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Women’s Health

Students’ capstone project helps lead to new lactation policy at VCU Health

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For their graduation project in the Adult Education Masters program at Virginia Commonwealth University’s School of Education, a team of six students investigated whether working mothers at VCU Health were adequately protected, supported, and empowered to express breast milk while they were at work.

The students interviewed dozen of VCU Health employees, researched federal and state laws, collected data, identified lactation guidelines in other workplaces, and eventually came up with a series of recommendations – the first of which was to encourage VCU Health to adopt a lactation support guideline.

On June 1, thanks in large part to the project, VCU Health introduced a Lactation Support Policy for team members that provides employees with guidelines and resources on how to express breast milk in the workplace during work hours.

“Working on this project was so stimulating,” said Kirsten Olsen, one of the students who worked on the project. “The whole process of learning how to work as an integrated team has really been a gift. Researching together what should be prioritized in work, disagreeing on what should be priority, and learning how to transform those conflicts into moments of discovery and moving forward is a skill that cannot be learned alone. I am forever grateful to all members of the Capstone team. “

In addition to Olsen, the team included Anna Clark, Brett Currie, Tasia Thompson, Sheila Regan and Beth Marcus.

While working on her project, “Are Working Mothers at VCU Health properly and effectively protected, nurtured, supported, trained, and empowered in their breastfeeding efforts?” Students were connected to Valerie Coleman, Lactation Manager at VCU Health, who acted as their sponsor.

“Their work provided a solid rationale for the need for such a policy to protect women from discrimination when they demand a clean, safe space and the time to maintain their milk supply by expressing,” said Coleman. “Her research has shown that many women have not been able to achieve their breastfeeding goals due to a lack of support and resources when returning to work. By June 2021, there are both state and federal laws mandating compliance, and our guidelines should be in line with evidence and the law. “

VCU Health’s new policy, Coleman said, will promote, protect and support breastfeeding.

“Science shows overwhelmingly that breast milk is nutritionally the best for human infants,” said Coleman. “One goal is to protect the intestinal flora, the supergenome of the intestine, the microbiome. Artificial milk substitutes or milk from another animal species (cows) sensitize the intestine before it is ready to make substances other than breast milk easily digestible. Infants who are not given breast milk are at increased risk of ear infections, eczema, diarrhea and vomiting, hospitalization for respiratory diseases within the first year of life, asthma, allergies, obesity, diabetes, leukemia and SIDS (Sudden Infant Death Syndrome). Women who do not breastfeed are at increased risk of breast and ovarian cancer, metabolic syndrome, postpartum depression, osteoporosis, osteoarthritis, diabetes, as well as high blood pressure and heart disease. “

Breastfeeding is the single most effective single measure of improving chronic and acute health outcomes, she said, and it has a significant impact on the health trajectories of the lives of women and children.

The capstone project, Coleman said, triggered a process that led to VCU Health’s implementation of the new policy.

“The students laid the foundation to identify obstacles in our own backyard that women faced and the lack of awareness of compliance issues among many in supervisory roles,” she said. “They toured the pump rooms on the medical campus and interviewed women to collect primary data. They were innovative and full of energy. “

Kirsten Olsen, Program Manager for Pregnancy and Parental Partnerships in the Obstetrics and Gynecology Department at the VCU School of Medicine, was one of the Masters students who worked on the Capstone Project. (File photo)

The new policy sets out multiple responsibilities for the healthcare system and its employees to create a supportive environment that enables breastfeeding team members to express milk.

It includes guidelines for giving team members appropriate breaks to express milk, as well as a clean, private place to express milk that is not a toilet and is close to the team member’s work area. It also provides guidelines that allow members to keep expressed milk in workplace refrigerators or in personal refrigerators.

The policy also requires team members who wish to express milk during work hours to keep managers informed of their needs so they can work together to coordinate reasonable accommodation. And it explains that team members are expected to do their part in keeping the lactation rooms clean.

