding, so much so that we almost didn’t believe it at first,” says Haricharan. “But the same patterns emerged over and over again in database after database.”
The mutations the researchers identified were in genes involved in cell replication, the process by which cells grow and divide. These genes are responsible for repairing mistakes when they happen—a process that goes awry in virtually all cancers.
“Cell cycle dysregulation occurs so early in the development of cancer that we generally don’t consider whether the individual mutations that cause cell cycle dysregulation can affect cancer’s eventual response to treatment or its ability to spread,” says Haricharan.
By connecting the specific type of cell cycle dysregulation that triggers cancer with the outcome of the disease many years after diagnosis, the research team proposes an entirely new paradigm for thinking about and studying all types of cancer.
“This is a radical shift in how we look at cancer, which could have implications well beyond breast cancer,” adds Haricharan.
To begin to test this idea, the researchers analyzed the effect of cell cycle mutations on patient outcomes in other types of cancer. In a final twist, they observed that across many cancer types, the mode of cell cycle dysregulation is significant for cancer in women, but less so for cancer in men. This suggests that the influence of cell-cycle dysregulation could depend on sex as well as age.
“These findings emphasize why it is important to study cancer in the context of the life history of the patient,” adds Haricharan. “Too often, cancer research is focused narrowly on cells in a petri dish, forgetting the whole, complex host system in which these cells transform and grow.”
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Additional authors on the study include Elena Oropeza, Sinem Seker, Sabrina Carrel, Aloran Mazumder, Daniel Lozano, Athena Jimenez and Nindo B. Punturi, Sanford Burnham Prebys; Sabrina N. VandenHeuvel, Dillon A. Noltensmeyer and Susan E. Waltz, University of Cincinatti; Jonathan T. Lei and Bora Lim, Baylor College of Medicine; Shreya A. Raghavan, Texas A&M University; and Matthew N. Bainbridge, Rady Children’s Institute for Genomic Medicine.
The study was supported by grants from Susan G. Komen (CCR18548157), the American Cancer Society (978170) and the National Cancer Institute (K22 CA229613, R21 CA263768, R37 CA269224, T32 CA203690). Additional support was provided by the California Institute for Regenerative Medicine, Takeda Oncology, Merck, Genentech, Puma Biotechnology, the National Institutes of Health, the Department of Defense, the Chan Zuckerberg Institute, the Adopt a Scientist Program, and the Texas A&M Engineering Experiment Station.
The study’s DOI is 10.1126/sciadv.adf2860.
About Sanford Burnham Prebys
Sanford Burnham Prebys is an independent biomedical research institute dedicated to understanding human biology and disease and advancing scientific discoveries to profoundly impact human health. For more than 45 years, our research has produced breakthroughs in cancer, neuroscience, immunology and children’s diseases, and is anchored by our NCI-designated Cancer Center and advanced drug discovery capabilities. For more information, visit us at SBPdiscovery.org or on Facebook facebook.com/SBPdiscovery and on Twitter @SBPdiscovery.
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Speaking to the Council’s annual meeting in Geneva on protecting the rights of women and girls, the UN High Commissioner said it was an urgent task, and there needed to be zero-tolerance of gender-based violence.
He highlighted the alarming reality that female human rights defenders, women journalists, and those in public office and political decision-making positions, routinely come under “vicious” attack.
“Such acts are deliberate, directed at those seen as challenging traditional notions of family and gender or harmful traditional social norms”, said Mr. Türk.
“Their purpose is clear”, he added, “to exercise control, to perpetuate subordination and to crush the political activism and aspirations of women and girls.”
To illustrate that, Mr. Türk pointed to a recent study conducted by UN Women in 39 countries. It found that 81.8 per cent of women parliamentarians had experienced psychological violence, while 44.4 per cent reported being threatened with death, rape, beatings, and kidnapping.
Additionally, 25.5 per cent had endured some form of physical violence.
Another study, by UNESCO, estimates that 73 per cent of women journalists have faced online violence, including through the spread of fake news, doctored images, and direct verbal threats and attacks.
Confronting the deep-seated structural discrimination requires comprehensive and systemic change. High Commissioner Türk called for the strengthening of national legal frameworks to ensure gender equality and protect women from violence, both online and offline.
“We must adopt codes of conduct with zero tolerance for gender-based violence and establish effective reporting mechanisms for those who experience it,” the High Commissioner said.
Concrete measures, both temporary and permanent, are urgently required. Mr. Türk underscored the need for quotas for women in public and political life. He believes that women should be given more of a chance to get elected to serve on public bodies. For that, awareness-raising campaigns and other forms of assistance to women who want to dedicate their time to politics are needed.
Supporting this point, Reem Alsalem, Special Rapporteur on violence against women and girls, who also addressed the Council on Friday said: “We must stem the tide of violence against women and girls in the private, public and political spheres of life and we must do so now.”
Increasing participation needs to start with changing habitual behaviour said the UN rights office (OHCHR) chief.
“We must also challenge archaic notions that confine domestic and care work to women and girls only,” he urged, adding that economic incentives, social protection measures and gender equality campaigns can be driving forces to promote greater equality overall.
Mr. Türk said improving education was an essential precondition for women’s equality participation in public affairs. He stressed the importance of boosting involvement in traditionally male-dominated fields such as science, technology, engineering, and mathematics (STEM). Education systems and curricula should include women as role models and highlight their contributions throughout history to address the lack of visibility and recognition.
“Women make up half of humanity. Gender equality is not a matter of isolated gains for women alone, it is a collective pursuit that benefits entire societies,” said Mr. Türk, calling upon Member States and the Council “to pledge to take concrete and transformative action to tackle gender-based violence against women and girls in public and political life, and to promote their participation and leadership.”
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It can still be incredibly difficult for U.S. women to get access to the right birth control—but last week, President Biden issued an executive order that could finally make a difference.
Biden issued the wide-ranging order, which includes several directives to protect and expand access to contraception, almost exactly one year after the Supreme Court overturned the constitutional right to an abortion. As part of his mandates, the president instructed federal agencies to address widespread insurance-industry practices that prevent women from accessing their preferred birth control. The order was issued two months after Fortune published an investigation into those problems.
Private insurance companies regularly refuse to fully cover some contraceptives, despite being required to do so by the Affordable Care Act, Fortune’s April investigation found. As a result, many women are unable to afford the birth control they want (and their medical providers prescribe), while the companies that develop and sell new kinds of contraceptives have struggled to stay in business.
On Friday, Biden specifically ordered federal agencies to address these problems, by considering issuing “new guidance” to ensure that private insurers fully cover women’s contraception. Such guidance could also “streamline the process for obtaining care women need and want,” the White House said. (White House advisers also acknowledged “some of the reports out there about [insurers’] failure to comply” with the Affordable Care Act, Stat News reported on Friday.)
These pervasive insurance coverage problems have contributed to a worsening reproductive health crisis: Almost half of all U.S. pregnancies are unplanned, according to the Guttmacher Institute. Now that the Supreme Court has overturned Roe v. Wade, millions of women with such unintended pregnancies no longer have access to abortions and adequate reproductive health care.
Biden’s executive order did not discuss a specific deadline for federal agencies to take new action. But reproductive-health advocates and industry executives alike celebrated the White House’s action, calling it a promising step in the right direction.
“I’m really hopeful,” Mara Gandal-Powers, director of birth control access and senior counsel for the National Women’s Law Center, tells Fortune. “It certainly indicates that this is really high priority for the President—and I do think that the agencies listen when these kinds of things come out.”
Executives at Agile Therapeutics, which makes a new kind of contraceptive patch called Twirla, also said they were heartened by the president’s order. They hope the federal agencies will release new guidance as soon as this summer, in what they call a best-case scenario—or, in a worst-case scenario, sometime next year.
