Thursday, October 27, 2011
Breastfeeding Promotion Act. The Breastfeeding Promotion Act of 2011 (H.R. 2758, S. 1463) amends the Civil Rights Act of 1964 to protect breastfeeding women from being fired or discriminated against in the workplace. It also ensures that executive, administrative, and professional employees, including elementary and secondary school teachers (in addition to non-exempt employees covered by the previous amendment), have break time and a private place to pump in the workplace. Click here for more information.
Tuesday, October 18, 2011
Monday's Menu
This menu comes rather late, but here it is no less. I absolutely LOVE autumn menus. It makes preparing for winter almost bearable.
Wednesday: Rich and Creamy Beef Stroganoff with Autumn Muffins
Thursday: Kids Favorite Meatloaf with Creamy Au Gratin Potatoes
Friday: Baked Potatoes and Bananas Foster Chimichangas
Saturday: Apple Braised Pork with Honey Roasted Red Potatoes
Sunday: While Chili (a new recipe, Keely, with Alfredo sauce) and Banana Bread
Can we tackle these, Purple People Eater Cupcake, this weekend?
Wednesday: Rich and Creamy Beef Stroganoff with Autumn Muffins
Thursday: Kids Favorite Meatloaf with Creamy Au Gratin Potatoes
Friday: Baked Potatoes and Bananas Foster Chimichangas
Saturday: Apple Braised Pork with Honey Roasted Red Potatoes
Sunday: While Chili (a new recipe, Keely, with Alfredo sauce) and Banana Bread
Can we tackle these, Purple People Eater Cupcake, this weekend?
Thursday, October 13, 2011
Newborn Genetic Testing
Most all parents are aware of the 48 hour newborn screen, often referred to as the PKU screening. Often this test is familiar because it was a fairly traumatic experience for baby, as not all nurses are well trained or skilled in obtaining the specimen. Our practice takes pride in doing these with very little upset and great success, and we do in fact, encourage the screening.
The test is required in the state of Indiana, unless a religious waiver is signed. I am not sure we care for clients with such religious conviction, but we certainly care for clients that oppose ethical, social, moral and legal issues revolving the newborn metabolic screen. I'll admit, I am beginning to question such issues myself.
Most importantly, I feel government regulations in the details of how a practitioner should practice are inappropriate. Legislature can not keep up with current evidence or appreciate individual circumstances, so these decisions should be left to the expert in practice. Parents as well, should have options available to them and information to make informed decisions, but should not be mandated to obtain such tests for their newborns.
Concern has been expressed among my clientele base that the government is collecting a DNA database through blood received on these tests, which could create discrimination by insurers or employers, restrict future reproduction, and violates their right to privacy. Is it absolutely necessary to discover a genetic predisposition to a disease that may never present or one that has no cure? Who bears the burden of cost for treating potential future medical conditions? Who owns and controls the personal DNA data? How might discovery of a certain genetic predisposition affect other family's members? What is the social or emotional impact of "knowing the future?"
The metabolic newborn screen is described as the PKU test by medical providers. In fact, that has been my understanding. Never before did I think of it as genetic testing, or even a test done without parental consent. Mandatory genetic testing on newborns - scary.
The PKU test was mandated in 1965 for all children except those with a religious exemption. Today, newborns are tested for nearly 50 conditions, including the most recent addition of cystic fibrosis. Hospitals, and our homebirth practice, sends five newborn blood spots to a state laboratory at the IU Medical Center. Results are reported to the pediatric provider, or in our practice, to the midwife. These results are entered by the practitioner into the child's permanent medical record.
Birthing facilities are required by law to maintain an electronic database of all children tested. These are linked with their birth certificate, hearing screen results, social security numbers and soon their newborn oxygen saturation results. Most parents are unaware that the birth certificate form is twelve pages long, asking about detailed clinical information regarding both mother and newborn, including birth defects. These genetic tests will be linked to such data.
As a scientist, I appreciate the data collection for epidemiological research, and have no use for the demographics. In fact, in the past when we've had clients declined the birth certificate or testing for concerns regarding privacy or initiating a "contract with the state," the client and I agree to sending statistical information with no identifying information. This means the state obtains our practice statistics, health data for particular populations and territories, but my client remains anonymous.
Imagine however for all those that have identifying information, nearly 20,000 each year in our state. These results are state property and a very rich source of DNA. Researchers, to my knowledge, have access to such information, and use by law enforcement is a future possibility.
Minnesota requires all persons and institutions who care for the newborn to share information with parents of their right to refuse to testing or allow the government testing, but require the child's test results/blood sample to be destroyed. To exercise these rights, Minnesota provides a form which is then sent by the birth facility or parent to MDH. The Citizen's Council on Health Care however states that most hospitals have not informed parents of their rights and options. Ironically, the Mayo Clinic, March of Dimes, and the University of Minnesota all opposed the bill allowing parents the right to say no.
The CDC has proposed a national databank of DNA from left over newborn metabolic screens that would allow for the assessment of genetic variations on the health of populations, which they feel would be critical to guide public health research, policy and practice.
Indiana maintains newborn metabolic screens for 23 years. YEARS.
The test is required in the state of Indiana, unless a religious waiver is signed. I am not sure we care for clients with such religious conviction, but we certainly care for clients that oppose ethical, social, moral and legal issues revolving the newborn metabolic screen. I'll admit, I am beginning to question such issues myself.
