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Lack Of Medical School Training On Abortion Contributes To Decline In Providers, Salon Opinion Piece Says
Salon contributor Kate Harding on Monday examined how a lack of training in medical schools is affecting the availability of abortion providers in the U.S. Harding reports that 87% of all U.S. counties and 98% of rural counties have no abortion services. In addition, nearly two-thirds of physicians who perform abortions in the second trimester are older than age 50 and "bound to retire sooner rather than later," she writes. Harding also cites figures from PBS" "NOW" showing that the number of abortion providers has dropped by one-third in recent decades -- from 2,680 in 1985 to 1,787 in 2005. According to Harding, although a fear of violence and a tendency of younger doctors born after Roe v. Wade to "take abortion for granted" are "probably" factors in the drop in providers, another important issue is inadequate education in medical schools. According to a recent survey of Medical Students for Choice student members published in the journal Contraception, 33% of the students ""reported no coverage of elective abortion-related topics,"" Harding writes. MS4C reported that fewer than 50 U.S. medical schools, out of 130 accredited institutions, offer abortion training as part of their residency programs. Harding adds that family planning training that does exist is "often patchy and rife with misinformation." The reasons for avoiding the issue of abortion in medical education vary, according to Harding. Mitchell Creinin, president of the Society for Family Planning, said that even though abortion is the second most common outpatient procedure in the U.S., many students will not pursue specialties that involve providing abortion and those who do might choose not to offer the procedure. Creinin also noted that doctors in many other specialties complain about the lack of medical school training in their particular fields. According to Harding, taking this view, "you could also argue that it"s a waste of time in an already overburdened curriculum."Another factor is that "the same relentless pressure" from abortion-rights opponents "that plagues practicing abortion providers is also directed at medical schools," Harding writes. According to Susan Wicklund, an ob-gyn in Montana, some antiabortion-rights groups pressure administrators and faculty at medical schools not to discuss abortion and threaten boycotts or picketing. Lois Backus, executive director of MS4C, said the lack of abortion training reflects a larger problem in medicine of focusing on men"s health needs over women"s. Backus said medical students report that they ""get two to three hours on Viagra and half an hour on every contraceptive method combined. That"s the reality of American medical education."" According to Harding, this fact is "even more troubling in light of research that shows exposure to comprehensive family planning education, including abortion, is a strong predictor of whether a medical student will go on to become a provider." Creinin said comprehensive education in reproductive health is worthwhile, even for doctors who never intend to perform abortions. He noted that many physicians received training on cancer care, though they are much more likely to treat a patient with an unintended pregnancy. According to Wicklund, the lack of physicians trained in reproductive health also means that women who travel to access an abortion provider cannot get adequate follow-up care when they return home. Harding adds that such "ignorance often leads to overreaction on the part of doctors" who do not understand how to treat minor complications resulting from abortions, which results in "expensive, unnecessary hospital stays for women who might not have insurance" (Harding, Salon, 6/15).
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Statistical Press Notice - Direct Access Audiology Referral To Treatment (RTT) Times Data February 2009, England
The "Improving Access to Audiology Services in England", document in
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Dartmouth Studies Influence Administration, Even In Choice Of Venue
When President Obama chose Green Bay, Wis., to talk about the need for health reform, he did so in part because the area has achieved a high level of quality, and compared with other parts of the country, succeeded in restraining health care costs, National Public Radio reports. "They"re certainly spending a lot less money, and they are providing care that is equal or better than the care that is provided in many other communities around the country," Elliot Fisher, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice told NPR in an interview. NPR says: "Some of the research the administration is relying on comes from the Dartmouth Institute for Health Policy and Clinical Practice," which focuses on variations in health quality and costs around the country.
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European Food Safety Authority Publishes Its First Report On Pesticide Residues In Food

The European Food Safety Authority (EFSA) has published its first Annual Report on Pesticide Residues, which provides an overview on the pesticide residues in food observed throughout the European Union (EU) during 2007 and assesses the exposure of consumers through their diets. The report showed that the majority of the samples complied with the legal maximum residue levels (MRLs) of pesticides and made a series of recommendations to further improve the collection of data required for pesticide exposure assessment. The report, prepared by EFSA"s Pesticide Risk Assessment Peer Review (PRAPeR) Unit, said that 96 % of the samples analysed were compliant with the legal Maximum Residues Levels (MRLs) and 4 % exceeded them, compared to 5% in 2006. In total, more than 74,000 samples of nearly 350 different types of food were analysed for pesticide residues in 2007, representing a 13 % increase in comparison with 2006. Considerable efforts were made by Member States in extending the scope of the analytical methods, which made it possible to detect up to 870 pesticides in 2007 -- an increase of 13 % compared to previous years. In order to protect consumers, MRLs are set at levels which are both safe for consumers and correspond to the lowest amount of pesticide used on the crop to achieve the desired effect. EFSA specified that the presence of pesticides in foods, and even the exceedance of an MRL, does not necessarily imply a food safety concern. When an MRL is exceeded, consumer exposure needs to be calculated in order to assess whether this represents a potential risk for consumers. In assessing chronic (long-term) consumer exposure, EFSA followed a cautious approach, using conservative assumptions which overestimate exposure. For all evaluated pesticides, except one (diazinon), the chronic exposure did not raise concerns for consumer health. It is worth noting that since December 2007 all authorisations concerning this substance have been withdrawn and MRLs have been lowered. The assessment of acute (short-term) exposure was also based on worst-case scenarios. Thus, estimates took into consideration high food consumption combined with the highest residue observed in the 2007 EU monitoring programme. Such critical intake cases are in reality very unlikely to occur. Assuming this scenario was to occur, a potential consumer risk could not be excluded for some of the results concerning 52 pesticide/commodity combinations, many of which have already been addressed by withdrawing authorisations or by lowering MRLs. EFSA provided a series of recommendations for future monitoring programmes on pesticide residues, such as amending the reporting format to ensure more detailed results which will allow more accurate exposure assessment. These improvements will help better inform and support risk managers in regulating the safe use of pesticides. Notes - MRLs are the upper legal levels of a concentration of pesticide residues in or on food or feed, based on good agricultural practices, requiring that authorised pesticides are used at the lowest level needed for effective plant protection. An indispensable precondition for setting MRLs is the performance of a risk assessment to ensure consumer safety. - The results listed in the report indicated a slight improvement in the compliance with MRLs compared to previous years, but accurate comparability is complicated, as the number of countries included in the report has increased from 16 in 1996 to 29 in 2007, national monitoring programmes differ from each other and have varied considerably over time. - EFSA"s PRAPeR Unit is responsible for assessing MRLs for pesticides through a comprehensive assessment of consumer exposure and of any potential health effects which may result from all intended uses in food and animal feed. EFSA verifies that exposure levels are safe for all consumer groups including potential vulnerable groups, such as young children, the elderly and vegetarians. Actual exposure of consumers to pesticides is evaluated in EFSA"s Annual Report on Pesticide Residues. - EFSA"s Panel on Plant Protection Products and their Residues (PPR) gives scientific guidance in the fields of toxicology, eco-toxicology, fate and behaviour of pesticides. The PPR Panel also provides scientific advice on issues related to pesticides, that cannot be resolved within the peer review of active substances. European Food Safety Authority


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