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Obama Says He Supports 'Robust' Protections For Health Workers With Moral, Religious Objections
President Obama on Friday said that although he intends to reverse the Bush administration"s provider "conscience" rule, he still favors a "robust" federal policy that would enhance the rights of health care workers to refuse to perform certain procedures because of moral or religious objections, the Washington Post reports. In a session with reporters one week before his first meeting with Pope Benedict XVI, Obama said that he is a "believer in conscience clauses." He added that a new policy from his administration "may not meet the criteria of every possible critic of our approach, but it certainly will not be weaker than what existed before the changes were made." According to the Post, Obama"s comments aimed to reassure Roman Catholic health care workers that they would still be able to refuse to perform abortions and other procedures that go against the Church"s teachings. Several federal laws in place since the 1970s protect the rights of health care workers with moral or religious objections (Salmon, Washington Post, 7/3). Nancy Berlinger, deputy director of the Hastings Center, said that conscience laws also "are on the books in almost every state." She added, "The idea was that when abortion moved from being an illegal procedure, therefore something that you did not offer in a hospital, to being a legal procedure, therefore something that you might offer in a hospital, there was a move to protect providers ... from having to participate in abortions." However, not all conscience laws are specific to abortion, NPR"s "Morning Edition" reports. For example, some allow providers to refuse to provide birth control, in vitro fertilization or end-of-life care (Rovner, "Morning Edition," NPR, 7/6).The Bush administration said its 2008 policy was designed to ensure that the federal laws are enforced. The policy would cut off federal funding to health care facilities and other entities that did not accommodate workers who refused to participate in certain procedures (Washington Post, 7/3). Joxel Garcia, the assistant secretary for health in the Bush administration who helped write the policy, said that it is necessary because few health care workers are aware of the protections. He added that the policy gives health workers "a mechanism to seek help" through HHS.However, critics of the Bush administration"s policy contend that it would widely expand the scope of health care covered by the policy and the type of health care workers who could object to procedures. Berlinger said, "Words like belief, when you talk about them in the context of health care, aren"t just anything you might think of." She noted that a "false belief about science or the promotion of ambiguity where things can be disambiguated," such as the claim that birth control is equivalent to abortion, "is not ethical" ("Morning Edition," NPR, 7/6).Obama"s plan to replace the policy has stoked concern from Catholic health care providers that they would be forced to perform abortions, sterilizations and other procedures that go against Catholic teachings (Washington Post, 7/3). A recent survey conducted for the Christian Medical Association found that 90% of doctors surveyed said that "they will quit their practices before violating their conscience," according to David Stevens, executive director of CMA. Stevens said that repealing the Bush administration"s rule "sends a clear message: It"s open season on health care professionals of conscience -- discriminate at will" ("Morning Edition," NPR, 7/6).Obama on Friday also said that although he and the pope have areas of "deep agreement ... there are going to be some areas where we"ve got some disagreements," such as abortion rights and embryonic stem cell research. The president will meet with the pope on July 10, while he is in Europe for a summit of the Group of Eight industrialized nations. Obama Addresses Catholic Concerns on Pregnancy PreventionObama also discussed opposition to the inclusion of comprehensive sex education and contraception in any legislative pac
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Decoding Leukemia Patient Genome Leads Scientists To Mutations In Other Patients
Decoding the complete DNA of cancer patients is giving scientists at Washington University School of Medicine in St. Louis a clearer picture of the complexity of the disease and allowing them to see intriguing and unexpected genetic relationships among patients.
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Rush University Medical Center Hosts Conference Examining Chicago Breastfeeding Rates And Ways To Reduce The Disparities
Over 100 certified breastfeeding peer counselors, lactation consultants, nurses, physicians, dietitians and community health workers are expected to gather at Rush University Medical Center on Thursday, August 6 from 8 a.m. until 1 p.m. in Room 500 at 1725 W. Harrison Street, Chicago, to attend the Griffin Inaugural Conference on Breastfeeding: The Primary Foundation for Health.
Mental Health

Atrial Fibrillation In Endurance Athletes Still Poses Problems For Sports Cardiologists