Most importantly, I feel government regulations in the details of how a practitioner should practice are inappropriate. Legislature can not keep up with current evidence or appreciate individual circumstances, so these decisions should be left to the expert in practice. Parents as well, should have options available to them and information to make informed decisions, but should not be mandated to obtain such tests for their newborns.
Concern has been expressed among my clientele base that the government is collecting a DNA database through blood received on these tests, which could create discrimination by insurers or employers, restrict future reproduction, and violates their right to privacy. Is it absolutely necessary to discover a genetic predisposition to a disease that may never present or one that has no cure? Who bears the burden of cost for treating potential future medical conditions? Who owns and controls the personal DNA data? How might discovery of a certain genetic predisposition affect other family's members? What is the social or emotional impact of "knowing the future?"
The metabolic newborn screen is described as the PKU test by medical providers. In fact, that has been my understanding. Never before did I think of it as genetic testing, or even a test done without parental consent. Mandatory genetic testing on newborns - scary.
The PKU test was mandated in 1965 for all children except those with a religious exemption. Today, newborns are tested for nearly 50 conditions, including the most recent addition of cystic fibrosis. Hospitals, and our homebirth practice, sends five newborn blood spots to a state laboratory at the IU Medical Center. Results are reported to the pediatric provider, or in our practice, to the midwife. These results are entered by the practitioner into the child's permanent medical record.
Birthing facilities are required by law to maintain an electronic database of all children tested. These are linked with their birth certificate, hearing screen results, social security numbers and soon their newborn oxygen saturation results. Most parents are unaware that the birth certificate form is twelve pages long, asking about detailed clinical information regarding both mother and newborn, including birth defects. These genetic tests will be linked to such data.
As a scientist, I appreciate the data collection for epidemiological research, and have no use for the demographics. In fact, in the past when we've had clients declined the birth certificate or testing for concerns regarding privacy or initiating a "contract with the state," the client and I agree to sending statistical information with no identifying information. This means the state obtains our practice statistics, health data for particular populations and territories, but my client remains anonymous.
Imagine however for all those that have identifying information, nearly 20,000 each year in our state. These results are state property and a very rich source of DNA. Researchers, to my knowledge, have access to such information, and use by law enforcement is a future possibility.
Minnesota requires all persons and institutions who care for the newborn to share information with parents of their right to refuse to testing or allow the government testing, but require the child's test results/blood sample to be destroyed. To exercise these rights, Minnesota provides a form which is then sent by the birth facility or parent to MDH. The Citizen's Council on Health Care however states that most hospitals have not informed parents of their rights and options. Ironically, the Mayo Clinic, March of Dimes, and the University of Minnesota all opposed the bill allowing parents the right to say no.
The CDC has proposed a national databank of DNA from left over newborn metabolic screens that would allow for the assessment of genetic variations on the health of populations, which they feel would be critical to guide public health research, policy and practice.
Indiana maintains newborn metabolic screens for 23 years. YEARS.
Sunday, October 9, 2011
Monday's Menu
Monday: Potato Soup for lunch, Bow Tie with Sausage and Tomatoes for Dinner
We have some beautiful yellow and orange tomatoes from the garden I am eager to use.
Tuesday: Peaches and Cream French Toast, Tomato Alphabet Soup and Grilled Cheese Sandwiches and Baked Chicken with Stuffing, Mashed Potatoes and Green Beans
Wednesday: Marinated Wild Salmon with Macaroni and Cheese casserole
Thursday: Ham and Swiss Egg Sandwiches, Chili Meatloaf and Potato Casserole
Friday: NuNu's and Hot Dogs, Cheesy Chicken Casserole
Saturday: BBQ Pork Sandwiches
Sunday: Cherry Chip Cookies and Sausage and Tortellini Soup
Tuesday, October 4, 2011
Wednesday - Wild Rice and Chicken Soup
2 1/2 cups chopped cooked chicken
2 cups sliced fresh mushrooms
2 med carrots, coarsely chopped
2 stalks celery, sliced
1 10.75 ounce can reduced-fat and reduced-Na cream of chicken soup or cream of mushroom
1 6-oz package long grain and wild rice mix
5 cups reduced-sodium chicken broth
5 cups water
In a slow cooker, stir together cooked chicken, fresh mushrooms, carrots, celery, cream of chicken soup, the long grain and wild rice with the contents of the rice seasoning packet. Gradually stir in chicken broth and the water. Cover and cook the soup mixture on low-heat for 6 to 8 hours, or on high for 3 to 4 hours.
Thursday - Cheesy Potato Soup
6 medium postatoes, peeled and chopped (6 cups)
2 1/2 cups water
1/2 cup chopped onion
2 tsp instant chicken bouillon granules
1/4 tsp ground black pepper
1 1/2 cups shredded American cheese
1 12-ounce can evaporated milk
crumbled, cooked bacon
snipped fresh chives
In a 3.5 or 4 quart slow cooker, combine potatoes, the water, onion, bouillon granules and pepper. Cover; cook on low-heat setting for 8 to 9 hours or on high-heat for 4 to 4.5 hours. Stir cheese and milk into mixture in cooker. Cover; cook on low-heat for 1 hour more or on high for 30 minutes. For a thicker soup, mash potatoes slightly. If you like, sprinkle with cheese and bacon.
ANNIVERSARY CELEBRATION FOR BELIEVE !!!
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