Agile spent more than a decade, and invested about $250 million, to get regulatory approval for Twirla—at a time when many larger and better-funded pharmaceutical companies have stopped investing in women’s health. But after the company launched its product in 2020, it discovered that insurance providers would routinely reject doctors’ prescriptions for it. In 2022, insurers refused to fully cover 55% of the prescriptions doctors wrote for Twirla, according to Agile—which lost more than $25 million last year.
In the past few months, Agile has raised money and continued to increase sales, but it’s still fighting insurers to get its product covered. (The company reported a net loss of $5.4 million for the first quarter of 2023.) Now CEO Al Altomari is hoping that the White House’s intervention will help him get back to his core business of selling birth control, without all the expensive insurance wrangling.
“My company’s fighting for its life right now. A couple of us are,” Altomari says. “I wanted it last year—but this could be really good.”
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Fredde Tchibinda uses artistic makeup to enhance and celebrate women who are making a difference in Senegal.
In Senegal, Fredde Tchibinda uses creative makeup as a powerful and imaginative way to portray strong African women.
In her studio and out in the streets of Dakar, she designs and creates striking portraits that enhance and celebrate women’s strength and confidence. Her subjects include eco-feminists and women protecting Dakar’s street children, and her work focuses on the issues that concern African women.
Her stunning creations offer a sense of power and optimism for the next generation.
Ata Messan Koffi is a Togolese filmmaker who has produced and directed several short and feature length films, both documentary and fiction. Through his production company he supports African filmmakers and a commitment to elevating the ‘”view from within” in African storytelling.
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Newswise — MIAMI, FLORIDA (EMBARGOED UNTIL 3:01 AM ET Monday, June 26, 2023) – Current evidence indicates Black women in the U.S. are at greater risk of developing advanced uterine cancer, also known as endometrial cancer, and of developing its more aggressive form – non-endometroid cancer – than white women.
But research to date has mostly studied Black women as a homogenous group, and there is limited data about specific African-descent subpopulations worldwide. That is until now.
A new study by researchers with Sylvester Comprehensive Cancer Center and the University of Miami Miller School of Medicine compared both the overall incidence and trends for endometrial cancer between African-descent women in the U.S. (Florida) and the French Caribbean, specifically the islands of Martinique and Guadeloupe, where most residents are Black or mixed-Black and quality health data is available.
Their study, which appears today in Cancer, a peer-reviewed journal of the American Cancer Society, found that endometrial cancer rates are related to factors beyond ancestry, including social determinants of health such as diet, psychosocial and physiological chronic stress and neighborhood/built environmental factors, among others.
“We need to disentangle the endometrial cancer disparities among Black women by focusing more on subpopulations, specifically on differences between countries and their associated socioeconomic factors while concentrating on patterns for the deadlier non-endometrioid subtype,” said Heidy N. Medina, PhD, MPH, researcher with UM’s Miller School of Medicine and the study’s corresponding author.
As of 2022, endometrial cancer was the fourth most common cancer for U.S. Black women with one of every 10 newly diagnosed cases being a woman of African descent, the authors noted. Black women experience a higher incidence than white women in the U.S. and their rates are rising more rapidly.
Medina and collaborators, including Frank Penedo, PhD, Sylvester’s associate director for Cancer Survivorship and Translational Behavioral Sciences, Tulay Koru-Sengul, PhD, Matthew P. Schlumbrecht, MD, MPH, and senior author Paulo S. Pinheiro, MD, PhD, analyzed data on almost 35,000 endometrial cancer cases from Florida and the French Caribbean from 2005 to 2018 for this study. Key findings included:
“Our study supports current evidence that Black women in the U.S. are disproportionately affected by endometrial cancer, but also highlights key differences among African-descent subpopulations that should not be overlooked,” Penedo explained. “These differences among Black women in different regions of the world are partly due to social factors and not solely related to genetic factors.”
Dr. Pinheiro, a Sylvester cancer epidemiologist, agreed. “This research shows cancer trends for U.S. Black women cannot be generalized to other African-descent populations worldwide where limited data exists,” he said. “The study underscores the importance of improving data collection in specific regions to better assess cancer risks for different population groups.”
Next steps, the researchers noted, are to examine differences between the majority African-descent populations of the French Caribbean to that of the predominantly white French mainland in collaboration with our colleagues in the Université des Antilles, Clarisse Joachim, MD, PhD and Jacqueline Deloumeaux, MD, PhD, to better pinpoint existing disparities.
“Additionally, we must pay particular attention to investigate risk factors for the more aggressive non-endometrioid subtype that is rising among all three groups in our current research,” Medina concluded.
Authors
The complete list of authors is noted with the research article.
Funding
Supplemental funding was provided by Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. This research was supported by the National Cancer Institute of the National Institutes of Health, grant P30CA240139 to Paulo S. Pinheiro. The project was also supported by grant R25CA11283 from the National Cancer Institute. Funding was also received from the Florida Education Fund McKnight Doctoral Fellowship to Heidy N. Medina.
Potential Conflicts of Interest The authors declare no conflicts of interest.
DOI: 10.1002/cncr.34789
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PHOTO CAPTION/CREDIT:
“We need to disentangle the endometrial cancer disparities among Black women by focusing more on subpopulations, specifically on differences between countries and their associated socioeconomic factors while concentrating on patterns for the deadlier non-endometrioid subtype,” said Heidy N. Medina, PhD, MPH, the study’s corresponding author. Photo by Sylvester.
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Twitter: @drheidymedina @DrFrankJPenedo @MatthewSchlumb1 @SylvesterCancer
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(EMBARGOED UNTIL 3:01 AM ET Monday, June 26, 2023)
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BUENOS AIRES, Jun 23 (IPS) – Viviana Mazur is a doctor at the Santojanni Hospital in Mataderos, a working-class neighborhood in Buenos Aires. She has witnessed the advances in women’s rights in Argentina, where until 2020 abortion was only allowed on two grounds, while it is now available on demand up to 14 weeks of pregnancy.
“Today what we see at the hospital is that most women come in for a consultation very early; in many cases they do so as soon as their period is late. This makes it possible to resolve almost all abortions with medication, in the woman’s own home, with medical advice and monitoring,” she said.
Mazur, who is also coordinator of Sexual Health in the Buenos Aires city government, said there are many advantages of medication abortion over the traditional surgical procedures.
“It’s less traumatic and less risky for the woman and it’s less costly for the public health system,” she told IPS.
In Argentina, as a result of years of struggle by the women’s rights movement, since January 2021 abortion has been decriminalized. In the last stage of the fight, mass demonstrations by women – and also men – wearing green headscarves, which has become a pro-choice symbol in Latin America, filled the streets.
Since then, Law 27,610 on Access to Voluntary Interruption of Pregnancy allows any woman to have an abortion up to the 14th week of pregnancy free of charge and without having to explain the reasons for her decision.
Until the law came into force, access was severely restricted: a Supreme Court ruling in effect since 2012 authorized what was called Legal Termination of Pregnancy, only in the case of rape or if the pregnancy endangered the woman’s life or health.
More abortions recorded in 2022
In 2022, the first full year in which the law allowing abortion on demand was in force, 96,664 abortions were performed in the public health system of this South American country of 46 million inhabitants, according to official data. This marked a significant increase over 2021, when the total was 73,847, partly due to the rise in abortions in the public health system.
“More than 85 percent of abortions in 2022 were performed with medication,” Valeria Isla, the national director of Sexual and Reproductive Health, told IPS.
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“The good news is that today these are safe practices taking place within the health system. In any case, since until recently most abortions were clandestine, we believe it is too early to draw conclusions with respect to the number. The figures have yet to stabilize,” she added.
Isla explained that her office provides training to health personnel from all over the country on how to perform abortions and that medications are distributed, as well as equipment for manual vacuum aspiration, which is a less risky medical procedure in a doctor’s office than dilation and curettage, which is performed in an operating room.
In this sense, since 2022 the incorporation of mifepristone into the Argentine health system, in addition to misoprostol, which has been used for years to perform medical abortions, has been a great step forward.
