Tuesday 17 November 2009

Same hormone evokes both love and envy, study finds | Science and Environment | Jerusalem Post

"With a reputation as the “love hormone,” oxytocin has been linked to trust, empathy and generosity. But new research suggests that oxytocin plays a role in jealousy and gloating as well. “Subsequent to these findings, we assume that the hormone is an overall trigger for social sentiments: When the person’s association is positive, oxytocin bolsters pro-social behaviors; when the association is negative, the hormone increases negative sentiments,” Israeli researcher Simone Shamay-Tsoory, of the University of Haifa, said in a news release from the university".


Same hormone evokes both love and envy, study finds | Science and Environment | Jerusalem Post

Study links genetic variation to individual empathy, stress levels

Researchers have discovered a genetic variation that may contribute to how empathetic a human is, and how that person reacts to stress. In the first study of its kind, a variation in the hormone/neurotransmitter oxytocin's receptor was linked to a person's ability to infer the mental state of others.

Hmmmmm, can't help but wonder what sort of birth and early upbringing the folks with the gene variation had. The environment has a huge impact on which genes get switched on which ones get switched off. How the genes get tinkered with and altered too depends upon the environment. Epigenetics is the field of science exploring genetic behaviour in response to environmental cues. The issue of the early environment on the person's oxytocin's receptor variation would be good study.

Study links genetic variation to individual empathy, stress levels

BBC NEWS | Health | Hypnosis has 'real' brain effect

"Hypnosis has a "very real" effect that can be picked up on brain scans, say Hull University researchers.
An imaging study of hypnotised participants showed decreased activity in the parts of the brain linked with daydreaming or letting the mind wander.
The same brain patterns were absent in people who had the tests but who were not susceptible to being hypnotised.
One psychologist said the study backed the theory that hypnosis "primes" the brain to be open to suggestion.

Hypnosis is increasingly being used to help people stop smoking or lose weight and advisers recently recommended its use on the NHS to treat irritable bowel syndrome".

Hypnosis is used in programs like 'Hypnobirthing' and 'Calmbirth' to help women give birth normally. This research helps to understand how hypnosis can be effective for some women and not for others. The self management skills that come through these programs are very beneficial for most people.

BBC NEWS | Health | Hypnosis has 'real' brain effect

Medical establishment prevents nurses from assuming new roles

Physicians still retain the bulk of decision-making power over nurses in Quebec - a situation that's detrimental to evolving nursing roles. According to a new study by Université de Montréal researchers, published in Recherches Sociographiques, nursing functions are still very much assigned by physicians who often oversee family medicine groups (FMGs), specialized nurse practitioners (SNP) and oncology nurse navigators (ONN).

Medical establishment prevents nurses from assuming new roles

Sunday 15 November 2009

Medical News: Listeriosis Risk to Fetuses Higher than Thought - in Infectious Disease, General Infectious Disease from MedPage Today

The risk of listeriosis in pregnant women and their fetuses is greater than previously thought, researchers said.

Listeria monocytogenes -- one of the most dangerous foodborne pathogens in the U.S. -- can cause miscarriages and stillbirths, according to Mary Alice Smith, PhD, and colleagues at the University of Georgia in Athens.

Medical News: Listeriosis Risk to Fetuses Higher than Thought - in Infectious Disease, General Infectious Disease from MedPage Today

Friday 13 November 2009

QUESTION 2. Should an infant who is breastfeeding poorly and has a tongue tie undergo a tongue tie division? -- Algar 94 (11): 911 -- Archives of Disease in Childhood

The whole issue (of whether tongue tie -ankyloglossia is related to breastfeeding difficulties) is complicated when considering that many studies have attempted to measure the degree of tongue tie, a notoriously difficult endeavour, and that once graded, the degree of impairment appears not to correlate with breastfeeding problems. With all this considered, one cannot ignore the plethora of documented experience that supports this procedure, so much so that NICE have produced an interventional procedure guideline that acknowledges that the little evidence there is does seem to suggest that this procedure can improve breastfeeding while having no major safety concerns. As a result it suggests that the evidence is enough to support the use of the procedure provided that normal arrangements are in place for consent, audit and clinical governance.11

If mothers overwhelmingly tell us that it works, then why should we argue?

