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San Jose Police Crack Down On Violence

The San Jose Police Department is cracking down on violent crime after the city's 25th homicide this year.

KQED Launches Affordable Care Act Guide

Are you confused about Obamacare? KQED and The California Report created a guide to help answer your questions about the Affordable Care Act.

First Ebola Patient Diagnosed in U.S. Dies

Liberian Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., died in Dallas Wednesday. As Ebola continues to spread in West Africa, where more than 3,400 people have died of the disease, five of the busiest US international airports will begin enhanced screening measures to find travelers infected with Ebola. Forum will discuss how prepared the Bay Area is for a possible Ebola outbreak and what the U.S., and the world, can do to contain the disease.

UC Riverside Aims to Keep New Doctors Working in Inland Empire

When UC Riverside opened its medical school two years ago, it was the first new medical school in the UC system since 1967. It now has 100 students. But it doesn't just want to turn out more doctors -- part of the school's mission involves working to keep them in the area. That's because the Inland Empire has among the lowest number of doctors in California.

PBS NewsHour

Why the ‘organic’ label is loosely applied to nonfood items

A shop of organic cosmetics and soap. Photo by Flickr user rosipaw

A shop of organic cosmetics and soap. Photo by Flickr user rosipaw

WASHINGTON — There’s a strict set of standards for organic foods. But the rules are looser for household cleaners, textiles, cosmetics and the organic dry cleaners down the street.

Wander through the grocery store and check out the shelves where some detergents, hand lotions and clothing proclaim organic bona fides.

Absent an Agriculture Department seal or certification, there are few ways to tell if those organic claims are bogus.

A shopper’s only recourse is to do his or her own research.

“The consumer should not need a law degree to read a label,” says Laura Batcha, president of the Organic Trade Association, the industry’s main trade group. Concerned about the image of organics, the association is pressuring the government to better investigate organic claims on nonfood items.

FROM SOAP TO T-SHIRTS

According to the Organic Trade Association, sales of those nonfood organic products were about $2.8 billion last year, a small share of the overall organic market but growing rapidly. Among the most popular items: household cleaners, cosmetics, gardening products, clothing, sheets and mattresses.

USDA doesn’t regulate any of those items, though, unless they’re made entirely from food or agriculture products overseen by its National Organic Program. That’s when they can carry the familiar “USDA organic” seal or other official USDA certification.

The rules are murkier when the items have ingredients that aren’t regulated by USDA, like chemicals in soaps or makeup. The department doesn’t police the use of the word organic for nonfood items, as it does with food.

Some examples:

  • Personal care products. Companies can brand any personal care product as organic with little USDA oversight as long as they don’t use the USDA organic seal or certification. Some retailers like Whole Foods Market have stepped in with their own standards requiring organic body care items sold at their stores to be certified. There’s also a private certification called NSF/ANSI 305, but most consumers don’t know to look for that label.
  • Clothing, sheets and mattresses made from organic cotton or other organic fibers. Some items are certified by the Global Organic Textile Standard, a third-party verification organization that reviews how the products are manufactured. Like body care, most consumers don’t know about it.
  • Gardening products. Some gardening products may be approved by USDA for use in organic agriculture, but not be certified organic themselves.

There are clear standards for items within the scope of USDA’s regulation, says Miles McEvoy, the head of department’s National Organic Program. “The areas that are outside of our scope could cause some confusion.”

THROUGH THE GOVERNMENT CRACKS

The Federal Trade Commission normally investigates deceptive claims. But the agency demurred in its “Green Guides” published in 2012, saying enforcement of organic claims on nonfood products could duplicate USDA duties.

A claim is only deceptive if it misleads consumers, the agency says. So, it will study consumer perceptions of the word organic. But officials weren’t able to say when such a study might begin.

The Organic Trade Association’s Batcha says the lack of enforcement could erode confidence in the organic industry as a whole. The industry has similarly been fighting overuse of the word “natural,” which has no legal meaning at all.

Ken Cook, head of the Environmental Working Group, an advocacy group that publishes online consumer databases on cosmetics and cleaning, is blunt: “Companies are chasing the consumers and the government is in the rear-view mirror.”

ORGANIC DRY CLEANERS

Some dry cleaners promote “organic” on their windows and in their stores, but there is no legal definition for that practice.

Mary Scalco, CEO of the industry group Drycleaning and Laundry Institute, said some of those businesses may actually be using petroleum-based solutions, which are not generally perceived as organic by the general public.

“The difficult part is the scientific meaning of organic and the consumer perception of the word,” she says.

Scalco says she is telling member companies to make sure their customers know what organic means.

“Because there is no real regulation on this right now, you want to make sure you don’t mislead the public,” she says.