The combination of mifepristone and misoprostol, called “combipack”, makes abortions more efficient and less painful for women, and in fact the combination of these two drugs for pregnancy termination is one of the techniques recommended by the World Health Organization (WHO) since 2005.
Last year, the WHO ratified both as essential drugs for providing quality health services and backed their efficacy and safety for abortion.
Isla explained that since last year the national government has been distributing mifepristone in public hospitals thanks to a donation from the United Nations Population Fund (UNFPA).
Since March of this year, mifepristone has been fully available also for the Argentine private health system, since the governmental National Administration of Medicines, Food and Medical Technology (Amnat) authorized its sale in pharmacies.
This has allowed the “combipack” to be used in recent months in the private health system as well, where women now also have easier access to abortion.
“The incorporation of mifepristone has been very important on a day-to-day basis to make abortion easier for women, because it means less misoprostol is used, side effects are reduced and the whole process can be carried out at home, with prior and subsequent checkups,” Florencia Grazzini, a social worker at a primary care clinic in the municipality of Lanús, on the outskirts of Buenos Aires, told IPS.
Grazzini began providing support to women who needed access to abortion long before the legalization of voluntary termination of pregnancy. She worked for years at the Kimelú counseling center, formed by feminist activists and serving the southern area of Greater Buenos Aires.
She said that while access to abortion has now been greatly facilitated, for some women termination of pregnancy is still a stigma.
“Despite the fact that with the law there is no need to gjve a reason for abortions up to 14 weeks of pregnancy, the justification for the decision continues to appear in the record of the consultations,” Grazzini pointed out.
She added that, “We are working so that people can share how they feel about their situation, but we don’t want them to feel that they need to explain in order to access an abortion.”
She said the women are told that they do not need to explain why they wish to have an abortion, although psychological assistance is provided to those who request it.
Abortion, however, sometimes encounters resistance from health professionals themselves. This was reflected in May, when the Ministry of Health updated the Protocol of Care and urged the “elimination of all requirements that are not clinically necessary for the safe practice of abortion.”
Specifically, it called for the elimination of waiting or reflection periods and the requirement of parental or partner consent.
The need for support
More data that shows that the legalization of abortion has not eliminated all the actual barriers is provided by Socorristas en Red (roughly, “Helpers Online Network”), a women’s organization that provides nationwide support for women who need an abortion.
In 2022, the network received 13,292 calls from women who wanted to terminate their pregnancies.
Only 10 percent of them had abortions in the public health system and the rest had abortions that they arranged elsewhere. The organization provided them with psychological assistance, information, instructions, WhatsApp messages, phone calls, and virtual and face-to-face company by “socorristas” or helpers. With all this they found greater comfort than in the health system.
This picture is completed by the visible inequality in access to abortion in different areas of the country.
Although the number of public hospitals and health centers that perform abortions reached 1793 in 2022 – against less than 1000 in 2021 – in some provinces the supply is very limited. For example, in the northern provinces of Santiago del Estero and Chaco there are only eight and nine health institutions, respectively, that perform abortions.
“In some places there is resistance from officials and a lack of knowledge among fellow workers about outpatient treatment with medications,” Ana Morillo, a social worker in the province of Córdoba, in the center of the country, told IPS.
Morillo, who is an activist and member of the Network of Professionals for Choice and the organization Catholics for Choice, said the advocacy work of the women’s rights movement has made Cordoba one of the provinces with the greatest access to abortion, since there are 180 hospitals and health centers that perform the procedure.
“The greatest inequalities are between cities and rural areas, where it is much more difficult to access an abortion. These are the disparities in the country on which we still have to work the hardest,” she said.
© Inter Press Service (2023) — All Rights ReservedOriginal source: Inter Press Service
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Newswise — Axillary web syndrome, also known as lymphatic thrombus, is a complication in the clinical manifestations suffered by many women after overcoming breast cancer, mainly affecting their shoulder mobility.
In order to reduce the evolution time of these axillary thrombi in patients with a mastectomy –total or partial extirpation of the breast–, researchers of the “Physiotherapy” group of the University of Malaga have developed a new therapy based on manual techniques that can “significantly” reduce pain and improve mobility.
A research led by Rocío Martín, Professor at the Faculty of Health Science of the UMA, and the physiotherapist María Jesús Vinolo that derives from the doctoral thesis of Jesús Baltasar González, which results have been published in the scientific journal Support Care Cancer.
According to these experts, the axillary web syndrome may delay the application of radiotherapy in mastectomized women, a treatment that should be done in a particular period of time. “This delay is caused by the impossibility of reaching the maximum flexion and abduction position of the shoulder during radiation. Thus, the importance of reducing the evolution time of the lymphatic cording to be able to receive treatment within the protocol times established by oncology”, they assure.
Manual therapy and stretching
It is an individualized physiotherapy treatment, based on manual therapy and stretching, applied by a lymphology specialist. It consists of 15 sessions carried out for three consecutive weeks, in addition to advice and exercises to do at home.
“So far, the treatments applied on women with axillary web syndrome do not usually go beyond the educational field”, says the researcher at the University of Malaga.
In this first phase of the study, the researchers have carried out a systematic review and a meta-analysis. As a next step, this scientific team is about to start a clinical trial within the Healthcare Management Area, Campo de Gibraltar Oeste, particularly, in the Lymphedema Unit of Algeciras, which already has the approval of the Ethics Committee.
They will work with a sample of about 50 women and study different variables like functionality, movement range, pain, and quality of life.
Bibliography:
González-Rubino JB., Vinolo-Gil MJ., & Martín-Valero R. (2023) Effectiveness of physical therapy in axillary web syndrome after breast cancer: a systematic review and meta-analysis. Support Care Cancer.;31(5):257. doi: 10.1007/s00520-023-07666-x.
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Newswise — Researchers at Karolinska Institutet in Sweden have identified a group of nerve cells in the mouse brain that are involved in creating negative emotional states and chronic stress. The neurons, which have been mapped with a combination of advanced techniques, also have receptors for oestrogen, which could explain why women as a group are more sensitive to stress than men. The study is published in Nature Neuroscience.
Just which networks in the brain give rise to negative emotions (aversion) and chronic stress have long been unknown to science.
By using a combination of advanced techniques, such as Patch-seq, large-scale electrophysiology (Neuropixels) and optogenetics (see factbox), KI researchers Konstantinos Meletis and Marie Carlén and their team have been able to map out a specific neuronal pathway in the mouse brain leading from the hypothalamus to the habenula that controls aversion.
The researchers used optogenetics to activate the pathway when the mice entered a particular room, and found that the mice soon started to avoid the room even though there was nothing in it.
Opens the way for novel treatments for depression
“We discovered this connection between the hypothalamus and the habenula in a previous study but didn’t know what types of neurons the pathway was made up of,” says Konstantinos Meletis, professor at the Department of Neuroscience, Karolinska Institutet. “It’s incredibly exciting to now understand what type of neuron in the pathway controls aversion. If we can understand how negative signals in the brain are created, we can also find mechanisms behind affective diseases like depression, which will open the way for novel drug treatments.”
The study was led by three postdocs at the same department, Daniela Calvigioni, Janos Fuzik and Pierre Le Merre, and as Professor Meletis explains, is an example of how scientists can use advanced techniques to identify neuronal pathways and neurons that control emotions and behaviour.
Sensitive to oestrogen levels
Another interesting discovery is that the neurons linked to aversion have a receptor for oestrogen, making them sensitive to oestrogen levels. When male and female mice were subjected to the same type of unpredictable mild aversive events, the female mouse developed a much more lasting stress response than the male.
“It has long been known that anxiety and depression are more common in women than in men, but there hasn’t been any biological mechanism to explain it,” says Marie Carlén, professor at the Department of Neuroscience. “We’ve now found a mechanism that can at least explain these sex differences in mice.”
The study was mainly financed by the Knut and Alice Wallenberg Foundation, the Swedish Research Council, the Swedish Brain Foundation and the David and Astrid Hagelén Foundation. The researchers report no potential conflicts of interest.