What a sensible conclusion!!!

QUESTION 2. Should an infant who is breastfeeding poorly and has a tongue tie undergo a tongue tie division? -- Algar 94 (11): 911 -- Archives of Disease in Childhood

BBC NEWS | Health | Music 'nurtures' premature babies

Music 'nurtures' premature babies
Music may help block pain

Hospitals that play music to premature babies help them grow and thrive, mounting evidence suggests.

The benefits are said to be calmer infants and parents as well as faster weight gain and shorter hospital stays.

A Canadian team reviewed nine studies and found music reduced pain and encouraged better oral feeding.

Music also appeared to have beneficial effects on physiological measures like heart and respiratory rate, Archives of Disease in Childhood reports.

BBC NEWS | Health | Music 'nurtures' premature babies

and of course, an even better solution is to provide one to one midwifery care to women as the rates of premature birth drop when women have midwifery care.

Early life stress has effects at the molecular level

More evidence of the need to keep mothers and newborn babies together and ensure skin to skin uninterrupted time at birth. Maternity service providers, midwives and doctors take note

Early life stress has effects at the molecular level

Georgianne Nienaber: Congo: Midwives Transform Trash Into Hope

"The midwives who fight to preserve new life as babies struggle to enter the world in the Mugunga camps and in the villages are tired, but their courage overcomes discouragement. When we visited with them in January of this year, their requests were simple. "Do not forget us." "We have no means to feed our own families." "Some cloth for the babies would be nice."

Georgianne Nienaber: Congo: Midwives Transform Trash Into Hope

"I swore never to be silent whenever and wherever human beings endure
suffering and humiliation. We must always take sides. Neutrality helps the
oppressor, never the victim. Silence encourages the tormentor, never the
tormented". Elie Wiesel

Thursday 12 November 2009

ScienceDirect - Current Biology : The Privileged Brain Representation of First Olfactory Associations

The first smell you associate with an object is given privileged status in the brain.

Yaara Yeshurun and colleagues at the Weizmann Institute of Science in Rehovot, Israel conducted a study on smells and memory, using functional magnetic resonance imaging. The hippocampus showed a characteristic pattern of neural activity when particular smells were represented to the participants. The researchers concluded that the brain reserves a special pattern of activity for memories that represent the first time we have associated a smell with a particular thing – and that such pairings are most likely to be laid down in childhood.

The brain may have evolved to lay down these privileged memories because it enhanced our ability to sense danger. "This is especially true for unpleasant odours," says Yeshurun.

This makes sense, says Rachel Herz, author of The Scent of Desire: Discovering our enigmatic sense of smell and visiting professor at Brown University in Providence, Rhode Island. "The evolutionary implication is that the situation in which you first encounter an odour is likely a reliable maker for its meaning, and it is highly adaptive to learn that meaning so that the odour can be responded to appropriately in the future."

This study provides more information about the importance of ensuring immediate skin to skin experience for newborn babies and their mothers. When mothers and babies are enabled to maintain skin to skin proximity at birth, both mother and baby are mapped neurologically to each other through their olfactory system. The importance of this neurological olfactory mapping between mother and baby is profound in terms of the baby identifying feeling safe, secure and calm in her/his mother's presence and having those feelings triggered by the scent of the mother. The feelings the mother experiences with the scent of her baby from birth patterning can be recognised to be similarly profound for the vibrancy of the relationship between them.


