As if the recent release of changes in recommendations regarding breast cancer early detection were not enough, we now have hot on it’s heels a major change in recommendations for cervical cancer screening.  The irony of these two recommendations, though from differing groups and based on review of extensive data (which certainly in the case of breast cancer is open to debate) is that they suggest changes in long standing policy regarding early detection, which have clearly had an effect on reducing the incidence and mortality from these two cancers.  The cervical cancer recommendations have some thoughtful commentary regarding using these tests too early in a young woman’s life.  These concerns are valid.  However, it is also true, that among many populations and peer groups early sexual activity is a fact of life.  Having said that, the rate of HPV is rampant  and it seems, from a public health perspective a bit perplexing, that when we have initiatives to use a new vaccine to prevent HPV, we would at that same time be suggesting taking measures that makes diagnosing HPV less likely.   Not sure ACOG has thought that angle through enough. Proper testing is important and excessive testing is not helpful.  However, the individualization of recommendations we applaud from a medical perspective, but we know that this will lead to coverage issues for patients and doctors as health insurers will adjust their payment policies to reflect these new recommendations.  Below is potpourri of comments from ACOG and various news leads on this most public story . . . ben kazie md

Women should have their first cervical cancer screening at age 21 and can be rescreened less frequently than previously recommended, according to newly revised evidence-based guidelines issued today by The American College of Obstetricians and Gynecologists (ACOG) and published in the December issue of Obstetrics & Gynecology. Most women younger than 30 should undergo cervical screening once every two years instead of annually, and those age 30 and older can be rescreened once every three years.  Cervical cancer rates have fallen more than 50% in the past 30 years in the US due to the widespread use of the Pap test. The incidence of cervical cancer fell from 14.8 per 100,000 women in 1975 to 6.5 per 100,000 women in 2006. The American Cancer Society estimates that there will be 11,270 new cases of cervical cancer and 4,070 deaths from it in the US in 2009. The majority of deaths from cervical cancer in the US are among women who are screened infrequently or not at all. Cervical cancer is a slow growing cancer caused by certain strains of the human papillomavirus (HPV), an extremely common sexually transmitted disease among women and men. HPV also causes genital and anal warts, as well as oral and anal cancer…..

First Cervical Cancer Screening Delayed Until Age 21 Less Frequent Pap Tests Recommended – http://www.acog.org/from_home/publications/press_releases/nr11-20-09.cfm

New guidelines for cervical cancer screening say women should delay their first Pap test until age 21, and be screened less often than recommended in the past. The advice, from the American College of Obstetricians and Gynecologists, is meant to decrease unnecessary testing and potentially harmful treatment, particularly in teenagers and young women. The group’s previous guidelines had recommended yearly testing for young women, starting within three years of their first sexual intercourse, but no later than age 21. Arriving on the heels of hotly disputed guidelines calling for less use of mammography, the new recommendations might seem like part of a larger plan to slash cancer screening for women. But the timing was coincidental, said Dr. Cheryl B. Iglesia, the chairwoman of a panel in the obstetricians’ group that developed the Pap smear guidelines. The group updates its advice regularly based on new medical information, and Dr. Iglesia said the latest recommendations had been in the works for several years, “long before the Obama health plan came into existence.”  She called the timing crazy, uncanny and “an unfortunate perfect storm,” adding, “There’s no political agenda with regard to these recommendations.”…..

Guidelines Push Back Age for Cervical Cancer Tests – http://www.nytimes.com/2009/11/20/health/20pap.html?_r=4

The cervical cancer screening advice follows another panel’s controversial mammogram report, but experts say it’s a much different situation. Still, Paps are the only reason some women see a doctor. Only days after a federal panel scaled back on breast cancer screening recommendations for many women, another organization — the American College of Obstetricians and Gynecologists — has done the same for a screening credited with drastically reducing the rates of cervical cancer in the U.S. Women of all ages should undergo Pap smears less frequently than they do now, those new guidelines say. And young women are advised not to bother until age 21. The pullback follows the U.S. Preventive Services Task Force’s dismissal of routine breast cancer screenings for women younger than 50. That move triggered a storm of protest from medical groups and individual women, with some breast cancer specialists and Republicans accusing health officials of moving toward a rationing of care and services. On Wednesday, U.S. Health and Human Services Secretary Kathleen Sebelius emphasized that the task force guidelines amounted to advice, not policy, and that women should continue to consult with their physicians about mammograms based on their own histories and needs…..

