Some China Provinces Could Relax One-Child Policy

Some rural Chinese provinces are likely to expand exceptions to China's one-child policy, as the federal government continues to re-examine the 30-year-old policy, Reuters reports. The Chinese government has been cautious about reversing the policy, which largely has controlled the country's population that is expected to peak at 1.65 billion in 2033. The policy was intended to last one generation.

The government currently allows several exceptions, including allowing rural families to have a second child if the first is a girl and for couples in cities to have a second child if both parents have no siblings. Five rural provinces in 2011 will participate in a pilot program in which couples will be allowed to have a second child if at least one parent is an only child.

Zhang Feng, director of the Guangdong Population and Family Planning Commission, told the Southern Metropolis Daily, "If population control reaches the expected goal, Guangdong is likely to let couples in which one of the two is an only child to have a second child after the Twelfth Five-Year plan," which ends in 2015 (Reuters, 9/26).

However, China Daily on Monday reported that Li Bin, head of the National Population and Family Planning Commission, said there are no plans to change the one-child policy in the near future (Olesen, AP/Yahoo! News, 9/27).

Critics of the policy argue that it has led to forced abortions and sterilizations, while also imposing punitive enforcement and expanding the gender gap. They say millions of female fetuses and infants have been aborted or abandoned because of a traditional preference for male heirs. According to Reuters, there were 119.45 male newborns for every 100 female births in 2009, compared with a natural ratio of about 105 males per 100 female births. The gender disparity is likely to result in 24 million Chinese men unable to find female counterparts by 2020, which could lead to an increase in women- and child-trafficking, Reuters reports (Reuters, 9/26).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families.


© 2010 National Partnership for Women & Families. All rights reserved.

'Political Stars Aligned' For Comprehensive Sex Education Proponents, Opinion Piece Says

Congress has "been up to its eyeballs in sex education lately," with sex education proponents and opponents both working to secure federal funding for their causes, Washington Times columnist Cheryl Wetzstein writes in an opinion piece. Last week, the National Abstinence Education Association brought 500 teenagers to Capitol Hill to discuss abstinence, and "[s]ex education proponents responded by blitzing members of Congress with calls for programs that offer plenty of information about birth control," she says. According to Wetzstein, the fiscal year 2009 omnibus spending bill President Obama signed last week "cuts funding for a major abstinence program" by more than $10 million. However, Sen. Arlen Specter (R-Pa.) "came through for abstinence, with more than $430,000 in earmarks -- all aimed at Pennsylvania programs, of course," she writes.

Wetzstein suggests "step[ping] back from this fray for a second." She goes on to cite historian Allan C. Carlson's "version of the rules for a sexual revolution," from his book "Family Questions," written 20 years ago. Carlson describes seven "rules" for a sexual revolution, beginning with "'declare the old morality dead'" and ending with "'seize control of the schools and begin indoctrination of the young" into a new moral code, according to Wetzstein. She says that "Carlson is a conservative who upholds marriage and the natural family, so his list is a warning not a call to arms," adding that his "conclusion ... describes us." He wrote that the U.S. is "'divided between two moralities'" and that unlike European nations, the "'great leap to the new morality of sexual freedom fell short" in this country, she says. Wetzstein writes that Carlson believes that U.S. teenagers are "'suspended' between two moral codes that are fighting for dominance -- and necessarily undermine each other."

Wetzstein continues that this "historical logjam may be broken at last this summer -- in favor of the 'new' moral code." She says, "The political stars are finally aligned for sex education proponents," who have "isolated the much-loathed Title V abstinence-education grant program, and all they have to do is get Congress to sit on its hands when the program expires June 30." Wetzstein concludes, "That would mean one abstinence program down, two to go" (Wetzstein, Washington Times, 3/17).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2009 The Advisory Board Company. All rights reserved.

Hormone Replacement Therapy Increases Risk For Breast Scan Abnormalities

Hormone replacement therapy (HRT) "could increase the risk of developing early signs of breast cancer after only one year", The Daily Telegraph reports. One of the largest studies of its kind has shown that "the group taking the hormones had a 4% greater risk of having an abnormal mammogram, or breast X-ray, than those taking the placebo", the newspaper said.