ScienceDirect - Current Biology : The Privileged Brain Representation of First Olfactory Associations

Monday 9 November 2009

AMA welcomes amendment to the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 | Australian Medical Association

The Medical Union crows victory over the right of women to choose where to birth and who with! Roxon and Rudd pawns in the AMA's game of control and domination

5 November 2009 - 3:05pm

AMA President, Dr Andrew Pesce, said today that the AMA welcomes the Government’s decision to amend the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 to specify a formal requirement that midwives and nurse practitioners must work in collaboration with medical practitioners.

Dr Pesce said the AMA has been negotiating with the Government for this vital change to the legislation for some time, and the AMA had received recent support from other medical groups, most notably the Royal Australian College of General Practitioners.

“We made it clear to the Government that without a requirement in law that there be collaborative arrangements between midwives, nurse practitioners and doctors then the legislation did not have any safeguards to ensure continuity of patient care, nor did it have any protections against the fragmentation of patient care services,” Dr Pesce said.

“I repeat – the amendments impose a legal requirement for collaborative arrangements between medical practitioners and midwives or between medical practitioners and nurse practitioners.

“The AMA has worked cooperatively with the Government on these amendments to the legislation.

“These changes create a framework of quality primary care delivery that supports team-based care and ensures that the role of medical practitioners, particularly the patient’s usual General Practitioner, is not undermined.

“Evidence shows that patients enjoy better health outcomes when they are treated in a model of care that provides coordinated, continuous, and comprehensive patient-centred care that is delivered by appropriately trained health professionals.

“The AMA commends the Government for recognising and accepting amendments that are in the interests of patient care.

The AMA will continue to work with the Government as further regulations and guidelines are developed to ensure that collaborative arrangements are based on best practice standards of medical care,” Dr Pesce said.

The AMA’s position was part of its submission to the Senate Community Affairs Committee on 22 July 2009. AMA President, Dr Andrew Pesce, appeared before the Committee on 6 August 2009.

5 November 2009

CONTACT:

John Flannery 02 6270 5477 / 0419 494 761

Peter Jean 02 6270 5464 / 0427 209 753

AMA welcomes amendment to the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 | Australian Medical Association

Sunday 8 November 2009

Fathers Gain Respect From Experts (and Mothers) - NYTimes.com

"when couples scored high on positive relationship traits like willingness to compromise, expressing affection or love for their partner, encouraging or helping partners to do things that were important to them, and having an absence of insults and criticism, the father was significantly more likely to be engaged with his children"

Fathers Gain Respect From Experts (and Mothers) - NYTimes.com

My Birth — Know your rights in labour. Protect your baby and protect your body. GET INFORMED.

A beautiful site about birth choice

My Birth — Know your rights in labour. Protect your baby and protect your body. GET INFORMED.

Doctors to gain veto powers over midwives and birth choices

Maternity Coalition sent out a press release which explains the current legislation changes very clearly.

Doctors to gain veto powers over midwives and birth choices

On 5 November the Government announced that the “Medicare for midwives” Bills
would be amended to require midwives to have “collaborative arrangements” with
“medical practitioners” before being eligible for professional indemnity insurance or Medicare rebates:
*before the midwife can access professional indemnity insurance, and
*before women can claim a Medicare rebate for midwifery services.
Doctors must approve each midwifeʼs entry to private practice:
*Midwives will be required by Commonwealth law to have “collaborative arrangements” with
“one or more medical practitioners” before being eligible for Commonwealth-subsidised professional indemnity insurance (PII).
*PII will be a prerequisite for a midwife to enter private practice, under new national registration laws, being enacted state by state.
*Doctors will be able to unilaterally withdrawal from collaborative agreements with a midwife, rendering her uninsured, and legally unable to practice in a private professional capacity.
*This legally mandates medical control over midwives’ ability to register and work in private practice.
*This will be set in Commonwealth law, which can only be changed by Commonwealth
Parliament.
*These provisions are contained in the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009.
Doctors must approve womenʼs access to Medicare rebates for midwifery care:
*Midwives will also be be required by Commonwealth law to have “collaborative arrangements” with “one or more medical practitioners” before their services are eligible for Medicare rebates.
*This puts women’s access to private midwifery care under medical control.