Group recommends less-frequent Pap tests – http://www.latimes.com/news/nationworld/nation/la-sci-pap-smears20-2009nov20,0,5747799.story

Women can delay having their first Pap test for cervical cancer until they turn 21 and many can wait longer to go back for follow-up screenings, according to new guidelines released Friday by a major medical group. The American College of Obstetrics and Gynecologists (ACOG) recommended the change after concluding that more frequent testing did not catch significantly more cancers and often resulted in girls and young women experiencing unnecessary stress, anxiety and sometimes harmful treatments because of suspicious growths that would not cause problems. “We really felt that the downsides of more frequent screening outweighed any benefits,” said Alan G. Waxman, a professor of obstetrics and gynecology at the University of New Mexico who led the revision of the guidelines. “More testing is not always more intelligent testing.” The change comes amid sharp controversy over new recommendations from a federal task force that women wait until age 50 before they begin having routine mammograms and that women age 50 to 74 scale back to getting the exams routinely every two years…..

Cervical cancer screening can wait till 21, group says – http://www.washingtonpost.com/wp-dyn/content/article/2009/11/19/AR2009111904743.html

Women in the United States should start cervical cancer screening at age 21 and most do not need an annual Pap smear, according to new guidelines issued on Friday that aim to reduce the risk of unnecessary treatment. The guidelines from the American College of Obstetricians and Gynecologists or ACOG now say women younger than 30 should undergo cervical cancer screening once every two years instead of an annual exam. And those aged 30 and older can be screened once every three years. The recommendations are based on scientific evidence that suggests more frequent testing leads to overtreatment, which can harm a young woman’s chances of carrying a child full term. “Overtreatment of minor abnormal pap tests in young women and adolescents can lead to consequences such as preterm labor in some cases. It increases the risk,” said Dr. Thomas Herzog of Columbia University in New York, who is chairman of an ACOG subcommittee on gynecologic cancers. “Preterm delivery has become a huge problem in the United States that has potential serious consequences for the unborn fetus,” said Dr. Jennifer Milosavijevic, a specialist in obstetrics and gynecology at Henry Ford Health System in Detroit, who supports the guideline changes…..

New guidelines: Pap smears should start at age 21 – http://in.reuters.com/article/worldNews/idINIndia-44108820091120

The revised guidelines released today by the American College of Obstetricians and Gynecologists also recommend that women 30 and older get screened with a so-called Pap test once every three years, instead of every two to three years. The American Cancer Society’s gynecologic cancer director said the society agreed with the advice of the doctors’ organization that additional screenings may lead to unnecessary treatment. The ob-gyn organization is the second medical group this week to recommend less-frequent cancer screenings, citing scientific data. A U.S.-backed panel said Nov. 16 that most women in their 40s shouldn’t get annual mammograms to prevent breast cancer, setting off protests from women, physicians and health advocacy groups such as the cancer society. “The data is very good that a Pap test every two years is as good as a Pap test every year,” said Alan Waxman, the lead author of the new guidelines and a professor of obstetrics and gynecology at the University of New Mexico in Albuquerque, in a telephone interview. The additional tests are inconvenient and costly, and research shows “it doesn’t make a difference in terms of lives saved,” he said…..