Olsen, a program manager for pregnancy and parenting partnerships in the Obstetrics and Gynecology Department of the VCU School of Medicine, came up with the idea for the Capstone Project, which focuses on VCU health and lactation support.

The idea arose from another research project Olsen had done on the psychographic effects of marketing infant formula. As part of the initial research, Olsen interviewed pregnant women working at VCU Health, many of whom were afraid of getting assistance back to work while breastfeeding. Olsen suggested further research into breastfeeding support at VCU Health. She introduced the subject to the keystone group, and they voted to continue the project under the direction of Robin Hurst, Ed.D., an associate professor in the School of Education.

“The students had a choice of assignments and selected them to study. It was a remarkable effort on their part and they completed their studies in one semester, ”said Hurst. “They were very focused during the semester and determined to find out what VCU Health has to offer their breastfeeding staff.”

The student project, Hurst added, is a great example of the “action learning process” that has been a cornerstone of adult education graduates at VCU for four decades.

“The action learning process is about asking questions and not just any questions, but difficult and often fresh questions to uncover problems,” said Hurst. “The students work with informants as well as with each other to analyze the problem and the answers and to make suggestions and recommendations for solving the problem.”

In the case of Olsen, work did not stop after the capstone project was submitted. In spring 2020, Olsen and Coleman gave a presentation to a VCU Health Human Resources working group that outlined the need for a guideline. Shortly afterwards, COVID-19 switched everything off. But the HR group started meeting later that summer, and Olsen worked with them.

They met weekly, worked with, and received approval from, various departments at VCU Health, including facilities, legal, risk management and leadership. Human Resources has also developed learning modules to train members of the VCU health team on the new policy.

“It was announced that it would go live and it is now VCU Health’s policy,” said Olsen. “Since June 1st we have a lactation policy and learning exchange modules.”

In the weeks since, Olsen said, other schools have reached out to the VCU to express their interest in a similar policy.

“If you take the time to create something like this and do all of the work that comes with it, it’s reproducible,” she said. “Someone else can just say, ‘Oh, cute. Do you have a policy and it has already been checked by risk management? Perfect. We just use it. ‘ It can easily be replicated throughout the system. “

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Women’s Health

Dubai’s Arab Health to examine why women had fewer babies during Covid-19 pandemic

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Obstetrics and gynecology experts will meet at the Arab Health Summit in Dubai this month to discuss why women have decided not to have babies because of the pandemic.

The Arab Health Obstetrics and Gynecology Conference will discuss trends in women’s health, including the impact of Covid-19 on reproduction and fertility.

dr Human Fatemi, medical group leader at ART Fertility Clinics in Abu Dhabi, said the pandemic has caused people to reconsider their plans to have children.

As an infertility specialist, I would not worry about Covid-19 and pregnancy

dr Human Fatemi, Medical Group Leader of ART Fertility Clinics

“The pandemic has definitely shifted the desire to become parents and the desire to have a child,” he said.

“For some patients, especially women with reduced ovarian reserve and aging, the pandemic will significantly affect their ability to have children.

“As an infertility specialist, I would not be concerned about Covid-19 and pregnancy. The key message is to maintain hygiene, wear masks, ensure social distancing and be careful. If you have a reduced ovarian reserve and want to get pregnant, don’t delay.”

Several research results show a direct link between the pandemic and women’s desire to have children.

According to research by the United Nations Population Fund, public health crises and economic shocks have long been recognized as conditions that alter reproductive behavior.

Data from the US, Europe and East Asia show sharp falls in births as of October 2020 compared to the same months last year, suggesting that Covid-19 has caused short-term fertility declines in many countries.

Research from the Australian Institute of Family Studies shows that one in five Australian women changed their baby plans because of the pandemic, and one in seven women said it likely affected when they would have children, with most study cohorts ( 92 percent) decided to delay pregnancy.