This is potentially defacto “parallel regulation” of the midwifery profession:
*Medical practitioners will control the registration status of midwives, despite their being a discrete, separately regulated profession.
*Medical professional organisations could set guidelines for collaborative arrangements,potentially forming defacto regulatory standards for midwifery endorsement and practice.

This gives doctors right of veto over womenʼs choices in birth care:
*Any birth care choice using private practice midwives, or developed under the
Commonwealth’s new arrangements, will be subject to medical control or veto.
*This gives medical practitioners unprecedented control over women’s choices and access to care.

“Collaborative arrangements” may be legally restricted to privately practicing doctors
*The amendments do not specifically include hospitals as able to form collaborative
arrangements with midwives. They require medical practitioners to be “of a kind or kinds specified in the regulations”.
*It is unclear whether a hospital, health service district or authority may be included within the definition of “one or more medical practitioners”.
*Doctors who are employees of public hospitals can’t make “collaborative arrangements” as employees of the hospital they work for. They work for the hospital, attend their workplace when rostered on and collaborate in line with hospital policies.
*A range of very serious consequences would flow if these arrangements were restricted to privately practicing doctors. Consequences could include:
o No new midwifery models in public hospitals.
o No private midwifery practice.
o No homebirth care from midwives in private practice.
o Practice midwives in private obstetricians rooms could be the only viable model of private practice or Medicare-funded midwifery.
This brief represents the best information available to Maternity Coalition on 8 November 2009. We are actively seeking ongoing clarification and dialogue with Government in order to ensure women and families have access to accurate information.

For full text of amendments go to:
http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;adv=yes;db=;group=;holdingType=;id=;orderBy=priority,title;page=7;query=Dat
aset%3AbillsCurBef%20Dataset_Phrase%3A%22amend%22;querytype=Dataset_Phrase%3Aamend;rec=11;resCount=Default

For more information contact: Bruce Teakle 07 3289 0231, teakle@maternitycoalition.org.au

Friday 6 November 2009

Who's behind Roxon's betrayal of Women's Birth Choices?

I wonder who?

This report in the Medical Observor might give some clues?

Government to mandate nurse practitioner teamwork

Andrew Bracey and Shannon McKenzie - Friday, 6 November 2009

AFTER months of intense lobbying, the Government has bowed to GP pressure and amended proposed legislation to ensure nurse practitioners must work in collaborative partnerships with doctors.
In what is being heralded as a win for the profession, Health Minister Nicola Roxon last week announced the new stipulation would be built into legislation that will grant nurse practitioners access to the MBS and PBS from November 2010.
However, the victory has been tempered by the news that legislation effectively handing politicians’ control of medical education and training standards has been passed by the Queensland Parliament, and will now begin its national rollout.
AMA Queensland president Dr Mason Stevenson said it would be “doubly hard” to win concessions now, and added the lack of outrage from grassroots doctors had made the lobbying efforts of the organisation more difficult.
The amendments to the nurse practitioner legislation will come as welcome relief for doctors, who feared that without mandated collaborative arrangements in place nurse practitioners would work independently and fragment care.
AMA vice-president Dr Steve Hambleton, who sits on the Government’s Nurse Practitioner Advisory Group (NPAG), said the crucial amendment would ensure nurse practitioners were not supported to work in competition with doctors.
“It clarifies the Government position – their [intention] was always there, but the clarification was not, and the fact the Government has brought this amendment forward is a good sign,” Dr Hambleton said.
In a statement Ms Roxon said the amendment had come “following requests for clarification” on the legislation. She told MO the Government had always been committed to ensuring team care. “I think everyone can recognise the skills of other professionals without fragmenting care.”
RACGP president Dr Chris Mitchell welcomed the news and said he was confident that NPAG would develop satisfactory frameworks.
Meanwhile, the fight for amendments to the national registration and accreditation scheme is set to shift into state parliaments. The Health Practitioner Regulation National Law Bill 2009 passed by the Queensland Parliament will now be adopted by all states and territories.
After failing to gain amendments to the initial legislation, doctors’ groups are now lobbying for changes at a local level.
The NSW, Victoria and WA state branches of the AMA are all calling for the insertion of a “public interest test” into the legislation, which would have to be satisfied before politicians could change medical education or training standards.
There will also be a last-minute push for further exemptions to the legislation’s mandatory reporting clauses, which will force doctors to report their spouses for any professional misconduct.