Screening for Cervical Cancer Should Start at 21 – http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aLDLltBDBErU

For the second time this week, a major U.S. medical panel has revised recommendations for a key test that millions of American women use to detect cancer. On Monday, it was mammograms. Today, it’s Pap tests. The American College of Obstetricians and Gynecologists says that women no longer need annual cervical cancer screenings. It also says women can now wait until they’re 21 to get their first Pap test, instead of getting one after they’ve become sexually active. “The tradition of doing a Pap test every year has not been supported by recent scientific evidence,” said Dr. Alan G. Waxman of the University of New Mexico, who headed the American College’s guideline revision…..

Annual Pap tests no longer needed, panel says – http://www.tampabay.com/news/health/annual-pap-tests-no-longer-needed-panel-says/1052944

Most women in their 20s can have a Pap smear every two years instead of annually, say new guidelines that conclude that’s enough to catch slow-growing cervical cancer. The change by the American College of Obstetricians and Gynecologists comes amid a completely separate debate over when regular mammograms to detect breast cancer should begin. The timing of the Pap guidelines is coincidence, said ACOG, which began reviewing its recommendations in late 2007 and published the update Friday in the journal Obstetrics & Gynecology.  The guidelines also say: -Routine Paps should start at age 21. Previously, ACOG had urged a first Pap either within three years of first sexual intercourse or at age 21. -Women 30 and older should wait three years between Paps once they’ve had three consecutive clear tests. Other national guidelines have long recommended the three-year interval; ACOG had previously backed a two- to three-year wait. -Women with HIV, other immune-weakening conditions or previous cervical abnormalities may need more frequent screening…..

Report: 20-somethings can go 2 years between Paps – http://www.washingtonpost.com/wp-dyn/content/article/2009/11/20/AR2009112000089.html

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]]> http://stmvosseifp.wordpress.com/2009/11/22/jornada-dimpuls-als-projectes-internacionals-programa-daprenentatge-permanent/ Sun, 22 Nov 2009 16:05:39 +0000 stmvosseifp http://stmvosseifp.wordpress.com/2009/11/22/jornada-dimpuls-als-projectes-internacionals-programa-daprenentatge-permanent/

El divendres, 20 de novembre de 2009 es va celebrar, a l’INS Vilatzara de Vilassar de Mar, la Jornada d’intercanvi i difusió d’experiències en llengües estrangeres (PAP).

L’objectiu va ser conèixer directament les bones pràctiques i experiències diverses relatives a l’aprenentatge de llengües estrangeres en sintonia amb els programes internacionals.

Il giudice fiorentino ha riconosciuto la possibilità di “andare in paternità” anche da un mese o due precedenti alla presunta data del parto, e di conseguenza per i quattro o tre successivi.

“Il Testo unico delle disposizioni in materia di tutela e sostegno della maternità e paternità – spiegano i legali della coppia, Leonardo Marconi e Claudio Gardelli – dispone che il padre lavoratore ha diritto ad astenersi dal suo impiego per tutta la durata del congedo di maternità.

Figurarsi che su un uomo va all’Inps per esercitare il diritto di flessibilità troverà solo moduli in cui è previsto un periodo di paternità di tre mesi.

La sentenza farà giurisprudenza, da ora in avanti sarà un’arma a disposizione di quelle famiglie che non si vedranno riconoscere i 5 mesi di paternità.

Fonte:
http://www.repubblica.it/2009/11/sezioni/cronaca/padri-parto/padri-parto/padri-parto.html

On 05 November 2009 the Pan-African Parliament’s (PAP) First Ordinary Session of the Second Parliament has closed in Midrand, South Africa, after nine days of deliberations. The focused of the session was on Africa’s integration.
At the final press briefing of the session, PAP President Hon. Dr. Moussa Idriss Ndele encouraged all Heads of State to advocate for a strong and unified Africa, saying Africans needed to unite on issues of common interest like climate change, peace and security and democratic governance.