This was supported by a study in the journal Proceedings of the National Academy of Science, which reported the link between the pandemic and births in 22 high-income countries and found particularly sharp declines in southern Europe – Italy (-9.1 percent), Spain (-8.4 percent) and Portugal (-6.6 percent).

But doctors said the research doesn’t prove there’s a greater risk for pregnant women. You should follow precautions and deliver babies safely.

dr Kiran Mehndiratta, a specialist obstetrician and gynecologist at NMC Specialty Hospital Abu Dhabi, told The National in May 2020 – during the peak of the first wave – that pregnant women are not at increased risk compared to others.

However, she added, it is important to know that pregnant women’s immunity is reduced to ensure the baby is not rejected by the mother as half of its genes come from the father.

That means people with pregnancy complications like diabetes or high blood pressure, which are known risk factors for severe Covid-19, could also be at higher risk.

Most of the “very small number” of pregnant women who die at NMC Specialty Hospital, where Dr. Mehndiratta works who tested positive for Covid-19 were also asymptomatic.

“Only a few of them gradually developed a cough,” she said.

This supports theories that suggest pregnant women are no more vulnerable to the effects of Covid-19 than others.

The Obstetrics and Gynecology Conference is a regular feature of Arab Health, taking place from 24th to 27th January at the Dubai World Trade Centre.

The conference will host several key sessions on fertility, reproduction and Covid-19, including a session on ‘Covid-19 and the Fetus’, presented by Prof Asma Khalil, who specializes in Obstetrics and Maternal-Fetal Medicine at St George’s University Hospital specializes. London. A session on ‘Covid-19 and the impact on fertility’ will be given by Dr. Johnny T Awwad, Executive Chairman of Women’s Services and Head of Reproductive Medicine at Sidra Medicine & Research Centre, Qatar.

Updated January 19, 2022 2:27 p.m

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Women’s Health

Menopause brings an onslaught of changes to women’s bodies. Why don’t we talk about it?

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Menopause affects 50 million women in the United States, especially when they are at the peak of their careers and personal relationships. It is usually diagnosed 12 months after a woman’s last period.

Menopause begins around age 51, on average, and brings with it a serious drop in estrogen levels that affects the body from head to toe, says Dr. Somi Javaid, a board-certified gynecologist and founder of HerMD, a growing chain of health clinics in Cinncinati specializing in menopause and sexual health.

She explains that women experience hot flashes, trouble sleeping and memory, increased anxiety and depression, dry skin, weight gain, joint problems, decreased sex drive, vaginal dryness, problems with orgasm, and no menstrual cycles for 12 straight months. And in the months or years leading up to menopause — a period known as perimenopause — there’s still some bleeding, and estrogen levels still drop, but not as much.

People don’t talk much about menopause because it’s a generational thing, says Sally Mueller, a former Target executive and now co-founder and CEO of wellness company Womaness.

“I’m 57, my mother hasn’t talked about her menopause. And so the baby boomers and even Gen Xers really grew up being uncomfortable talking about it because their moms didn’t talk about it. And I see it really, really changing with millennials. Millennials are breaking every taboo and starting to open the conversation, so thank goodness.”

Despite the physical symptoms, women at this stage feel confident, have wisdom to share, and feel empowered and creative, Mueller points out.

hormone replacement therapy

According to Javaid, hormone replacement therapy (HRT) is safe for millions of women and can effectively address many of the symptoms mentioned above, as well as other hidden problems such as bone loss and an increased risk of cardiovascular disease.

Timing is important with HRT. “When hormones are prescribed within the first five years of menopause, they are actually cardioprotective. As for the increased risk of breast cancer, yes, if you have an estrogen receptor or progesterone receptor positive tumor, you can definitely accelerate growth. However, we still haven’t proven that HRT actually causes the cancer cells to start in the first place. But for patients who have a history or a strong family history, or who have genetic mutations such as BRCA, we do not recommend hormone replacement therapy for them.”

Does HRT help women become younger again? Javaid says that in her 20 years of clinical practice, women have said their skin changes, acne disappears, and joints hurt less.