There has been ongoing debate about the risks and benefits associated with HRT. It is known to cause a slight increase in the risk of breast cancer if taken for longer than five years. This news report will no doubt raise concerns among many women taking, or considering taking, HRT.
The report is based on data from a large Women's Health Initiative (WHI) study in the US. However, the study was not directly investigating any link between breast cancer and HRT. Instead it looked at whether HRT increased the chances of detecting an abnormality on a mammogram that then required a biopsy for further investigation; this would not necessarily involve a diagnosis of breast cancer. The study's authors say that HRT seemed to increase the chances of having to undergo further investigation after a mammogram and reduced the ability of the mammogram to detect breast cancer accurately. They advise that these issues should be considered when doctors are discussing the risks and benefits of HRT with women, and this seems to be sensible advice.


Where did the story come from?

This research was carried out by Dr Rowan Chlebowski and other investigators for the WHI in the US. The WHI is funded by the US Department of Health and Human Services' National Heart, Lung and Blood Institute. It was published in peer-reviewed medical journal Archives of Internal Medicine.


What kind of scientific study was this?

This study reports an analysis of data from a large randomised controlled trial in which the researchers aimed to clarify the effect of combined HRT (oestrogen and progestogen) on breast cancer detection.


The WHI researchers enrolled 16,608 postmenopausal women (aged 50 to 79 years) from 40 clinics in the US between October 1993 and December 1998. The women received either a combination of oestrogen and medroxyprogesterone in a single daily tablet (HRT) or a placebo tablet. Women were not included in the trial if they had a family history of breast cancer, had any other cancer within the past 10 years, or another medical condition that meant they could die within three years of the start of the study. All participants had a normal mammogram and breast examination at the start of the trial. Researchers also collected participants' personal information, including details of health, lifestyle and previous use of HRT.















The women were followed up six weeks after starting the tablets to check they were taking the medication as directed and to monitor any symptoms. They had a clinical assessment every six months and a yearly breast examination and mammogram. Any mammograms that were suggestive of abnormalities or possible cancer were referred to a doctor who decided whether further investigation was needed.

In their analysis the researchers looked at the mammograms of the women who received HRT and those who received the placebo. They monitored two factors: specificity, which refers to the proportion of women without breast cancer whose mammogram was, correctly, free from abnormalities; and sensitivity, which refers to the proportion of women with breast cancer whose mammogram correctly showed the abnormality. They also looked at the rates of false-positive and false-negative test results. They carried out this analysis after the women had been taking the medications for three periods of time: one to two years; three to four years; and five or more years. Non-adherence to study medications was taken into account when conducting the analyses.


Researchers report that medications in all women were discontinued when it was considered that the risks of combined HRT therapy outweighed any benefits. Women were advised to continue with follow up assessments every six months and yearly mammograms. The researchers used this later data to assess the accuracy of mammograms for correctly detecting breast cancers 2.4 years after the women finished taking the study medication.


What were the results of the study?

The average age of women in this study was 63 years. There were no differences in demographics, lifestyle or relevant medical factors between the HRT and placebo groups. During the course of the study, breast cancers were diagnosed in 199 of the HRT group and 150 of the placebo group (giving a small increase in the risk of breast cancer in the HRT group). When breast cancer was diagnosed in the HRT group, it was generally at a later stage. These results have already been published.


The frequency of detecting an abnormality on a mammogram was higher in the HRT group (35% compared with 23% for the placebo group) with a corresponding increase in the number of biopsies that needed to be carried out. The increase in the chances of having an abnormal scan with HRT compared with placebo increased during the time HRT was taken (4% increase with one year of HRT, rising to an 11% increase with five years of HRT).


The researchers found that the specificity of mammograms was very similar in the HRT and placebo groups. However, the sensitivity of mammograms for correctly identifying women with breast cancer was reduced with HRT. Of all the women who went on to have a biopsy after a mammogram, fewer in the HRT group demonstrated actual breast cancer (14.8%) than those in the placebo group (19.6%).


For 12 months after the participants stopped taking HRT, the effects upon abnormality detection at mammography remained significant; however, they decreased after this time.