Factbox: Here are the techniques used
Patch-seq: Patch-seq combines measurements of the electrical properties of individual cells with measurements of gene expression (RNA sequencing) and makes it possible to map the different types of neurons in the brain.
Neuropixels: The Neuropixels probe is a new type of electrode for large-scale electrophysiological measurements that makes it possible record the activity of hundreds of individual neurons simultaneously.
Optogenetics: Optogenetics is used to control how and when selected neurons are active. The method involves introducing light-sensitive proteins (such as channel proteins from the membranes of single-cell organisms) into the neurons to be studied. Light can then be used to control individual cell types in the mouse brain to ascertain their function.
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Across the internet, a biological scapegoat has emerged for almost any mysterious medical symptom affecting women. Struggling with chronic fatigue, hair loss, brain fog, or dwindling sex drive? When no obvious explanation is at hand, an out-of-whack endocrine system must be to blame. Women have too much cortisol, vloggers and influencers say; or not enough thyroxine, or the wrong ratio of progesterone to estradiol. Social media is brimming with advice from self-proclaimed hormone “gurus” and health coaches; the tag #hormoneimbalance has racked up a staggering 950 million views on TikTok alone.
Now dozens of start-ups promise to diagnose these imbalances from the comfort of your home. All it takes is the prick of a finger, a urine sample, or a vial of spit. You mail your sample out to a lab or run the test right in your kitchen, no co-pay or doctor visit required. A few days later, you receive a slick lab report and in some cases, a customized treatment plan to alleviate the depression, the insomnia, the feeling of just being off.
Hormone imbalances can indeed contribute to an array of mental and physical symptoms, and hormone testing overseen by providers is a routine practice in medicine. Doing so remotely could theoretically improve women’s health and access to care. But despite their growing popularity and Amazon-like convenience, at-home hormone tests might cause more problems than they solve. Several women’s-health and hormone specialists told me that remote testing has long been useful for detecting pregnancy and tracking ovulation, but that few, if any, products now for sale have been consistently and rigorously proven to work for broader, newly advertised purposes. Testing kits are marketed as a way of helping women decipher puzzling symptoms or assess their fertility. But experts said that the technology—at least as it stands right now—is unreliable and could have the opposite effect, causing anxiety and confusion instead.
Mindy Christianson, an ob-gyn and the medical director of the Johns Hopkins Fertility Center, told me that in the best-case scenario, an accurate home hormone test would lead its users to seek out necessary medical care for real medical problems. That’s what happened to Chrissy Rice, a 38-year-old in Georgia. From 2018 to 2022, Rice experienced a racing heart, panic attacks, skin rashes, fatigue, and stomach pain—but her blood work and cardiac tests kept coming back normal. Her doctor chalked her symptoms up to anxiety and prescribed an anxiolytic medication. Rice wasn’t satisfied, so she skipped the meds and ordered a $249 women’s-health-testing kit from a company called Everlywell. The kit, which uses saliva and finger-prick sampling, claims to check for abnormal hormone levels that may be keeping women from “feeling their best.” When Rice’s results lit up with four abnormal readings, she was “honestly relieved,” she told me: It gave her confidence that her symptoms hadn’t all been in her head. When she brought the results to another provider, he ordered more tests and eventually diagnosed her with an autoimmune condition called Hashimoto’s, for which she’s since been treated.
Rice’s success story relied on a lot of things going right: The test correctly flagged that something about Rice’s body chemistry had gone awry. (In this case, #hormoneimbalance really did apply.) In response, Rice used her results to advocate for appropriate care from a trusted health provider. But not everyone is so lucky.
Tests like the one Rice took rely on processes that have not yet been rigorously validated in clinical trials. Where traditional hormone testing involves in-person blood draws followed by a highly sensitive and specific process called liquid chromatography–tandem mass spectrometry, home tests typically use dried urine, dried blood, or saliva sampling and a variety of techniques for measuring what’s in those samples. Women have, of course, been peeing on pregnancy-testing sticks since the 1980s. But these tests work well because the target hormone is present at relatively high levels, and should be found only during pregnancy. By contrast, hormones such as estradiol, testosterone, and progesterone—which are commonly targeted by this new wave of start-ups’ tests—regularly circulate throughout the body during various stages of a woman’s life, and are far trickier to measure using the low-volume samples involved in dried urine, dried blood, and saliva tests.
A handful of small studies from the past three decades (many of which are funded by direct-to-consumer testing companies or conducted by their employees) suggest that these methods may be accurate. Jennifer Conti, an ob-gyn physician and professor at the Stanford University School of Medicine who advises the home-hormone-testing start-up Modern Fertility, told me that the company’s internal data, especially a study published in the peer-reviewed journal Obstetrics & Gynecology in 2019, convinced her that its technology was useful for consumers who want to make more informed family-planning decisions. “But this idea that at-home testing is a godsend is not true,” Conti said. “It’s something that can be very helpful right now for a certain population of people to open the door and start a conversation.”
Other experts still aren’t confident that the tests are worthwhile. I asked Andrea Dunaif, a professor and specialist in endocrinology and women’s health at Mount Sinai, and Hershel Raff, an endocrinology and molecular-medicine expert at the Medical College of Wisconsin, to review the 2019 study. According to the study’s authors, their findings suggest that Modern Fertility’s finger-stick testing methods can be used interchangeably with traditional blood draws to measure fertility-related hormones. But Dunaif and Raff pointed out a laundry list of methodological issues that they argue limit the power of the findings: The type of assay used isn’t accurate for determining testosterone or estradiol levels in women. Researchers didn’t use appropriate hormone-level ranges to test accuracy. Samples were analyzed within 48 hours—a timeline that doesn’t match up with real-world shipping. (Current leadership and members of Modern Fertility’s clinical-research team declined multiple requests for comment. But Erin Burke, a clinical researcher who co-authored the study and is no longer working for Modern Fertility, said she stands by the data. She told me that the team’s work shows that these testing methods are accurate and precise.)
Although many experts see minimal data to support their use, at-home tests can still be sold on account of a regulatory loophole: The FDA does not typically review what it calls “low risk general wellness” products before they hit the market. Some endocrinologists advise looking for home hormone tests with a certification from the Clinical Laboratory Improvement Amendments program (which is legally required for every direct-to-consumer testing company) or the College of American Pathologists, both of which ensure that a company’s labs maintain certain quality standards and undergo regular inspections. But Dunaif told me the certifications don’t guarantee precise results. She would never recommend that consumers use a currently available product for testing women’s sex steroid hormones remotely, she said, arguing that people will waste money and likely get information that is either “falsely reassuring or falsely distressing.” (Dunaif recently consulted for Quest Diagnostics, a large clinical-lab chain that doesn’t offer home hormone tests.)
Charlotte, a New Jersey woman in her mid-30s, experienced the muddle of uncertain results firsthand. (I’m identifying her by only her first name to protect her medical privacy.) In 2021, Charlotte ordered a hormone panel from Modern Fertility after she began experiencing irregular periods. Her results showed an abnormally high level of prolactin, a hormone involved in ovulation and lactation, which made her think she might be infertile. Charlotte spent days scouring the internet for information while she waited to discuss the results with her doctor. When she finally showed her ob-gyn the Modern Fertility report, the doctor was incredulous. She basically dismissed the at-home results out of hand, and instead put Charlotte on progesterone. A few months later, Charlotte got pregnant.
Like Rice’s home test, Charlotte’s helped her start a conversation with a trusted health-care provider and develop a plan. But Charlotte told me that the process wasn’t worth the panic-filled waiting game and desperate Googling. She wishes she’d skipped the home test and consulted her doctor first.
