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Appeals Court Panel Says Pharmacists Must Distribute Emergency Contraception Under Washington State Regulation
A three-judge panel of the U.S. Circuit Court of Appeals for the 9th Circuit on Wednesday unanimously ruled to lift an injunction blocking Washington state officials from penalizing pharmacists who refused to dispense the emergency contraception pill Plan B, the Los Angeles Times reports (Williams, Los Angeles Times, 7/9). The panel said the district court judge who issued the injunction refused to consider women"s need for EC (Egelko, San Francisco Chronicle, 7/9). The panel"s ruling is part of a larger case before the district court involving the constitutionality of a 2007 state regulation requiring pharmacies to stock and dispense EC. Joyce Roper, an assistant attorney general for Washington state, said the appeals court ruling means that the 2007 regulation will take immediate effect.The plaintiffs in the case, Stromans -- a supermarket pharmacy owner -- and two pharmacists employed elsewhere, argued that the state regulation requiring pharmacists to stock and dispense EC violated their First Amendment right to freedom of religion (Los Angeles Times, 7/9). The regulation said that pharmacies must stock and fill legally prescribed prescriptions but allowed individual pharmacists to object on moral or religious grounds if another pharmacist was available, in person or by telephone, to fill the order (San Francisco Chronicle, 7/9). The plaintiffs argued that the regulation would force them to choose between following their religious beliefs and keeping their jobs. They contended that EC prevents implantation of a fertilized egg, which they equated with abortion. The U.S. District Court in Seattle awarded the plaintiffs the temporary injunction in November 2007, pending trial on the constitutionality of the regulation (Los Angeles Times, 7/9). Plan B contains a high dose of a drug found in most birth control pills that generally prevents ovulation or the fertilization of an egg. Recent research suggests that it does not prevent a fertilized egg from implanting in the uterus (Woodward, AP/Seattle Post-Intelligencer, 7/8). FDA in April lowered the age limit for nonprescription purchase of Plan B from 18 to 17 (San Francisco Chronicle, 7/9). Appeals Panel Returns Case to District CourtThe appeals court panel ruled that the freedom to exercise one"s religion "does not relieve an individual of the obligation to comply with a valid and neutral law of general applicability." The panel added, "Any refusal to dispense -- regardless of whether it is motivated by religion, morals, conscience, ethics, discriminatory prejudices or personal distaste for a patient -- violates the rules" (Los Angeles Times, 7/9). The panel ordered the district judge to reconsider the 2007 regulation under Supreme Court standards that allow states to pass neutral laws that may affect religious practices. According to the panel, the regulation does not aim to interfere with religious practices or beliefs and is intended to promote patients" health. In addition, the panel said the district court judge did not consider how the injunction would affect "sexually active women of childbearing age who will be denied reasonable access to Plan B" (San Francisco Chronicle, 7/9). According to the Times, the panel"s ruling could foretell future judgments in the case, including that a patient"s right to timely medication surpasses a pharmacist"s personal beliefs (Los Angeles Times, 7/9).
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ATS, ERS Jointly Issue Asthma Assessment Guidelines
The American Thoracic Society and the European Respiratory Society have released official standards for clinical trials and practice with respect to the assessment of asthma. The statement appears in the July 1 issue of the American Journal of Respiratory and Critical Care Medicine.
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Therapy Technique Cuts Divorce/Separation Rate By Nearly 50 Percent
Four simple questions on well-being asked at the start of each session of ongoing couples therapy can greatly increase chances for reconciliation and improved relationships, according to a newly published study. The largest clinical trial with couples to date, it shows that divorce and separation rates for couples that used this feedback technique were 46.2 percent less than that of couples who received therapy as usual. The findings, published in the August 3, 2009, Journal of Consulting and Clinical Psychology, are the results of a 2-year study conducted at the Vestfold Family Counseling Center in Norway by a U.S.-Norwegian team of researchers.
Sexual Health

Scientists Identify Genetic Links To High Blood Pressure

An international scientific study involving researchers from the University of Glasgow has identified eight common genetic differences which may increase the risk of high blood pressure. The University researchers, led by Professor Anna Dominiczak and Professor John Connell, contributed to the global study of genes in high blood pressure through participation in the Medical Research Council"s British Genetics of Hypertension study. High blood pressure - or hypertension - affects at least eighteen million people in the UK and is a major risk factor for heart disease and stroke. Although lifestyle factors such as smoking and diet can raise blood pressure, it also runs in families suggesting a genetic link. The genes identified by the researchers are thought to influence blood pressure in different ways: for example, through the production of chemicals, known as steroids, which affect how the kidneys process salt; or how the blood vessels regulate blood pressure. Although the effect of each of the new gene variants is small, when combined their influence could significantly raise a person"s risk of stroke or heart attack. The role of steroid hormones in controlling hypertension is one of the key areas studied within the British Heart Foundation Glasgow Cardiovascular Research Centre at the University. Prof Connell, a senior researcher and Professor of Endocrinology, whose research group has a particular interest in steroids and blood pressure, said: "This latest study increases understanding of the underlying causes of high blood pressure, why some people are more susceptible to it than others and opens up further avenues for research into potential treatments. "It is important to stress that environmental factors also play a big part so diet, smoking and weight control all important methods of controlling high blood pressure." In the new study, scientists looked at the human genome for genetic variations affecting blood pressure. They compared 2.5 million genetic variants from more than 34,000 people with measurements of their blood pressure. They found eight genetic differences linked to changes in blood pressure. The study, published in Nature Genetics, involved over 150 scientists from 93 centres in Europe and the USA with funding from a variety of s including the Medical Research Council, the British Heart Foundation and the Wellcome Trust. Nexxus, Scotland


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