“It’s only a united and strong Africa that can survive the 21st century, the integration of the whole Africa is sine quo none. It does require that the states will come up with a prerogative. We need strong executives. We cannot be strong without an independent legislative arm. All heads of state agreed on this,” Hon. Ndele said.
He was optimistic the PAP, which has been operating as a consultative body since its establishment five years ago, would evolve into a legislative body by 2011. “It is our hope that by the end of the January 2010 Session, the new Protocol (to make PAP a legislature) will be examined by the Heads of State,” he said.

“There are a few countries that have not ratified the Protocol to the Treaty of the African Economic Community Relating to the PAP. There are some other countries that have been suspended or have financial constraints and so have not fulfilled their financial obligations to the body. We have pledged to bring back the countries by asking them to ratify the Protocol so that they can sit in PAP with other parliamentarians.”

During the just ended session, parliamentarians resolved to push for the full implementation of the Kyoto Protocol at the forthcoming Copenhagen conference in Denmark this December. They also proposed a budget for the PAP totalling US$ 22,351,781 for 2010.

The PAP also called upon the military in Guinea not to contest the elections but to hold fresh, credible elections to be supervised and monitored by the African Union.

Besides that, PAP also raised concerns about the political situation in Niger, and denounced the recent national elections as null and void, hence demanding for a re-run under the supervision of ECOWAS. West African leaders and ECOWAS had also raised concerns about the political impasse in Niger, threatening full sanctions if President Mamadou Tandja does not suspend legislative elections.

On the issue of preparations for the 2010 FIFA World Cup in South Africa, Ms. Tumi Dlamini, Head of International Relations at the 2010 FIFA World Cup Organizing Committee in South Africa, addressing the Members said nine out of 10 stadia and about 20 specific training venues had been completed and were in the process of being handed over to FIFA for inspection. “Construction of the stadia has gone on very well, without incidents. All the dates set have been met, except for the Cape Town stadium because it had litigation issues at the beginning,” Dlamini said. “But it will be ready by January (2010) to give us enough time to test it, since the World Cup is only starting in June.”

The Parliament also adopted a report presented by Hon. Mary Mugyenyi, Second Vice President of the PAP on behalf of the Parliament’s Women Caucus, calling for the immediate abolishment of harmful traditional practices in Africa that continue to affect the safety of African women and children, mainly female genital mutilation (FGM).

The Women’s Platform Action Plan in Africa is an initiative that organized three women conferences, the first of which was organized by the Parliament of South Africa in Cape Town in 2006, whereas the second and third were held at the PAP in October 2008 and October 2009 respectively. This year’s conference theme was “Women Parliamentarians against Harmful Traditional Practices in Africa: in Particular Female Genital Mutilation/Cutting”.
Statistics show that at least 30 countries in Africa, mostly countries in the Horn of Africa and in West Africa, practice female genital mutilation, regardless of dire health, social and psychological consequences that the harmful traditional act inflicts on women and children.

According to the Deputy Chairperson of the Women’s Caucus, Hon. Anab Abdulkadir Ahmed, the motivation behind the existence of the practice in the continent is the believe in most communities that the act is religious, to others it’s a culture they say they have to adhere to in order to control and avoid early relationships.

In their presentation, the Women Caucus tabled recommendations highlighting the need to implement legislations in countries where the act is mostly practiced. Amongst the ten recommendations presented by the Women’s Caucus, is the need for political will at the highest level; the need for governments to put in place votes and budgets for programmes that champion the eradication of the act; the need to have a systematic plan approach; the need for a proper action plan to deal with FGM; and the need to offer alternative income generating activities to people who engage in FGM.

The Caucus also highlighted the urgent need to work towards the transformation of governance and legislative regimes so as to eradicate practices and beliefs that discriminate against women. They also proposed that PAP should be given legislative powers to enable it to legislate against FGM.

It was concluded that the PAP will table the recommendations before the next AU Assembly of the Heads of State and Government.

Parliament also adopted a motion to exert pressure on the government of the Kingdom of Morocco to release the seven Sahrawi human rights activists who were abducted “upon their return from visiting their families in the Saharawi refugee camps.”

