The Food and Drug Administration began hearings Monday on the regulation and marketing of homeopathic products. Homeopathy is based on the notion that illnesses can be cured by highly diluted doses of the substance causing the illness. At issue is whether or not these remedies should go through a drug approval process similar to conventional treatments. Considered a pseudo-science by the medical establishment, patients and practitioners swear by the efficacy of homeopathy. We'll get an update on the hearings and discuss whether or not the FDA should regulate homeopathic products.
A study published this week found that 10 percent of human breast milk purchased online is tainted with cow's milk. The report illuminates the intense demand for breast milk by families who are unable to produce milk of their own and whose babies may be sensitive to formula. In this hour, we discuss the growing demand for breast milk and examine the ethical and safety implications of online sales and donations.
Teacher Janneke van den Heuvel leads
her 8-year old students in a group discussion during Spring Fever week in the Netherlands. NewsHour photo by Saskia de Melker
“Who here has been in love?” Anniek Pheifer asks a crowd of Dutch elementary school students.
It’s a Spring morning in Utrecht, and the St. Jan de Doper elementary school gym is decked in heart-shaped balloons and
streamers. Pheifer and Pepijn Gunneweg are hosts of a kids television program in the Netherlands, and they’re performing
a song about having a crush.
Kids giggle at the question. Hands — little and bigger — shoot up.
Welcome to “Spring Fever” week in Dutch primary schools, the week of focused sexuality classes… for 4-year olds.
Of course, it’s not just for 4-year-olds. Eight-year-olds learn about self-image and gender stereotypes. 11-year-olds
discuss sexual orientation and contraceptive options. But in the Netherlands, the approach, known as “comprehensive
sex education,” starts as early as age 4.
Kindergarteners attend the opening assembly for Spring
Fever week at the St Jan de Doperschool in Utrecht, the Netherlands. NewsHour photo by Saskia de Melker
You’ll never hear an explicit reference to sex in a kindergarten class.In fact, the term for what’s being taught
here is sexuality education rather than sex education. That’s because the goal is bigger than that, says Ineke
van der Vlugt, an expert on youth sexual development for Rutgers WPF, the Dutch sexuality
research institute behind the curriculum. It’s about having open, honest conversations about love and relationships.
By law, all primary school students in the Netherlands must receive some form of sexuality education. The system allows
for flexibility in how it’s taught. But it must address certain core principles — among them, sexual diversity and sexual
assertiveness. That means encouraging respect for all sexual preferences and helping students develop skills to protect against
sexual coercion, intimidation and abuse. The underlying principle is straightforward: Sexual development is a normal process
that all young people experience, and they have the right to frank, trustworthy information on the subject.
“There were societal concerns that sexualization in the media could be having a negative impact on kids,” van der Vlugt
said. “We wanted to show that sexuality also has to do with respect, intimacy, and safety.”
“We have to help young people navigate all the choices they face and stand up for themselves
in all situations, sexual and otherwise,”
There are multiple factors that likely contribute to these numbers. Easy access to contraception is one. Condoms, for example,
are available in vending machines, and the birth control pill is free for anyone under age 21. But there’s also a growing
body of research that specifically credits comprehensive sexuality education. A
recent study from Georgetown University shows that starting sex ed in primary school helps avoid unintended pregnancies,
maternal deaths, unsafe abortions and STDs.
Courtesy of Rutgers WPF
Proponents of the Dutch model argue that their approach extends beyond those risks. Their brand of sex ed reflects a broader
emphasis on young people’s rights, responsibility and respect that many public health experts say is the foundation of sexual
A 2008 United Nations report found that comprehensive
sex ed, when taught effectively, allows young people to “explore their attitudes and values, and to practice the decision-making
and other life skills they will need to be able to make informed choices about their sexual lives.” Students who had completed
comprehensive sex education in the Netherlands were also found to be more assertive and better communicators, according to
an independent health research agency that conducted a study of the Dutch programs.