What interpretations did the researchers draw from these results?

The researchers concluded that the use of combined oestrogen and medroxyprogesterone HRT increased the rates of finding any abnormality on a mammogram and of needing to have a biopsy investigation, while "compromising the diagnostic performance of both". This, they say, results in "one in 10 and one in 25 women having otherwise avoidable mammogram abnormalities and breast biopsies, respectively".


What does the NHS Knowledge Service make of this study?


This was a complex and well-conducted study in which the WHI researchers attempted to clarify how HRT affects the risks of having an abnormal mammogram test. This follows on from the earlier findings of this study that use of HRT for over five years increases the risk of developing breast cancer. Being a large study, it offers valuable information; however, there are still points that should be taken into account:


- The newspaper headline in The Daily Telegraph that "HRT could increase breast cancer risk" is a slight oversimplification of the study's findings. The actual increase in the number of cases of breast cancer in the HRT group compared with the placebo group was relatively small, and was not the focus of this investigation. The main finding of the study was that the diagnostic accuracy of mammography was decreased in women who had taken combination HRT.


- This study only investigated one type and one dosage of combination HRT. The findings may not be the same with other drug combinations or for oestrogen therapy alone in women who have undergone a hysterectomy. The effects upon women with a family history of breast cancer are also unclear.


- This study was conducted in the US. Findings may be similar in other countries, but care should be taken when applying the results to the UK or elsewhere because the sensitivity of detection of abnormalities on mammograms may be slightly different.


- The researchers suggest that the decrease in diagnostic accuracy of the mammograms may be due to the increase in breast density that occurs because of hormone therapy. This was not assessed by the study, the researchers explain, so the precise role of this factor remains unknown.


The authors say that the emotional and economic costs for women who have an abnormal mammogram and need further investigation may be significant. They therefore advise that these issues are considered when doctors are discussing the risks and benefits of HRT with women. At the current time, this seems to be sensible advice.


Sir Muir Gray adds... One of the reasons that breast screening shows less benefit in women under the age of fifty is that the breast tissue is denser before the menopause. It is therefore not surprising that HRT makes mammograms more difficult to read.


Links to the headlines


HRT could increase breast cancer risk.
The Daily Telegraph, February 26 2008


Links to the science


Estrogen Plus Progestin and Breast Cancer Detection by Means of Mammography and Breast Biopsy.
Chlebowski RT, Anderson G, Pettinger M, et al.
Arch Intern Med 2008; 168:370-377

This news comes from NHS Choices

Odds Of Experiencing Sexual Aggression 19 Times Greater On Days Of Binge Drinking For College Women

According to researchers at the University at Buffalo's Research Institute on Addictions (RIA), the odds of 18-19 year old college women experiencing sexual aggression are 19 times greater when they binge drink than when they don't drink. Binge drinking or heavy drinking was defined as drinking four or more drinks on a drinking occasion.


The analysis that led to this finding was based on daily reports of 179 young college women during an eight-week study. The majority of the women, 118 (66 percent of the sample), reported drinking alcohol during the study. Among those who drank, 73 women (62 percent) reported one or more days of heavy drinking. For this particular group of women, heavy drinking translated to on average, seven drinks.


Reports of aggression were provided by 63 women (35 percent) in the sample of 179. Across the entire sample, a total of 127 days of aggression was reported. Sexual aggression was reported on 26 of these days (or 20 percent of the time). The odds of experiencing sexual aggression were 19 times greater on heavy drinking days compared to non-drinking days. Physical aggression was reported on 16 of the days (or 13 percent of the time). The odds of experiencing physical aggression were 12 times greater on heavy drinking days compared to non-drinking days.


According to Kathleen A. Parks, Ph.D., principal investigator on the study, "Our goal was to investigate the relationships among drinking, aggression, and mood. What we found - in the very high odds of sexual and physical aggression on heavy drinking days - indicates major consequences of binge drinking for women that no research study had previously established."


Parks is a senior research scientist at RIA with expertise in women's substance use and misuse, and alcohol-related victimization of women.