The motion stated that “in view of the Moroccan convinced authorities’ decision to bring the seven human rights defenders before a Moroccan military court and the dangerous outcome of such action on the United Nations-African Union peace progress in the territory”, that the Parliament’s “previous recommendations which re-affirm the Saharawi people’s right to independence and self-determination” still stands.
“Sahrawi is fully recognized by all African countries. The country was a founder member of the AU. It’s time to establish a just and democratic system in Africa. Let’s stand against this unjust oppression”, Hon. Hammi Laroussi, Vice President of the PAP said.

Source: www.pan-african-parliament.org

Coimbatore: Though not a torrential downpour as it was in the last couple of days, intermittent showers have been improving the storage in the Parambikulam Aliyar Project reservoirs. Rain continues in the Western Ghats, especially in the catchments of the PAP as well as in Siruvani and Pilloor.

In Sholayar, the dam level stood at 151.88 ft as against the Full Reservoir Level (FRL) of 160 with the inflow at 599 cusecs and outflow at 634 cusecs and rainfall at 33 mm. In Parambikulam, the storage was 71.90 ft as against the FRL of 72 and inflow was 680 cusecs and discharge was 680 cusecs and rainfall was 19 mm. Aliyar had a storage of 119.70 against an FRL of 120 ft and inflow was 748 cusecs and discharge was 829 cusecs while rainfall was 1.6 mm.

Thirumurthy had a storage of 44.28 ft as against the FRL of 60 ft and the inflow was 114 cusecs while the discharge was 14 cusecs and rainfall 3 mm. Thirumurthy had a storage of 79.60 ft as against the FRL of 90 ft and inflow stood at 3,164 ft and discharge was 7 cusecs and rainfall 2 mm.

The Water Resource Organisation (WRO) of the Public Works Department have already commenced the works for removal of the boulder and sand from the Aliyar Feeder canal as well as the breached Contour Canal. The access road to the breach site of the Canal Road is also almost ready for reaching men and materials. The works are expected to be speeded up once the rain stops.

In Coimbatore, Siruvani dam registered a rainfall of 22 mm while the foothills registered 18 mm and the dam continued to surplus at 878.5 ft. The surplus continued in Pilloor also.

From THE HINDU

An essay on the possible reasons why the PAP has managed to stay in power in Singapore for so long. Interesting read, even if it’s government sanctioned.

סרטן צוואר הרחם הוא סרטן מסוג קרצינומה המתפתח באזור צוואר הרחם.

סרטן זה מתפתח כמעט תמיד לאחר הדבקות בוירוס הפפילומה האנושי (HPV). לזניו הנפוצים יותר של וירוס זה חיסון אותו ניתן לקבל ובכך למנוע כ- 70% ממקרי הסרטן.

בנוסף, עוברות נשים בישראל באופן קבוע בדיקת PAP (משטח צוואר הרחם), שמטרתה לזהות התפתחות של סרטן צוואר הרחם. בדיקה זו מסוגלת לזהות בשלב מוקדם שינויים טרום סרטניים.

בדיקת ה- PAP אינה מדע מדויק. על כן, מרבית מקרי הרשלנות הרפואית בהקשר של סרטן צוואר הרחם הם מקרים העוסקים ברשלנות באבחון הסרטן בזמן.

משרדנו מתמחה בטיפול משפטי אישי ואנושי בנפגעי מחלות קשות. למידע נוסף על זכויות משפטיות בהקשר של סרטן. ליצירת קשר עם עו”ד טלי פישר, ניתן להתקשר בכל עת לטלפון 03-7553866 או במקרי חירום לנייד 054-8033035.

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Ribancok éjszakája II. – HoolieWeen és Dancsi Birthday Party

Az elkövetkezendő napokban folyamatosan pakolom fel a jobbnál jobb képeket, melyeket Ti természetesen már menthettek is le magatoknak! Köszönjük a részvételt és reméljük a 3. Ribancok éjszakáján is résztvesztek majd!