Julia Gillard's 2005 speech about the importance of choice for childbearing women

In 2005, Julia Gillard was the Shadow Minister of Health, Manager of Opposition business in the House of Representatives. Ms Gillard spoke at the following conference: 

Midwifery By The Sea - Riding The Waves Of Change
Speech - ANNUAL CONFERENCE OF NSWMA
20th October 2005 
Following are excerpts from Ms Gillard's speech
"Thank you very much for your invitation to join you here today at your annual state conference by the sea.
The best start in life
It will not surprise this audience - I'm sure you will all agree - if I now say that I see the pregnant woman as the best focus for early intervention.
Between us we could draw up an impressive list of perinatal programs that would boost the health of the mother and her baby, and improve outcomes, and give all our kids the best start in life. 
Obstetric services and workforce shortages
In the middle of this is the big event - the birth.
I know that midwives - as a group and individually - have strong ideas about what should be provided in terms of birthing services. 
But shockingly, it is increasingly the case that for some women the idea of having a choice of birthing services and having continuity of care throughout their pregnancy, the birth and in the post-natal period is an impossible luxury - not just unaffordable, but unobtainable in their local area.
The shortage of midwives is also a problem. The Australian Health Workforce Advisory Committee estimates a current national shortage of 1850 midwives, and this is expected to increase over the remainder of the decade.
Midwives face additional concerns about the lack of professional recognition as well as limited opportunities to practise as primary carers and provide continuity of care to women. 
The need for a concerted approach 
Clearly this is no time for turf warfare between doctors and midwives, but it is time for all health care professionals involved in delivering obstetrics care to mount a combined attack on the Howard Government to force them into action to address this situation.
Unless and until the Government is shocked and shamed into realising that Australian women are now scrambling to find the birthing centre of their choice, and in some cases scrambling to find any professional who will deliver their child, the situation will not improve. 
It seems to me that we need a variety of solutions to fit all the circumstances that arise.  There is no 'one size fits all' way to solve the problems that present so differently in metropolitan Sydney, the isolated community of Wilcannia, the growing town of Byron Bay and the multicultural suburbs of Western Sydney.  The one common factor is the pregnant woman and her child - they must be at the centre of the solution.
… I believe that midwives … are key heath care professionals whose role in the care of women and their babies has yet to be fully realised in the Australian health care system.
We need to realise that potential so that mothers have real choice in their birthing experience, and their babies have the best start in life".  

Beautiful and true words. However, now we are finding that it is no longer the Howard government standing in the way of women's choice, it is now the Labor Government.  Right now, Nicola Roxon  is seeking to abort women's choice in birth place and birth attendant.  Ms Gillard, you need to ensure that your words in 2005 were not empty rhetoric and politically driven spin to win brownie points in opposition. 

The time for action on your words is now. 

1. Ensure the needs and choices of all childbearing women are at the centre of any  goverrnment, health /maternity  service or policy action. 

2. Ensure that midwives are able to work unhampered by politics in the way that the World Health Organisation recommends.  
3. Provide a level playing field for health care providers (midwives , lactation consultants (IBCLC) and doctors) who work with childbearing women (access to Medicare, insurance and PBS)
4. Remove professional silos and institute true dialogic conversations and interactions for those situations when childbearing women require a multidisciplinary approach for their situation).
 