Even when home hormone tests are accurate, their results are not diagnostic on their own. Drawing a straight line from hormone levels to a diagnosis is impossible without a medical history or physical exam; a user can’t predict her chances of pregnancy, for example, solely based on measurements of her fertility-related hormones. Nor would low levels of, say, estradiol or progesterone be enough to indicate endometriosis. Most people’s symptoms aren’t tied directly to a hormone imbalance, says Stephanie Faubion, the director of the Mayo Clinic Center for Women’s Health and the medical director of the North American Menopause Society. The more than 50 chemical messengers that coordinate all kinds of processes, including metabolism, reproduction, and mood, are constantly fluctuating and difficult to measure with a quick-hit hormone test, Faubion told me; people’s symptoms may be attributable to multiple interrelated factors. “Just checking a hormone level and saying Here’s your problem doesn’t serve women well,” she said. “It’s oversimplifying an issue.”
Some companies offer physician-reviewed reports, chat services, or phone calls with health providers to clarify any confusion. But Mary Jane Minkin, a gynecologist, menopause expert, and clinical professor at Yale School of Medicine, told me that those services might not be enough to curb misinterpretation, especially if test results aren’t reliable. Minkin worried that users may make drastic lifestyle changes or take off-the-shelf supplements. Christianson, of the Johns Hopkins Fertility Center, said that a growing number of her patients visit her clinic believing they are infertile or in premature menopause based on abnormal readings, when it’s not true. Others are rushing to freeze their eggs unnecessarily. And Faubion worries that providers, too, might use tests that aren’t evidence-based to make decisions about hormone therapy for patients. Some testing start-ups already offer personalized treatment plans and bioidentical hormone-replacement therapy via telehealth based on a user’s results.
Other experts had the opposite concern: that women whose home-test results appear normal would miss out on crucial interventions. Christianson told me that she’s seen men skip out on necessary infertility evaluations based on at-home semen tests. Women could end up making similar mistakes. And Dunaif said that women experiencing chronically irregular periods might be falsely reassured by a home hormone test and delay needed treatment for endocrine disorders or polycystic ovarian syndrome (PCOS).
At-home-hormone-testing companies aim to solve a pressing demand for clarity and control as women address their medical needs. If women have been tempted to blame their hormones for anything that’s wrong, that’s at least partly because they aren’t receiving sufficient guidance from doctors. For decades, female patients have been dismissed, misdiagnosed, and mistreated by their health providers more than male patients have. Far less clinical research has been conducted on women than men, which can make health care a guessing game. A diagnosis for a hormone disorder such as PCOS or endometriosis typically takes consultations with several doctors across two to 10 years. Plus, traditional hormone testing can be expensive, and specialists are difficult to find. Only 1,700 reproductive endocrinologists and 2,000 menopause specialists practice in the United States; fertility clinics are rare outside cities.
In an ideal world, women wouldn’t feel the need to circumvent their doctors to test their hormones at home. But as it stands, many are desperate for answers, and direct-to-consumer testing companies are responding to their frustrations. Someday, the tests might help point users to the appropriate specialist, provide useful information for women in medical deserts, or enable people to better monitor chronic conditions for which the relevant hormones are simple to measure. But until they are rigorously evaluated, women are left with imperfect choices.
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“Half of people worldwide still believe men make better political leaders than women, and more than 40 per cent believe men make better business executives than women,” according to the UN Development Programme (UNDP) in its latest Gender Social Norms Index (GSNI) report.
“Social norms that impair women’s rights are detrimental to society more broadly, dampening the expansion of human development,” said Pedro Conceição, head of UNDP’s Human Development Report Office.
A staggering 25 per cent of people believe it is justified for a man to beat his wife, according to the report, reflecting the latest data from the World Values Survey.
The report argues that these biases drive hurdles faced by women, manifested in a dismantling of women’s rights in many parts of the world with movements against gender equality gaining traction and, in some countries, a surge of human rights violations.
Biases are also reflected in the severe underrepresentation of women in leadership. On average, the share of women as heads of State or heads of government has remained around 10 per cent since 1995 and in the labour market women occupy less than a third of managerial positions.
The report also sheds light on a broken link between women’s progress in education and economic empowerment. Women are more skilled and educated than ever before, yet even in the 59 countries where women are now more educated than men, the average gender income gap remains a 39 per cent in favour of men.
“Lack of progress on gender social norms is unfolding against a human development crisis,” Mr. Conceição said, noting that the global Human Development Index (HDI) declined in 2020 for the first time on record and again the following year.
“Everyone stands to gain from ensuring freedom and agency for women,” he added.
The UNDP report emphasized that governments have a crucial role in shifting gender social norms, from adopting parental leave policies, that have changed perceptions around care work responsibilities, to labour market reforms that have led to a change in beliefs around women in the workforce.
“An important place to start is recognizing the economic value of unpaid care work,” said Raquel Lagunas, Director of UNDP’s gender team.
“This can be a very effective way of challenging gender norms around how care work is viewed. In countries with the highest levels of gender biases against women, it is estimated that women spend over six times as much time as men on unpaid care work.”
United Nations
SDG Goal 5: Gender Equality.
The report emphasized that despite the continued prevalence of bias against women, the data shows change can happen.
An increase in the share of people with no bias in any indicator was evident in 27 of the 38 countries surveyed. The report authors said that to drive change towards greater gender equality, the focus needs to be on expanding human development through investment, insurance, and innovation.
This includes investing in laws and policy measures that promote women’s equality in political participation, scaling up insurance mechanisms, such as strengthening social protection and care systems, and encouraging innovative interventions that could be particularly effective in challenging harmful social norms, patriarchal attitudes, and gender stereotypes.
For example, combatting online hate speech and gender disinformation can help to shift pervasive gender norms towards greater acceptance and equality, according to the report.
The report recommended directly addressing social norms through education to change people’s views, policies and legal changes that recognize the rights of women in all spheres of life, and more representation in decision-making and political processes.
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Newswise — JERSEY CITY, N.J., June 5, 2023 /PRNewswire/ — MEDSIR announced today the results of the PALMIRA trial. This randomized phase 2 study evaluated the safety and efficacy of palbociclib maintenance in combination with second-line endocrine therapy in patients with hormone receptor-positive/HER2-
MEDSIR Study Finds No Progression-Free Survival Benefit with Palbociclib Maintenance After First-Line Regimen in HR+/HER
The PALMIRA study is sponsored by MEDSIR, a company dedicated to advancing clinical research in oncology, and was led by Dr. Antonio Llombart-Cussac along with Dr. Javier Cortés and Dr. José Pérez as Scientific Coordinators. The trial involved 198 patients with HR+/HER2- advanced breast cancer from 41 centers in 6 European countries.
Endocrine therapy is the mainstay of treatment for patients with HR+/HER2- advanced breast cancer. Several studies have demonstrated that the addition of cyclin-dependent kinases 4 and 6 (CDK4/6) to first- and second-line endocrine therapy leads to an improved progression-free survival and overall survival. However, the optimal treatment after progression on a CDK4/6 inhibitor in patients with HR+/HER2- advanced breast cancer remains undetermined.
One of the therapeutic options that have been evaluated in this scenario is the maintenance of CDK4/6 inhibition beyond progression switching the endocrine therapy and maintaining or shifting the CDK4/6 inhibitor or continuing the same endocrine therapy and changing to a different CDK4/6 inhibitor. Some of these studies had already suggested a continued benefit from this clinical approach but they must be interpreted with caution due to potential biases, mainly the use of a different CDK4/6 inhibitor.
The PALMIRA study aimed to determine if palbociclib maintenance could improve the antitumor activity of second-line endocrine therapy in HR+/HER2- advanced breast cancer patients who had showed a confirmed progressive disease on first-line palbociclib plus endocrine therapy-based treatment after having achieved clinical benefit to this regimen.
“Results of the PALMIRA trial, while negative, will guide further research on the optimal treatment upon progression to CDK4/6 inhibitors and our clinical practice,” said Dr. Llombart-Cussac, principal investigator of the study and Head of Service at Arnau de Vilanova Hospital in Valencia, Spain. Findings from the PALMIRA study indicate that “re-treatment with the same CDK4/6 inhibitor and switching the endocrine therapy does not improve patient outcomes”.