The fulfilment which so many people increasingly derive from competitive sports and endurance training comes with a real - even if rare - twist. Because, while most people will enjoy the benefits and pleasures of exercise, there are a few for whom regular athletic training will increase the risk of cardiac arrhythmias and even sudden death, especially among those in middle-age or with pre-existing cardiac diseases. "It"s for this reason that sports medicine has focused on pre-participation screening," says Dr Luis Mont from the Hospital Clç­nic de Barcelona, Spain, "in an attempt to detect any hidden heart disease." On the other hand, disturbances in heart rhythm, particularly atrial fibrillation, which represent one of the major cardiovascular reasons for hospital admission, is more common among cyclists, marathon runners and other athletes with a long history of endurance training. Dr Mont reports that atrial fibrillation is more frequent in middle-aged individuals who formerly took part in competitive sports and continue to be active, or simply in those involved in regular endurance training without having actually participated in competitive sports. "So we have to look at the effects of endurance or athletic training with a more open view," says Dr Mont. However, he adds that the cost-effectiveness of routine pre-participation screening in a broad population of athletes and endurance sports participants has not yet been clarified. A debate on the subject takes place at this Congress on Sunday 21st June at 16.00. What does seem clearer, however, is that long-term endurance sport participation may well increase the incidence of cardiac arrhythmias, particularly atrial fibrillation, atrial flutter, sinus node dysfunction, and right ventricular premature beats. "Given the fact that an increasing number of individuals engage in regular endurance sports," says Dr Mont, "it is certainly of great interest to define which recommendations for sport should be implemented in an individual patient, and how best to manage arrhythmias in participants." Atrial fibrillation is the most common arrhythmic condition, and sudden cardiac death remains a risk. Three papers presented at this congress by Dr Mont"s group reflect the research effort now being directed towards sports cardiology and the prevention and treatment of rhythm disorders. 1. Efficacy of the circumferential pulmonary vein ablation of atrial fibrillation in endurance athletes. CPVA is a recently introduced technique which identifies the signals causing the atrial fibrillation and isolates their in the pulmonary veins from the left ventricle of the heart. The technique has been successfully used in routine patients with atrial fibrillation and, according to new data presented here in Berlin, is now as effective in AF secondary to endurance sports as in other causes. A series of 182 patients in Dr Mont"s Barcelona clinic found that freedom of arrhythmias following CPVA was similar in the sports participants as in the regular patients. Left atrial size and long-standing atrial fibrillation were the only independent predictors for arrhythmia recurrence after the treatment, not sports participation. 2. Deconditioning reverses expression of cardiac fibrosis markers in an animal model of endurance training. A more basic science study from Dr Mont"s group in Barcelona also suggests that those with a history of arrhythmias following endurance training may benefit from a period of "deconditioning" following their efforts. The suggestion follows a study in animal models which found that markers of cardiac fibrosis in rats whose treadmill exercise was followed by a period of inactivity returned to control levels. Endurance exercise causes cardiac structural changes, including atrial and right ventricular fibrosis - and this fibrosis may play a role in the development of arrhythmias. Although it has been noted that the athlete"s heart regresses after inactivity it is not known if the sport-induced atrial and right ventricular fibrosis also reverses after deconditioning. This study suggests that it does and that a period of inactivity might be of benefit in those with a history of fibrillation. 3. Losartan attenuates heart fibrosis induced by chronic endurance training in an animal model. Just as inactivity after training may inhibit cardiac fibrosis in animal models, a similar study suggests that the anti-hypertensive drug losartan prevents the heart fibrosis induced by endurance exercise. The anti-fibrotic effect of losartan, an angiotensin type-II receptor antagonist, appears to be mediated suppression of angiotensin II-induced proliferation of fibroblasts. Again, markers of fibrosis were reduced by administration of losartan. Notes: 1. EHRA, the European Heart Rhythm Association, aims to serve as the leading organisation in the field of arrhythmias and electrophysiology in Europe, and to attract physicians from all of Europe and beyond to foster the development of this area of expertise. EHRA is a registered branch of the European Society of Cardiology (ESC). EHRA is based in Sophia Antipolis, France. 2. The European Society of Cardiology (ESC) represents more than 50,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe. 3. Cardiac arrhythmia describes conditions in which heart beat is too fast, too slow, or irregular. The cause is abnormal electrical activity in the heart. Some arrhythmias may be life-threatening and result in sudden cardiac death. The average healthy heart beats 200,000 times per day. 4. The most common arrhythmia (after a skipped beat) is atrial fibrillation, which affects up to 5 per cent of all adults, mainly the over-65s. 5. Full scientific programme of EUROPACE 2009 ESC Press Office European Society of Cardiology


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