Facebook | RALLY FOR BIRTH CHOICES - SYDNEY

The proposed amendment to the nurses and midwives legislation is contained in the Federal Minister of Health's press release below.

As Jo Hunter, convenor of Homebirth Australia explains:

"The point that will redefine the fundamental nature of midwifery and certainly homebirth midwifery in Australia is that “collaborative arrangements with medical practitioners will be required to access the new arrangements”. In short this amendment will require midwives to work with GP obstetricians and private obstetricians and have a “collaborative arrangement” in place at all times.
This is NOT acceptable. How will it be possible for a midwife who attends homebirths and for women wishing to birth at home to gain the support of a GP ob or private obstetrician when their own college statement does not support homebirth?
RANZCOG statement reads -
“The College does not support Home Birth or ‘Free-standing’ Birth Centres
(without adjacent obstetric and neonatal facilities) as appropriate Health Care
Settings. The College acknowledges that a very small minority of women will
choose to birth in these centres, even if appropriately informed of the
consequences”
In solidarity with our northern and southern sisters (who will be rallying outside Kevin Rudd’s Brisbane office and Julia Gaillard’s Vic office) please come and rally outside the Minister for the status of women, Tanya Plibersek’s office in Sydney".

Facebook | RALLY FOR BIRTH CHOICES - SYDNEY


THE HON NICOLA ROXON MP
MINISTER FOR HEALTH AND AGEING

MEDIA STATEMENT – 5 NOVEMBER 2009

Midwives/ Nurse Practitioner Amendment


The Minister for Health and Ageing, Nicola Roxon has today circulated an amendment the Government intends to introduce into the Health Legislation (Midwives and Nurse Practitioners) Bill and the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill.

This amendment makes clear in the legislation something that was articulated both on introduction of the Bill to parliament and in the explanatory material tabled at that time.

Following requests for clarification, this amendment will simply clarify in legislation that collaborative arrangements with medical practitioners will be required to access the new arrangements.

The details of these requirements will be specified in subordinate legislation following the ongoing consultation with the professional groups.

These bills are a key plank of the Government’s 2009/10 Budget commitments which recognises for the first time the role of appropriately qualified and experienced midwives and nurse practitioners in our health system.

The Minister for Health and Ageing said today “I thank the doctors, nurses and midwives for their constructive engagement to date to ensure these new opportunities for nurses and midwives are implemented in an integrated fashion for the benefit of patients.”
For more information contact the Minister’s office on 02 6277 7220

Wining and dining doctors a $60 million a year industry / Current news / The University of Newcastle, Australia

Transparency is important. Where funding comes from and goes to, what makes the cost of pharmaceuticals so high are financial and health related issues that the government and the general population need to know more about.

The Baby Friendly Hospital Initiative has sought to keep maternity services free from the wining and dining, 'gift' freebee culture of formula makers that creates dependency and a sense of 'owing one' to the generous one. If anyone wonders if it is necessary to keep midwifery free of funding by vested interests of formula makers and the like, wonder no more.

Wining and dining doctors a $60 million a year industry / Current news / The University of Newcastle, Australia

Sunday 1 November 2009

iPhone in OBGYN Business Timesaver

Isn't this the best thing now!

Handy for those busy obstetricians

"AirStrip OB, which enables obstetricians to monitor different stages of labor even when they’re not by a patient’s side"

Apple - iPhone in Business - Profiles - Memorial Hermann Healthcare System

“AirStrip OB is an absolutely indispensable app that iPhone completely unlocks. It fundamentally changes the way I’m able to interact with labor and delivery.”
Dr. Marco Giannotti, Obstetrics and Gynecology, Memorial Hermann
The Woodlands Hospital

Yes, I'm sure it will.

If anyone had any doubt about the benefits of one to one midwifery care, this may help them understand more.