Dr. Cortés, director of the International Breast Cancer Center, stated, “based on the results of the PALMIRA study, we suspect that there is a subgroup of patients that could benefit from maintaining palbociclib after prior progression on a palbociclib-based regimen. Biomarkers are the way to identify these patients and optimize the best future treatment options for them”.
The results of the primary endpoint, progression-free survival, have been presented as an oral presentation at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting.
ABOUT MEDSIR
Founded in 2012, MEDSIR works closely with its partners to drive innovation in oncology research. Based in Spain and the United States, the company manages all aspects of clinical trials, from study design to publication, utilizing a global network of experts and integrated technology to streamline the process. The company offers proof-of-concept support and a strategic approach that helps research partners experience the best of both worlds from industry-based clinical research and investigator-driven trials. To promote independent cancer research worldwide, MEDSIR has a strategic alliance with Oncoclínicas, the leading oncology group in Brazil with the greatest research potential in South America. Learn how MEDSIR brings ideas to life: www.medsir.org
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Newswise — JERSEY CITY, N.J., June 2, 2023 /PRNewswire/ — MEDSIR announced today the positive results of the PHERGain trial. This study is the first to use an adaptive design that tailors treatment in the neoadjuvant/adjuvant setting of patients with HER2-positive early breast cancer. The main objective of this trial was to assess the feasibility of a chemotherapy-free strategy based on a dual HER2 blockade with trastuzumab and pertuzumab through a positron emission tomography (PET)-based, pathologic complete response response(pCR)-adapted strategy.
MEDSIR PHERGain trial is the first to use an adaptive design in HER2-positive early breast cancer.
PHERGain is a randomized, controlled phase 2 clinical trial that involved 356 early-stage HER2-positive breast cancer patients from 45 centers in seven European countries. It was sponsored by MEDSIR, a company dedicated to advancing clinical research in oncology, and led by scientific investigators Dr. Javier Cortés, Dr. Antonio Llombart-Cussac, and Dr. José Pérez. The first primary endpoint was the pCR rate in patients with PET response included in group B, whose positive results were published in 2021 in Lancet Oncology.
The results of the second primary endpoint, 3-year invasive disease-free survival in all patients assigned to group B, have been presented at the 2023 American Society of Clinical Oncology (ASCO) congress. Overall, 95.4% of patients who followed this chemotherapy de-escalation strategy using PHERGain’s adaptive design remained cancer-free after three years of follow-up from breast cancer surgery. This is especially relevant because around 30% of these patients did not receive chemotherapy without compromising patient’s outcome. Among this latter group, 98.9% remained cancer-free after three years of follow-up from breast cancer surgery.
“This study offers a potential future therapeutic option that enables a significant reduction of toxicity and an improvement in quality of life for this patient population without reducing efficacy”, explains Dr. Cortés. In addition, the most relevant finding “is that 99% of the subgroup who received anti-HER2 therapy without chemotherapy have not presented a recurrence of the disease after three years of follow-up”.
“These results bring us closer to the end of chemotherapy in a significant percentage of patients with this type of tumor,” explains Dr. Llombart-Cussac, “It is critical to design more efficient strategy-based clinical trials with adaptive designs to bring effective therapies to patients in the shortest amount of time.”
ABOUT MEDSIR
Founded in 2012, MEDSIR works closely with its partners to drive innovation in oncology research. Based in Spain and the United States, the company manages all aspects of clinical trials, from study design to publication, utilizing a global network of experts and integrated technology to streamline the process. The company offers proof-of-concept support and a strategic approach that helps research partners experience the best of both worlds from industry-based clinical research and investigator-driven trials. To promote independent cancer research worldwide, MEDSIR has a strategic alliance with Oncoclínicas, the leading oncology group in Brazil with the greatest research potential in South America. Learn how MEDSIR brings ideas to life: www.medsir.org
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As a mental health therapist, you’d think I’d have all of the knowledge and skills needed to navigate loneliness, side-stepping it easily. But you couldn’t be more wrong.
Feeling lonely is so much more than a simple feeling of a lack of connection. It can cause what feels like a physical weight of dread in our hearts, never-ending hopelessness, and a deep sense of not belonging. I’ve waded through this season more than once in my life. My hope is that by sharing my stories and lessons learned with you, it can be the spark to bring you out to the other side of your loneliness.
Around 18 years ago, I met a man who would change my life as I knew it. Despite being so young, I knew he was my destiny! His Coast Guard blue uniform definitely helped seal the deal, too. In the years since we said “I do,” we’ve navigated challenges and hardships that take my breath away when I think of them. Has there been adventure, beauty, and joy? Sure. But life as a military spouse can be a very lonely one.
I was only 22 years old when we married, and just months later, we moved halfway around the world from my family and everything I knew. It doesn’t matter how much you try to prepare; you’re never really ready. There would be moments when I despaired that God had left me behind.
Those early years would be fraught with a lot of growing and changing. I would weather losing family members, feeling guilt from being gone, and trying to build a healthy marriage with no mentorship around me.
I hope my struggles can serve as a lesson and inspiration for the wider Christian community to come alongside our military neighbors a little bit better. We so desperately want to feel like we are not just welcomed but wanted. There were many times when I felt like a tolerated guest inside the walls of a church.
Our roots may be temporary, but they need to be fed and watered, too.
Though many of you reading this article may have no military connections, I venture you’ve felt loneliness and may even be experiencing it right now. Even inside your own church, if you have one. The COVID-19 pandemic forced much of the world into isolation which led to a mental health crisis unlike anything else we’ve ever seen before.
Walking through this journey as a seasoned military spouse would inspire me to write my book, Never Alone: Ruth, the Modern Military Spouse and the God Who Goes With Us, in hopes that I could reach folks going through it and help them get to the other side.
Ruth has always been a treasured book of the Bible for me. The words “Where you go, I go” transcend and parallel so much for my life. From following my husband from duty station to duty station to the friendships I cultivated to build my circle, the story of Naomi and Ruth did nothing but inspire.
But before we dive into the beauty of Ruth and the lessons learned, I think it’s vitally important to understand what loneliness is and isn’t. Check out this quick excerpt from my book on the three kinds of loneliness we should recognize and understand:
1. Situational loneliness is exactly what it says and revolves around environmental factors. Examples include interpersonal conflicts, disasters, or migration (for us, this is a fancy word for moving, something we are deeply familiar with). Sadly, we’ll probably all sit in this type of loneliness a time or two, or five. Situational can also equate to life stressors, something almost entirely unavoidable but more easily treatable.
2. As human beings, we thrive on close emotional attachments. When that is missing, it can lead to loneliness, which can then spiral into a myriad of mental illness symptoms. This can accompany a loss of someone close to you who you had previously confided in and shared attachment with. Think about things like broken friendships, lost connections due to frequent moves, or any other force coming between you and a close attachment. It causes emotional weight like no other.
3. Isolation and a lack of community support is detrimental. Emotional and social loneliness go hand in hand, each wreaking havoc on your health. This kind will arise when there is no sense of belonging or feeling valued. As creatures of God who were intended to thrive in families, groups, or communities, missing support and connection socially is perhaps the most harmful. In this type of loneliness, we will see isolation and declining health, and it is a road that takes a lot of work to find your way back home.
I believe the Christian church has an opportunity to tackle all three of these different types of loneliness and be part of the solution to healing. Though many may show up to Sunday services in their best, very often, it’s to hide a mess going on in the background. By showing up well for everyone in genuine and intentional ways, you can foster the foundation of not only faith but the ability to see the light in the dark, even when it appears hopeless.
The local church has the opportunity to provide wrap-around care to folks going through situational loneliness, emotional loneliness, and social loneliness.
-Truly include people within the church! Don’t just ask how someone is doing; get to know them on a deeper level and help them feel seen.