“We have to help young people navigate all the choices they face and stand up for themselves in all situations, sexual
and otherwise,” said Robert van der Gaag, a health promotion official at Central Holland’s regional public health center.
‘Little butterflies in my stomach’
At the St. Jan de Doper school, a group of kindergartners sit in a circle, as their teacher, Marian Jochems, flips through
a picture book. The pages contain animals like bears and alligators hugging.
“Why are they hugging?” she asks the class.
“Because they like each other,” one girl answers.
Jochems asks them to think about who they like the most. Several kids say their mom or dad. One girl names her little sister.
A few name other children at school.
“How does it feel when that person hugs you?” Jochems asks.
“I feel warm from the inside,” one boy replies. “It’s like there are little butterflies in my stomach.”
Lessons like this are designed to get kids thinking and talking about the kind of intimacy that feels good and the kind
that doesn’t. Other early lessons focus on body awareness. For example, students draw boys’ and girls’ bodies, tell stories
about friends taking a bath together, and discuss who likes doing that and who doesn’t. By the end of kindergarten, students
are expected to be able to properly name body parts including genitals. They also learn about different types of families,
what it means to be a good friend, and that a baby grows in a mother’s womb.
CLICK HERE TO READ A LESSON
PLAN taught to Dutch kindergarten and first graders. Courtesy of Rutgers WPF
“People often think we are starting right away to talk about sexual intercourse [with kindergartners],” van der Vlugt says.
“Sexuality is so much more than that. It’s also about self image, developing your own identity, gender roles, and it’s about
learning to express yourself, your wishes and your boundaries.”
That means the kindergartners are also learning how to communicate when they don’t want to be touched. The goal
is that by age 11, students are comfortable enough to navigate pointed discussions about reproduction, safe sex, and sexual
Let’s not talk about sex
In the United States, sexual education varies widely from state to state. Fewer than half of U.S. states require schools
to teach sex ed, according to the Guttmacher Institute, a
global nonprofit that researches sexual and reproductive health. And Deb Hauser, president of Advocates
for Youth, a nonprofit dedicated to sexuality education, says that sex ed in the U.S. still overwhelmingly focuses on
minimizing the risk of pregnancy and STDs from heterosexual intercourse.
And nearly four in 10 millennials report that the sex education they received was not helpful, according
to a survey by the Public Religion Research Institute.
“We have failed to see that sexual health is far more than simply the prevention of disease or unplanned pregnancy,” says
Hauser. That narrow focus, she says, leaves young people with few skills to cope with their feelings and make decisions in
Utah state representative Bill Wright has further tried to restrict sex ed. In 2012, he proposed a bill requiring that
abstinence only be taught and that it be an optional subject. It passed but was vetoed by the governor.
Sex ed is “not an important part of our curriculum,” Wright said.
“ It is just basically something out there that takes away from the character in our schools and takes away from the character
of our students.”
In other areas, the tide is shifting toward an approach closer to that of the Dutch. Two of the largest school districts
in the country — Chicago Public Schools and Florida’s Broward County — have recently mandated sex education for
elementary school students. Chicago Public Schools requires
at least 300 minutes a year of sex education for kindergarten through fourth grade students and twice as much time for
fifth through twelfth graders. In the fall of 2015, schools in Broward
County will teach sex education at least once a year in every grade, and the curriculum will include information about
topics like body image, sexting and social media.
Courtesy of Rutgers WP
In the Netherlands, schools aim to educate parents too. Parents nights are held to give parents tools to talk to their
kids about sex. Public health experts recommend that parents take cues from their kids and make it an ongoing conversation,
rather than one awkward, all-encompassing “birds and the bees” talk. For example, they advise, if you walk in on your child
masturbating, don’t react shocked; don’t punish or scold them. Have a talk about where it is appropriate for such behavior
“We talk about [sex] over dinner,” said one father at a Spring Fever Parents Night. Another said he recently answered questions
about homosexuality posed by his twin 6-year-olds during bath time.