SMART SHOPPING

So what’s a consumer to do, especially when organic products are often more expensive and the market is continuing to grow?

Right now, retailers are the first line of defense.

Four years ago, Whole Foods Market announced strict standards for labeling in the store’s well-stocked cosmetics, home cleaning and clothing aisles. The retailer also requires all products to list ingredients.

“In areas where there isn’t a government regulation, we have stepped up to create our own,” says Joe Dickson, global quality standards coordinator for the Austin, Texas-based chain.

David Bronner, the president of Dr. Bronner’s Magic Soaps, has fought for years to get the USDA to expand its powers on organics to include personal care products. He says Whole Foods’ standards have helped clean up the market, but there are still less scrupulous companies that stretch the meaning of the word organic to include petroleum-based oils and nonorganic palm and coconut oils that make up the base of many personal care products. Some grocery stores, spas and online retailers have no standards at all.

Bronner advises shoppers to read labels carefully and scan lists of ingredients. If you find several unpronounceable ingredients that sound like chemicals, “it’s probably not organic,” he says.

The post Why the ‘organic’ label is loosely applied to nonfood items appeared first on PBS NewsHour.

Dozens cleared from Ebola quarantine in Texas

The Texas Department of State Health Services has started monitoring 100 people who were potentially exposed
         to Ebola. Caption:DALLAS, TX - SEPTEMBER 30: A general view of Texas Health Presbyterian Hospital Dallas where a patient has
         been diagnosed with the Ebola virus on September 30, 2014 in Dallas, Texas. The patient who had recently traveled to Dallas
         from Liberia marks the first case of this strain of Ebola that has been diagnosed outside of West Africa. (Photo by Mike Stone/Getty
         Images)

Watch Video | Listen to the Audio

GWEN IFILL: The headlines on Ebola in the U.S. were more hopeful today. They included news that the pool of potential Ebola cases is shrinking.

JUDGE CLAY JENKINS, Dallas County: It’s somewhat of a happy press conference for us

GWEN IFILL: After weeks of uncertainty, a bit of relief. Dallas County Judge Clay Jenkins announced that 43 people no longer need to be monitored. All had initial contact with Thomas Duncan, the Liberian man who died of Ebola at a Dallas hospital. They included several of Duncan’s relatives and his fiancee, all allowed to leave quarantine today.

JUDGE CLAY JENKINS: There’s zero risk that any of those people who have been marked off the list have Ebola. They were in contact with a person who had Ebola. And the time period for them to get Ebola has lapsed. It is over. So they are — they do not have Ebola.

GWEN IFILL: Five more people will complete their 21-day monitoring period in coming days; 120 others are still under watch in Texas, including those who cared for Thomas Duncan.

But a Dallas hospital worker who handled some of his specimens, and then went on a cruise, also tested negative. The ship returned to Texas yesterday. Two infected nurses, Nina Pham and Amber Vinson, are still being treated at special facilities in Bethesda, Maryland, and Atlanta.

In Washington today, Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases said both had exposed skin, even though they followed existing guidelines.

DR. ANTHONY FAUCI, Director, National Institute of Allergy and Infectious Diseases: So the protocol that was quite successful — it worked very well in Ebola in Africa — the way that was written was a risk for the nurses. And they — they went by the protocol. They got infected. Right now, those protocols are being changed.

GWEN IFILL: Those new guidelines will be issued by the Centers for Disease Control and Prevention.

Meanwhile, in West Africa, ground zero of the epidemic, Nigeria was declared Ebola-free today by the World Health Organization.

RUI GAMA VAZ, Country Representative, World Health Organization: This is a spectacular success story that shows to the world that Ebola can be contained. But we must be clear that we have only won a battle. The war will only end when West Africa is also declared free of Ebola.

GWEN IFILL: Nigeria had 20 Ebola cases in total and eight deaths. There’ve been more than 9,000 cases and 4,500 deaths in Guinea, Liberia, and Sierra Leone.

An American doc who caught Ebola in Sierra Leone and was treated at Emory University Hospital in Atlanta was declared free of the virus today and released.

We will turn our focus to the Ebola fight in Liberia right after the news summary.

 

The post Dozens cleared from Ebola quarantine in Texas appeared first on PBS NewsHour.

Ambulance nurse confronts death and desperation in the heart of the Ebola epidemic

ebola_nurse

Watch Video | Listen to the Audio

GWEN IFILL: Now: an intimate look at the front lines in the fight to contain Ebola in hard-hit Liberia. An estimated 4,200 people have contracted the virus since the outbreak began; 2,500 people have died.

In this report produced by The New York Times, video journalist Ben Solomon spends three weeks with an ambulance nurse overwhelmed by an onslaught of patients needing care.