–When fostering relationships with the military community, include us. We want to be part of the ministry and the body of the church – even if it’s only for a few years.
And outside of the church, there are many tools and tricks to navigate the impacts of loneliness, which is usually accompanied by things like depression. My advice is to build a go-bag to tackle the feelings that come along with loneliness. Here are a few tools you should utilize:
1. Engage in thought-reframing, which is a key component of cognitive behavior therapy. This means that when you have a negative intrusive thought, replace it with something positive or change the way you have that thought. This prevents spiraling.
2. Infuse joy into your day. Coping through loneliness means finding ways to actively seek happiness. Music, exercise, reading, or crafting are just a few ideas for intentionally seeking joy. Do what brings you joy!
3. Talk to someone. Therapists need therapists! Having an unbiased person outside of your circle to give you advice, help you look at things differently, and unpack what’s in your head and on your heart can be revolutionary.
In reading the story of Ruth, we see unimaginable hardship. Naomi has lost not only her husband but then her two sons and finds herself lost. Not only is she floundering, but she’s really bitter and angry at God while she does it all. Ruth was the one daughter-in-law who refused to allow Naomi to leave her behind as she made her way back home, and the pagan woman would become the anchor she so desperately needed to find her way back to God. She would also be the unlikely ancestor to bring us our Savior, Jesus Christ.
1 Peter 5:10 (ESV) is encouraging: “And after you have suffered a little while, the God of all grace, who has called you to his eternal glory in Christ, will himself restore, confirm, strengthen, and establish you.”
If you’re going through it, I see you, and so does He. God is with you, friend. You’re never alone.
Photo Credit: ©Getty Images/Im Yeongsik
Jessica Manfre is the author of Never Alone: Ruth, the Modern Military Spouse, and the God Who Goes With Us, and the proud wife of a U.S. Coast Guardsman. She is a licensed social worker, author, and Chief Financial Officer and co-founder of Inspire Up, a nonprofit foundation that serves the military and first responders. She has also received national media attention for her initiative, #GivingTuesdayMilitary, which encourages people to offer one million acts of intentional kindness. Facebook: @JessicaManfreLMSW Instagram: @jess_manfre www.jessicamanfre.com
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WFP’s Country Director in Sudan, Eddie Rowe, told reporters in Geneva that in a major breakthrough, the agency distributed food assistance to 15,000 people in both Sudanese Armed Forces (SAF) and Rapid Support Forces (RSF) controlled areas of Omdurman, part of the Khartoum metropolitan area, beginning on Saturday.
Speaking from Port Sudan, Mr. Rowe highlighted other recent food distributions, in Wadi Halfa in Northern State to reach 8,000 people fleeing Khartoum and on their way to Egypt, as well as to 4,000 newly displaced people in Port Sudan.
In total, WFP has been able to reach 725,000 people across 13 states in the country since it resumed its operations on 3 May, following a pause brought on by the killing of three aid workers at the start of the conflict.
Mr. Rowe said that WFP was rapidly scaling up its support, which they expected to expand depending on progress in negotiations for humanitarian access for all regions, including the Darfurs and Kordofans, strongly impacted by violence and displacement.
In addition to the 16 million Sudanese who were already finding it “very difficult to afford a meal a day” before the fighting started, Mr. Rowe warned that the conflict compounded by the upcoming hunger season, could increase the food insecure population by about 2.5 million people in the coming months.
With the lean season fast approaching, WFP’s plan was to reach 5.9 million people across Sudan over the next six months, he said.
He stressed that WFP needed a total of $730 million to provide required assistance as well as telecommunications and logistics services to the humanitarian community, including all of the UN agencies operating in Sudan.
He also reiterated the humanitarian community’s call on all parties to the conflict to enable the safe delivery of urgently needed food aid, and deplored that so far, WFP had lost about 17,000 metric tonnes of food to widespread looting across the country, particularly in the Darfurs.
Just two days ago, he said, the agency’s main hub in El Obeid, North Kordofan, came under threat and looting of assets and vehicles was already confirmed.
The UN Children’s Fund (UNICEF) reported that “more children in Sudan today require lifesaving support than ever before”, with 13.6 million children in need of urgent assistance. “That’s more than the entire population of Sweden, of Portugal, of Rwanda,” UNICEF spokesperson James Elder told reporters in Geneva.
According to reports received by UNICEF, hundreds of girls and boys have been killed in the fighting. “While we are unable to confirm these due to the intensity of the violence, we also have reports that thousands of children have been maimed,” Mr. Elder said.
He also pointed out that reports of children killed or injured are only those who had contact with a medical facility, meaning that the reality is “no doubt much worse” and compounded by a lack of access to life-saving services including nutrition, safe water, and healthcare.
Mr. Elder alerted that “all these factors combined, risk becoming a death sentence, especially for the most vulnerable”.
UNICEF called for funding to the tune of $838 million to address the crisis, an increase of $253 million since the current conflict began in April, to reach 10 million children. Mr. Elder stressed that only 5 per cent of the required amount had been received so far, and that without the therapeutic food and vaccines which this money would allow to secure, children would be dying.
The dire situation of healthcare in the country has been aggravated by continuing attacks on medical facilities. From the start of the conflict on 15 till 25 May, the World Health Organization (WHO) verified 45 attacks on healthcare, which led to eight deaths and 18 injuries, the agency’s spokesperson Tarik Jašarević said.
He also cited reports of military occupation of hospitals and medical supplies warehouses, which made it impossible for people in need to access chronic disease medicines or malaria treatment. Mr. Jašarević recalled that attacks on healthcare are a violation of international humanitarian law and must stop.
The UN High Commissioner for Refugees, Filippo Grandi, concluded a three-day visit to Egypt on Tuesday, with an urgent call for support for people fleeing Sudan – and the countries hosting them – insisting that the borders must remain open.
More than 170,000 people have entered Egypt since the conflict started – many through Qoustul, a border crossing that Grandi visited close to the end of his trip. The country hosts around half of the more than 345,000 people who have recently fled Sudan.
Mr. Grandi met newly arrived refugees and Egyptian border officials, to get a sense of the hardships being endured.
“I heard harrowing experiences: loss of life and property on a huge scale,” Grandi said. “People spoke of risky and expensive journeys to arrive here to safety. Many families have been torn apart. They are traumatized and urgently need our protection and support.“
The UNHCR chief also held talks with the Egyptian President, Abdel Fattah Al-Sisi, and discussed how best to support refugees and mobilize resources for host countries, not least Egypt.
“I commend Egypt for its long-standing commitment to providing a safe haven to those fleeing violence,” Mr. Grandi said. “The Government, the Egyptian Red Cresent and the people, have been very generous in supporting arrivals. We urgently need to mobilize more resources to help them to maintain this generosity.”
Prior to this conflict, Egypt was already host to a large refugee population of 300,000 people from 55 different nationalities.
After registering with UNHCR, refugees and asylum-seekers have access to a wide range of services including health and education. UNHCR’s emergency cash assistance programme started during the last week.
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Perinatal Mental Health of Indigenous Pregnant Persons and Birthing Parents During the COVID-19 Pandemic
Sawayra Owais MSc 1, Ryan J. Van Lieshout MD, PhD 1 2https://doi.org/10.1016/j.jogc.2023.04.015
Newswise — The COVID-19 pandemic has had a significant impact on Indigenous individuals during pregnancy and the postpartum (perinatal) period. Despite this, less than 1% of studies examining perinatal mental health during the pandemic included Indigenous persons. The current work examined pandemic-related stressors and depression and anxiety among Indigenous women and mothers attending an Indigenous midwifery clinic.
We found that a fear of COVID-19 infection, parenting and home-schooling children, and lack of support from female relatives and friends were particularly stressful. Despite these stressors, levels of depression (21%) and anxiety (26%) were lower than other groups surveyed during the pandemic and suggest that receiving culturally-supportive care from Indigenous midwives may have played a protective role. Exploring the aspects of culturally-consistent care that may be contributing to the well-being of these Indigenous parents, as well as following them over time could help to optimize their mental health and that of their families.