“Yes, patients are seeing a return or resolution of some of their ailments. But I want to be clear: I’m not going to take a 51-year-old patient and make her 21 again. But they definitely feel better.”

There are now non-hormonal options, such as radiofrequency treatments and CO2 lasers, that are used for vaginal dryness, Javaid points out.

Start early – learn and adapt

It’s important to understand that menopause can lead to longer-term health effects, and many women aren’t informed until they’re already through menopause, Mueller says. “It would be a much easier transition if they were educating themselves even in their 30s and early 40s.”

Javaid says she begins educating her patients in her 30s. “I always tell my patients: nobody knows your body better than you do. If your provider is not listening to you, you need another provider. … I truly encourage women to live their best life, to understand what’s going on with them, and to seek the care that fits both their choices and their lifestyle. I think the sooner they find out about this, the better they will do with their healthcare.”

Javaid says women need to eat differently, too, and she’s a big proponent of intermittent fasting to lower insulin levels, which helps with weight gain during menopause.

Also, turn to weight loads to counter osteoporosis and do pelvic floor strength training to maintain sexual function and stay continent, she adds. “We don’t want to pee on ourselves when we’re exercising, coughing, or laughing with friends.”

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Women’s Health

Do advanced therapies have a place in women’s health?

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Lehr participated in a biotech showcase session titled “Women’s Health: Progress and Innovation Continue to Generate Investor Interest.” The panel included executives from Context Therapeutics, EndoCyclic Therapeutics, Gennev, iSono Health and Univfy.

What is women’s health?

Defining women’s health seems deceptively simple, but there are many definitions, according to Biotech Showcase panelists. For some companies and investors, it is defined by certain diseases, such as hormonal diseases or diseases that affect women differently than men. For others, the term is limited to just breast cancer.

An evolving term – femtech – has emerged to refer to technologies focused on women’s health. Panelists explained that the classification helped increase visibility and make investors (traditionally a male-dominated space) intrigued and motivated to explore and learn more about the category. Ultimately, the committee called for more female investors.

Recently, femtech-focused companies and products have emerged. But according to Lehr, the innovations of this group are only incremental improvements. What the industry needs are logarithmic changes that catalyze a massive step forward toward healing.

One such innovation that has the potential to create that logarithmic jump is immunotherapy, Lehr said. Investors are already interested in this space, and getting investors to invest in female cancer immunotherapy could be transformative.

Advanced therapies for women’s cancer

Lehr explained that Context Therapeutics is a mission-driven company dedicated to women’s oncology. The company strives to develop products that improve the quality of life for women living with cancer.

The Company’s lead candidate is Onapristone Extended Release (ONA-XR), a progesterone receptor antagonist that inhibits the progesterone receptor by binding to chromatin, which in turn downregulates cancer stem cell mobilization and blocks immune evasion. The progesterone receptor is a ligand-activated transcription factor that promotes progesterone-dependent cancers such as ovarian, uterine (endometrial) and breast cancer.

These cancers hijack progesterone to stimulate cancer cell proliferation, metastasis, regeneration and immune evasion. ONA-XR is currently being evaluated in four Phase II studies and the Company expects to report results from these studies in 2022.

Context is also developing Claudin 6 bispecific, an anti-CD3 x, anti-Claudin 6, antigen bispecific monoclonal antibody that redirects T cell-mediated lysis to malignant cells that express Claudin 6. Claudin 6 is a target for a tight junction protein and is particularly enriched in ovarian and endometrial tumors. The combination of precision medicine and immunotherapy aims to attack tumors directly without damaging normal tissue.

As excitement and innovation in the field continues to grow, Lehr and other Biotech Showcase panelists expressed optimism about near- and long-term progress in bringing advanced therapies and transformative technologies to the women’s health sector.

Do you have a unique perspective on your research related to women’s health or femtech? Contact the publisher today to learn more.

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