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BMA Scotland GP Leader Calls On Scottish Government To Listen, Support And Work With GPs To Help Improve Patient Care
As GPs across the UK gathered in London for the Annual Conference of Local Medical Committees, Dr Dean Marshall, chairman of the BMA"s Scottish General Practitioners Committee, slammed the government for trying to strip GPs of funding and called for the profession to make decisions about general practice, not civil servants.
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Obama Administration's Filings On Asylum For Abused Foreign Women Brings 'Overdue Dose Of Clarity,' Editorial Says
The Obama administration recently laid out "a clear but narrow pathway" toward asylum for foreign women who have experienced severe physical or sexual abuse, a New York Times editorial states, noting that the U.S. government has debated the issue for 15 years. According to the editorial, the "question is not the fact of persecution, but whether the women would qualify for protection under the law, which limits asylum to those who suffer due to their race, religion, nationality, political opinion or "membership in a particular social group."" It adds that attorneys general under former Presidents Clinton and George W. Bush "have gone both ways and in circles" in their decisions.Although "[n]ot all victims will qualify," the Obama administration "made it clear that some could," the editorial states. "A petitioner would have to demonstrate to a judge that domestic violence was widely tolerated by society and government in her country, that women were viewed as subordinate to men and that she had no place within its borders to find a safe haven," the editorial adds.Department of Homeland Security lawyers say the new definition could apply to a severely abused Mexican woman, identified only by her initials, whose asylum petition is before a San Francisco immigration court. The editorial notes that DHS "did not immediately recommend asylum" for the woman, but "it did urge that she be allowed to continue to gather evidence and to refine her case according to the standards it proposed." The editorial concludes, "Advocates who have fought for years to advance women"s rights are celebrating the department"s action, which brings reasoned compassion, and an overdue dose of clarity, to an issue of anguish and difficulty" (New York Times, 7/19).
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Reprogrammed Mouse Fibroblasts Can Make A Whole Mouse
In a paper publishing online July 23 in Cell Stem Cell, a Cell Press journal, Dr. Shaorong Gao and colleagues from the National Institute of Biological Sciences in Beijing, China, report an important advance in the characterization of reprogrammed induced pluripotent stem cells, or iPSCs.
Public Health

During Pregnancy Obese Women Should Not Gain Weight, Study Suggests

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


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