See the paper here: https://www.sciencedirect.com/science/article/pii/S1701216323003195?dgcid=author
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“I can’t think of a better way than using food to bring everyone to the table,” said Elroi Yee, an investigative reporter and producer of the Dari Dapur campaign. “We need shared stories that show migrants and refugees have a place in the Malaysian narratives.”
Tales and tastes of Tamil puttu, Cambodia’s nom banh chok, Kachin jungle food shan ju, Yemeni chicken mandy, and Rohingya flatbread ludifida flavour those narratives, telling their stories in Dari Dapur’s videos featuring Malaysian celebrities who sampled culinary history and heritage.
Launched by OHCHR in December 2022, the campaign partnered with untitled kompeni, a Kuala Lumpur-based social impact production team, with a view to putting these delicious stories at the heart of public discourse.
Through seven short videos, celebrities visited the kitchens of migrant workers and refugees to share a home-cooked meal around the same table, hearing about each other’s lives, hopes and dreams, and learning what they have in common.
“Anytime you cook food and you bring your guests, everyone turns to smile and be happy because food always brings people to the table,” said Chef Wan in an episode with Hameed, who served up a scrumptious Pakistani ayam korma.
“Regardless of which culture, where we come from, everybody will need to eat,” he said.
Liza, a Cambodian plantation worker, shared more than just a meal with her guests, Malaysian comedian Kavin Jay and food Instagrammer Elvi. During a day trip to visit her on the plantation, Liza showed them how she cooks nom banh chok, a fragrant fermented rice noodle dish.
“To have someone come here to visit me, to see me and to see my friends, I’m so happy,” Liza said.
Exchanging jokes around the table, Mr. Jay said “everyone has a migration story”.
“It doesn’t matter what your race is, if you look back far enough, you will find your migration story,” he said.
Similar exchanges around dinner tables unfolded in other Dari Dapur episodes that starred migrant and refugee chefs with social justice influencer Dr. Hartini Zainudin, hijabi rapper Bunga, educator Samuel Isaiah, Tamil film star Yasmin Nadiah, Chinese-language radio DJ Chrystina, and politician and activist Nurul Izzah Anwar.
From Myanmar to Malaysia, breaking fast was common ground in an episode that brought broadcast journalist Melisa Idris and US Ambassador Brian McFeeters tableside with Ayesha, a Rohingya community trainer.
“I would like to know them, and I am also very happy that I can explain what I am doing and who I am [to them],” Ayesha said, as she prepared an iftar feast for her guests.
Sitting them down at a table laden with traditional dishes along with some of her friends, Ayesha was frank.
“Before this, I’ve never cooked for other communities,” she admitted, ahead of a lively conversation about Eid celebrations.
Ms. Idris and Ayesha’s friend, Rokon, shared similar childhood memories, from her Malaysian village and to his family home in Rakhine, Myanmar.
The way they treated me today, if we could be as gracious a host as a country, it would go such a long way. – journalist Melisa Idris
“It’s exactly the same!” Ms. Idris exclaimed. “Sometimes we focus on the differences and don’t realize we have almost exactly the same traditions.”
Post-feast, she shared gratitude and a revelation.
She said it was clear how “complicit the media has been in othering refugees and migrants, in normalizing the hate, in sowing the division, and targeting an already marginalized community as a scapegoat of our fears during a pandemic.”
“They gave us the best; they gave everything to us,” she said, tearfully. “The way they treated me today, if we could be as gracious a host as a country, it would go such a long way.”
To design the campaign, OHCHR commissioned research that revealed a complex relationship between migrants and Malaysians. Findings showed respondents overwhelmingly agreeing that respect for human rights is a sign of a decent society and that everyone deserves equal rights in the country.
Some 63 per cent agreed that their communities are stronger when they support everyone, and more than half believed they should help other people no matter who they are or where they come from. Around 35 per cent of respondents strongly or somewhat strongly believed that people fleeing persecution or war should be welcomed, with an equal number wanting to welcome those who are unable to obtain healthcare, education, food, or decent work.
“Migration is a complicated and often abstract issue for many Malaysians,” said Pia Oberoi, senior advisor on migration in the Asia Pacific region at OHCHR, “but storytelling is a good way to cut through the noise.”
“Our research found that people want to hear and see the everyday lives of people on the move, to understand and appreciate that we have more in common than what divides us,” she said, adding that the campaign was built on shared realities and values that personify the words of the Universal Declaration of Human Rights, which turns 75 this year.
With the production of these short films, she said “we hope to inspire Malaysian storytellers to share the narrative space, and for all of us to rethink the way we relate to our migrant and refugee neighbours.”
On a sprawling oil palm estate, actress Lisa Surihani tucked into a meal of kaldu kokot – cow’s feet soup – dished up by her host Suha, an Indonesian plantation worker.
“What I learned was ‘try and not let what you do not know of affect the way you treat other human beings’,” actress Lisa Surihani said in a Dari Dapur episode.
“No matter who it is, our actions should be rooted in kindness,” Ms. Surihani said.
Learn more about the Dari Dapur campaign here.
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Period poverty, or the inability to afford menstrual products, is a serious issue especially in developing countries, an issue menstruating girls and women grapple with monthly and a spotlight topic on Menstrual Hygiene Day, observed annually on 28 May.
“I’m happy to come work here because I meet and work with other people,” said Ms. Fatty, who operates a special machine to install snaps on each pad. “This place gives me joy because I can forget about my disability while working here.”
The sturdy, long-lasting pads she produces help women like her with a mobility impairment, who have trouble going to the restroom. After working there for a year, Ms. Fatty hopes to continue. While her disabilities bring many challenges and she struggled to make ends meet for a long time, her life has become better since she joined the project.
In The Gambia, Africa’s smallest nation, period poverty is prevalent across the country, but it hits harder in rural areas, according to the UN Population Fund (UNFPA). Some girls skip school for around five days every month due to the lack of menstrual products and sanitary facilities.
The girls are afraid of staining their clothes and become a target of bullying or abuse, the agency said. As a result, gender inequality widens; boys will have an advantage as they attend school more often than girls, who have a higher chance of dropping out of education.
To tackle this problem, UNFPA developed a project in Basse, in the country’s Upper River Region, to produce recyclable sanitary pads. These pads are distributed at schools and hospitals in local communities.
The agency takes it as an opportunity to talk about bodily autonomy and sexual and reproductive health with young girls to mitigate period shaming and stigma.
The project is also a way of empowering young women in the community as it provides them with a secure job and an opportunity to learn new skills.
United Nations
SDG Goal 6: Clean Water and Sanitation
Since 2014, Menstrual Hygiene Day has been observed on the 28th day of the fifth month of the year as menstrual cycles average 28 days in length and people menstruate an average of five days each month.
Poor menstrual health and hygiene undercuts fundamental rights – including the right to work and go to school – for women, girls and people who menstruate, according to UNFPA.
It also worsens social and economic inequalities, the agency said. In addition, insufficient resources to manage menstruation, as well as patterns of exclusion and shame, undermine human dignity. Gender inequality, extreme poverty, humanitarian crises and harmful traditions can amplify deprivation and stigma.
With that in mind, the theme for Menstrual Hygiene Day this year is “Making menstruation a normal fact of life by 2030”, said UNFPA Executive-Director Natalia Kanem.
“A girl’s first period should be a happy fact of life, a sign of coming of age with dignity,” she said. “She should have access to everything necessary to understand and care for her body and attend school without stigma or shame.”
The Day brings together governments, non-profits, the private sector, and individuals to promote good menstrual health and hygiene for everyone in the world. The occasion also aims at breaking the silence, raise awareness around menstrual issues and engaging decision-makers to take actions for better menstrual health and hygiene.
Learn more about what UNFPA is doing to eliminate period poverty here.
UNFPA has four broad approaches to promoting and improving menstrual health around the world:
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