Lessons in love
Sabine Hasselaar teaches 11-year-olds. In a recent class, Hasselaar posed a series of hypothetical situations to her students:
you’re kissing someone and they start using their tongue which you don’t want. A girl starts dancing close to a guy at
a party causing him to get an erection. Your friend is showing off pornographic photos that make you feel uncomfortable.
The class discusses each scenario. “Everyone has the right to set their own limits and no one should ever cross those limits,”
There is an anonymous ‘Question Box.’ in her class during “Spring Fever” week. Students submit questions that teachers
later address in class. “Nothing is taboo,” Hasselaar says. One of her students, for example, wrote: “I think I am lesbian.
What should I do?”
Hasselaar addressed the issue in class: “It’s not strange for some girls to like other girls more than boys. It’s a feeling
that you can’t change, just like being in love. The only difference is that it’s with someone that is the same sex as you.”
And in fact, most of the questions from her students aren’t about sex at all. “Mostly they are curious about love. I get
a lot of questions like, “What do I do if I like someone?” or ‘How do I ask someone to go out with me?’”
Questions like these are taken just as seriously as the ones about sex.
“Of course we want kids to be safe and to understand the risks involved with sex, but we also want them to know about the
positive and fun side of caring for someone and being in a healthy relationship,” van der Vlugt says.
That’s why you’ll find teachers discussing the difference between liking someone (as a friend) and liking
someone. There’s even a lesson on dating during which a teacher talked about how to break up with someone in a decent way:
“Please, do not do it via text message,” the teacher said.
“In the Netherlands, there’s a strong belief that young people can be in love and in relationships,”
After elementary school, these students will likely go on to receive lessons from a widely-used curriculum called Long
“In the U.S., adults tend to view young people as these bundles of exploding hormones. In the Netherlands, there’s a strong
belief that young people can be in love and in relationships,” says Amy Schalet, an American sociologist who was raised in
the Netherlands and now studies
cultural attitudes towards adolescent sexuality, with a focus on these two countries.
“If you see love and relationships as the anchor for sex, then it’s much easier to talk about it with a child,” Schalet
says. “Even a young one.”
GERMANY – NOVEMBER 15: Two female inhabitants of a residential care home for Alzheimer’s disease and dementia
patients walk hand-in-hand in the corridor of the residential home on November 15, 2011 in Wolfratshausen, Germany. (Photo
by Alexandra Beier/Getty Images)
WASHINGTON (AP) — Sticky plaque gets the most attention, but now healthy seniors at risk of Alzheimer’s are letting
scientists peek into their brains to see if another culprit is lurking.
No one knows what actually causes Alzheimer’s, but the suspects are its two hallmarks — the gunky amyloid in those
brain plaques or tangles of a protein named tau that clog dying brain cells. New imaging can spot those tangles in living
brains, providing a chance to finally better understand what triggers dementia.
Now researchers are adding tau brain scans to an ambitious study that’s testing if an experimental drug might help
healthy but at-risk people stave off Alzheimer’s. Whether that medication works or not, it’s the first drug study
where scientists can track how both of Alzheimer’s signature markers begin building up in older adults before memory
“The combination of amyloid and tau is really the toxic duo,” predicted Dr. Reisa Sperling of Boston’s
Brigham and Women’s Hospital and Harvard Medical School, who is leading the so-called A4 study. “To see it in
life is really striking.”
The A4 study — it stands for Anti-Amyloid Treatment in Asymptomatic Alzheimer’s — aims to enroll 1,000 healthy seniors
like Judith Chase Gilbert, 77, of Arlington, Virginia. The recently retired government worker is mentally sharp but learned
through the study that her brain harbors amyloid buildup that might increase her risk. Last week, researchers slid Gilbert
into a doughnut-shaped PET scanner as she became one of the first study participants to also have their brains scanned for
“We know that tau starts entering the picture at some point, and we do not know when. We do not know how that interaction
happens. We should know,” said chief science officer Maria Carrillo of the Alzheimer’s Association, which is pushing
to add tau scans to other dementia research, too.