GORDON KAMARA, Liberian Ambulance Nurse: My name is Gordon Kamara. I’m an ambulance nurse.

From March until now, I have been fighting these Ebola cases. Our job is to save the people.

In the morning, we start very fresh. Today is going to be a very busy day, getting — detecting cases from Westpoint. I have assessed cases in Johnsonville, another five cases in Benton. Three cases in Kaba. The calls just keep coming. The calls just keep coming.

There are patients all over. The first thing I do, I give them courage. I tell them, “Don’t be afraid.”  They feel fear. I see it in their eyes. I’m tired of seeing people getting sick. I don’t rest, even when I go to bed. Sometimes, I see them in my dreams.

We have only three treatment centers in Monrovia. It is insufficient.

I feel hopeless.

Sometimes, when I sit down and think about it, I think, “Wow, that could be me.

Any little mistake you make, you’re going to be down with the virus.

Every morning, I pray. I pray that one day Ebola will go.

There is no space. The doctor, he can’t take the people because he’s supposed to admit 50 persons, and now he got 85 in there. He’s overloaded.

She’s very critical. She’s vomiting. She’s weak. If she doesn’t go in, she won’t live.

There is no hope here.

Ebola will last for long. In the next three to four months, the Ebola will be worse. I wish I could do more, but it’s not easy.

GWEN IFILL: The girl who we saw in that piece, who was 17 years old, died at home the next day.

 

The post Ambulance nurse confronts death and desperation in the heart of the Ebola epidemic appeared first on PBS NewsHour.

Small group of specialty drugs could make up half of total pharmacy spending by 2018

Specialty
         medications, which include high-cost drugs that require extra care, are dramatically increasing in cost. Photo by Flickr user
         e-Magine Art

Specialty medications, which include high-cost drugs that require extra care, are dramatically increasing in cost. Photo by Flickr user e-Magine Art

Some patients are paying sky-high prices for ‘specialty medications’ when cheaper options exist, a team of researchers has found.

A specialty medication is defined by Medicare as any drug that costs more than $600 a month. Such drugs typically require special handling like refrigeration or additional supplies like syringes. They represent only a fraction of prescriptions filled, but by 2018, are expected to account for half of total annual pharmacy spending, or $235 billion, according to a study published in the October issue of Health Affairs.

Though specialty medications are used by only 3.6 percent of the commercial population, rising costs of these drugs accounted for a 3.2 percent increase in total prescription drug spending in 2013. That’s $329.2 billion according to a report by the IMS Institute for Healthcare Informatics.

Several factors contribute to the soaring costs.Health Affairs

There’s the simple issue of supply and demand. Huge dollar amounts go into developing drugs that, in the case of rare diseases, few patients buy.

Another obstacle is that generic alternatives for these drugs are typically unavailable. Unlike more popular drugs, there’s no regulatory or scientific pathway for specialty medications to become generics. The Hatch-Waxman Act, which became a law in 1984, paved the way for generics to be manufactured, a move that led to “astronomical” savings, according to Dr. Alan M. Lotvin, the executive vice president for specialty pharmacy at CVS Caremark and lead author of the Health Affairs report. The legislation required that a generic drug be “bioequivalent” to the original. In other words, the active ingredient in the generic version must be absorbed at the same rate and extent as the original drug. But specialty medications are often too complex to be replicated under these requirements.

Plus, the price is set by manufacturers, Lotvin said. “To put it simply, the expansion of Medicaid and the 340b program make it harder for manufacturers to raise prices once they’re on the market. So the economically rational approach is to start off at a higher price.”

Lotvin’s team found that specialty drugs are not always the only or even the best choice. In other words, some patients may disproportionately shoulder a hefty burden of drug costs when a cheaper option may work just as well.

So how can a patient navigate the choices available? Here are some tips from Lotvin.

  • Check whether the drugs are being sold in-house. Doctors choose drugs based on their assessment of the care needed for the patient, but if there are two equivalent drugs, the doctor has an incentive to prefer those where they both purchase and administer the product, Lotvin said.
  • With some specialty drugs, doctors are required to fill out extra medical details about the patient — details on the diagnosis or other drugs the patient is taking, for example — before insurance will cover the drug. The process is known as prior authorization, or prior approval. This is a good thing, Lotvin said. Prior authorization adds another quality check to the prescribing process.
  • Finally, a specialty drug is typically less expensive when administered at home or in a doctor’s office rather than in a hospital.

“Administering a specialty medication is usually less expensive outside of the outpatient hospital setting — at a physician’s office or a home setting,” he said.

The post Small group of specialty drugs could make up half of total pharmacy spending by 2018 appeared first on PBS NewsHour.