Verbal aggression was reported on 85 of the 127 days of aggression (or 67 percent of the time). The odds of verbal aggression were a little over two times greater on heavy drinking days compared to non-drinking days. This is of some interest because verbal aggression often precedes physical and sexual aggression. When women experienced negative psychological symptoms or moods (described as depression or anxiety), the odds of verbal aggression increased by three times. Furthermore, the odds of alcohol consumption were three times higher for the 24 hour period following involvement in verbal aggression.


The researchers also determined that not all drinking puts women at risk for experiencing aggression. Rather, heavy drinking (consuming four or more drinks per occasion) increased women's risk for involvement in sexual, physical, and, to a lesser degree, verbal aggression.


"These findings provide support for the need to develop intervention programs targeted to this problem," Parks concluded. "In addition, they help define characteristics that put women at increased risk for aggression, regardless of alcohol consumption. Women who enter college with a history of experiencing aggression or a history of heavy drinking are at greater risk for later aggression, as are women who experience depression or anxiety while in college."


This study was part of a larger four-year investigation of 995 first-time freshmen college women. It took place during the spring semester of the second year at college when the women were 18-19 years old. Sixty-one percent of the women were white, 15 percent were black, 13 percent Asian, and the remaining 10 percent were from other ethnic groups.



A complete report of the study was published in the June 2008 issue of Psychology of Addictive Behaviors.


Parks conducted this study in collaboration with Ya-Ping Hsieh, Ph.D., data manager and analyst; Clara M. Bradizza, Ph.D., senior research scientist at RIA and research assistant professor of psychiatry in UB's School of Medicine and Biomedical Sciences; and Ann M. Romosz, M.A., project director.


The Research Institute on Addictions has been a national leader in the study of addictions since 1970 and a research center of the University at Buffalo since 1999.


The University at Buffalo is a premier research-intensive public university, a flagship institution in the State University of New York system and its largest and most comprehensive campus. UB's more than 28,000 students pursue their academic interests through more than 300 undergraduate, graduate and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.


University at Buffalo

Supreme Court Denies Appeal Of Lower Court Ruling That Alaska Right To Life Committee Must Adhere To State Campaign Finance Laws

The U.S. Supreme Court on Monday without comment denied an appeal by the Alaska Right to Life Committee to a ruling by the 9th U.S. Circuit Court of Appeals that said Alaska's campaign finance laws do not violate the First Amendment, the AP/Anchorage Daily News reports (Volz, AP/Anchorage Daily News, 10/2). The Alaska Legislature in 2002 approved a law requiring interest groups that produce political materials within 30 days of a general election to register with the state Public Offices Commission, report the expenditures involved in the campaigning and disclose their identities in advertisements. The Alaska Right to Life Committee, which is affiliated with Alaska Right to Life, in a lawsuit filed in November 2002 said that the rules are "too broad" and thus can "also encompass issue advocacy," which is protected by the Constitution. The suit -- which was seeking to have certain sections of the law declared unconstitutional -- cited a telephone campaign that the group planned to launch shortly before the Nov. 5, 2002, election. The campaign focused on the gubernatorial race between Gov. Frank Murkowski (R) and former Lt. Gov. Fran Ulmer (D). Campaigners would have telephoned households and asked people their position on abortion; if respondents identified themselves as "antiabortion," callers would have outlined the abortion positions of Murkowski and Ulmer. Although the campaigners would not have "explicitly" endorsed either candidate, they would have stated that Murkowski "supports Alaska Right to Life's pro-life vision." The suit said that officials from the Public Offices Commission -- which is charged with enforcing the law -- told the organization that "due to the nature of the campaign," the calls would have to be funded and directed through the AKRTL Political Action Committee, not the organization itself (Kaiser Daily Women's Health Policy Report, 11/26/02). A lower court dismissed the lawsuit, and the 9th Circuit Court in March upheld the decision.

Reaction
"It's good to know that our electioneering definition will withstand a court challenge," Public Offices Commission Executive Director Brooke Miles said. AKRTL Executive Director Karen Lewis said she is disappointed that the Supreme Court would not hear the case, adding, "It seems like we're being silenced. Free speech should always be in place." Lewis said the group would release its campaign messages for the November election through its PAC within the 30-day period (AP/Anchorage Daily News, 10/2).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.