More than 35 million people worldwide have Alzheimer’s or similar dementias, including about 5 million in the U.S.
Those numbers are expected to rise rapidly as the baby boomers get older. There is no good treatment. Today’s medications
only temporarily ease symptoms and attempts at new drugs, mostly targeted at sticky amyloid, have failed in recent years.
Maybe that’s because treatment didn’t start early enough. Scientists now think Alzheimer’s begins quietly
ravaging the brain more than a decade before symptoms appear, much like heart disease is triggered by gradual cholesterol
buildup. Brain scans show many healthy older adults quietly harbor those sticky amyloid plaques, not a guarantee that they’ll
eventually get Alzheimer’s but an increased risk.
Yet more recent research, including a large autopsy study from the Mayo Clinic, suggests that Alzheimer’s other bad
actor — that tangle-forming tau protein — also plays a big role. The newest theory: Amyloid sparks a smoldering risk, but
later spread of toxic tau speeds the brain destruction.
Normal tau acts sort of like railroad tracks to help nerve cells transport food and other molecules. But in Alzheimer’s,
the protein’s strands collapse into tangles and eventually the cell dies. Most healthy people have a small amount of
dysfunctional tau in one part of the brain by their 70s, Sperling said. But amyloid plaques somehow encourage this bad tau
to spread toward the brain’s memory center, she explained.
The A4 study, which is enrolling participants in the U.S., Australia and Canada, may give some clues.
The goal is to check up to 500 people for tau three times over the three-year study, as researchers tease out when and
how it forms in those who are still healthy. They won’t be told the results — scientists don’t know enough yet
about what the scans portend.
At the same time, study participants will receive either an experimental anti-amyloid drug — Eli Lilly & Co.’s
solanezumab — or a placebo as researchers track their memory. The $140 million study is funded by the National Institutes
of Health, Lilly and others; the Alzheimer’s Association helped fund the addition of the tau scans.
The idea: If the drug proves to be helpful, it might be tamping down amyloid formation that in turn reins in toxic tau.
In previous studies, solanezumab failed to help full-blown Alzheimer’s but appeared to slow mental decline in patients
with mild disease, raising interest in testing the still healthy.
“We’re trying to remove amyloid’s downstream effects on tau formation,” said Dr. R. Scott Turner
of Georgetown University Medical Center, where Gilbert enrolled in the study.
Seeing how amyloid and tau interact in living brains “is opening a whole new chapter into possible therapies,”
For Gilbert, learning she had amyloid buildup “was distressing,” but it has prompted her to take extra steps,
in addition to the study, to protect her brain. On her doctor’s advice, she’s exercising more, and exercising
her brain in a new way by buying a keyboard to start piano lessons.
“It’s exciting to be part of something that’s cutting edge,” said Gilbert, who had never heard
of tau before.
And she has a spot-on question: “So what’s the medication for the tau?”
Stay tuned: A handful of drugs to target tau also are in development but testing will take several years.
When does a second opinion give the
most value to a patient? Photo by Heather Charles/Chicago Tribune/MCT via Getty Images
Actress Rita Wilson, who was diagnosed with breast cancer and underwent a double mastectomy recently, told People
magazine last month that she expects to make a full recovery “because I caught this early, have excellent doctors and
because I got a second opinion.”
When confronted with the diagnosis of a serious illness or confusing treatment options, everyone agrees it can be useful
to seek out another perspective. Even if the second physician agrees with the first one, knowing that can provide clarity
and peace of mind.
A second set of eyes, however, may identify information that was missed or misinterpreted the first time. A study that
reviewed existing published research found that 10
to 62 percent of second opinions resulted in major changes to diagnoses or recommended treatments.
Another study that examined nearly 6,800 second
opinions provided by Best Doctors, a second-opinion service available as an employee benefit at some companies, found
that more than 40 percent of second opinions resulted in diagnostic or treatment changes.
But here’s the rub: While it’s clear that second opinions can help individual patients make better medical decisions, there’s
little hard data showing that second opinions lead to better health results overall.
“What we don’t know is the outcomes,” says Dr. Hardeep Singh, a patient safety researcher at the Michael E. DeBakey VA
Medical Center and Baylor College of Medicine in Houston, who co-authored both those studies. “What is the real diagnosis
at the end? The first one or the second one? Or maybe both are wrong.”
That doesn’t mean second opinions are a bad idea. Experts estimate that diagnostic
errors occur in 10 to 15 percent of cases.
“There’s no getting away from it, diagnosis is an imprecise thing,” says Dr.
Mark Graber, a senior fellow at RTI International who also co-authored the studies. Graber is the founder and president
of the Society to Improve Diagnosis in Medicine.
Second opinion requests were related to diagnosis questions in 34.8 percent of cases in the Best Doctors study. These included
22.5 percent of patients whose symptoms hadn’t improved, 6.3 percent who hadn’t gotten a diagnosis and 6 percent who had questions
about their diagnosis.
In Wilson’s case, she wrote that after two breast biopsies she was relieved to learn that the pathology analysis didn’t
find any cancer. But on the advice of a friend, she decided to get a second opinion, and that pathologist diagnosed invasive
lobular carcinoma. Wilson then got a third opinion that confirmed the second pathologist’s diagnosis.
Getting a second opinion may not involve a face-to-face meeting with a new specialist, but it will certainly involve a
close examination of the patient’s medical record, including clinical notes, imaging, pathology and lab test results, and
any procedures that have been performed. Some people choose to have that second look done by physicians in their community,
but other patients look for help elsewhere.
In addition to employer-based services like Best Doctors or Grand Rounds, medical centers such as the Cleveland
Clinic and Johns Hopkins in Baltimore also offer individual
patients online second opinions.
“It really does give people relatively easy access to expertise,” says Dr. C. Martin Harris, chief information officer at
the Cleveland Clinic.
Face-to-face meetings with specialists who provide a second opinion and review a patient’s medical record are more likely
to be covered by insurance than an online consult, but nothing is guaranteed.
“Usually it’s not the second opinion where the hiccup is,” says Erin Singleton, chief of mission delivery at the Patient
Advocate Foundation, which helps people with appeals related to second opinions. “It may be that the MRI that they want to
do again won’t be approved.” Many insurers won’t pay for diagnostic or other tests to be redone, she notes.
Patients seeing an out-of-network specialist for a second opinion may encounter significantly higher out-of-pocket costs,
particularly if they want to subsequently receive treatment from that provider. In those instances, the foundation can sometimes
work with patients to make the case that no specialist in their network is equally experienced at treating their condition.
Of course, asking for a second opinion doesn’t necessarily mean accepting the advice. In the Best Doctors survey, 94.7
percent of patients said they were satisfied with their experience. But only 61.2 percent said they either agreed or strongly
agreed that they would follow the recommendations that they received in the second opinion.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family
Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
You can view the original report here.
From the time he was a kid, Ohman and his father fished together,
usually bringing home nothing but jokes about the day’s poor catch. They may not have had a lot in common, “but we had fishing,”
Three years after his father’s health steadily began to decline, Ohman knew this trip was important, and he couldn’t have
picked a better time to take it.
When he and the boatman lifted his father and placed him into the boat, the Oregon sky was blue, the birds sang and the
flowers were in bloom. “It was unbelievably poignant,” Ohman recalled.
It was a banner day. Ohman’s father not only caught the most fish but also the biggest. By the time the trip was over,
Ohman eagerly offered to plan the next one.
“I said, ‘We could go again,’ and he said, ‘No, I don’t think so,’” Ohman said. “That’s when I knew. This was his way of
telling me, this was it, he was closing up shop.”
There was nothing Ohman could say. He never brought it up again.
His father died nine months later.
Ohman knows he’s not the only person who has grappled with a parent’s mortality.
“This is a story that millions of Americans are experiencing everyday,” Ohman said.
Look for the next installment in Ohman’s cartoon series about his experience taking care of his father, arriving in