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"content": "\u003cp>Jewelry with the toxic metal cadmium is showing up on the shelves of national retailers including Ross, Nordstrom Rack and Papaya, according to newly released test results.[contextly_sidebar id=”ALDsOv55bDFULA2So32zIuna6vUPT8ZY”]\u003c/p>\n\u003cp>Analysis done for the nonprofit Center for Environmental Health revealed some jewelry sold with women’s dresses and shirts was nearly pure cadmium, which can cause cancer and reproductive harm after prolonged exposure.\u003c/p>\n\u003cp>Consumer advocates were hopeful cadmium had disappeared from the U.S. jewelry market following changes prompted by a 2010 Associated Press investigation that found Chinese manufacturers were using the metal to make kids’ jewelry. States including California outlawed cadmium in children’s jewelry, and testing by the center found the chemical had virtually disappeared from jewelry by 2012.\u003c/p>\n\u003cp>No laws address cadmium in adult jewelry, however, and last year the center decided to check those products. Lab testing found 31 adult jewelry items purchased from retail stores were at least 40 percent cadmium, and most were more than 90 percent, according to results shared exclusively with the AP.\u003c/p>\n\u003cp>California’s law allows no more than 0.03 percent cadmium in children’s jewelry. The precise health risk from the tested jewelry is unclear because researchers did not assess whether small amounts shed when the jewelry is handled and worn.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Over time, cadmium accumulates in the body and can damage the kidneys and bones. Most exposure happens by ingesting small amounts or by breathing it, most commonly through tobacco, which can contain cadmium. Researchers also have documented some absorption through skin contact, though the phenomenon is not well-studied.\u003c/p>\n\u003cp>Michael Harbut, a practicing doctor who as a university professor has researched cadmium’s cancer-causing properties, noted that contact can trigger skin rashes including psoriasis.[contextly_sidebar id=”9G8nAOWjWB7rKBq3G09Isa3CXvUagJIr”]\u003c/p>\n\u003cp>“Cadmium is bad,” said Harbut, who teaches at Michigan State University’s College of Human Medicine. “Given a choice between wearing something with cadmium in it, or wearing something without cadmium in it, I would take the product without cadmium.”\u003c/p>\n\u003cp>The Oakland-based nonprofit bought all the test samples in the San Francisco Bay Area this year or last. The extent to which contaminated jewelry is in stores elsewhere isn’t clear, though a national retailer would not typically limit a product to just one region.\u003c/p>\n\u003cp>The center said the problem should not be underestimated because of the limited market sampling.\u003c/p>\n\u003cp>“If you’re the person that buys and is wearing that jewelry, you don’t really care whether it’s a common problem or a rare problem,” said Caroline Cox, senior scientist at the center. “You have a problem.”\u003c/p>\n\u003cp>Brent Cleaveland, executive director of the Fashion Jewelry and Accessories Trade Association, said he does not believe the test results suggest a larger problem. Most major retailers have a stringent system for testing and analyzing what they sell, he said.\u003c/p>\n\u003cp>Most of the tainted items were sold at Ross, which operates more than 1,400 stores in 38 states. One pendant from a necklace chain was 100 percent cadmium, according to the testing.\u003c/p>\n\u003cp>In a written statement, Ross said it is committed to protecting its customers and has “addressed this issue with our supplier.” The retailer would not say whether it pulled suspect jewelry from stores.\u003c/p>\n\u003cp>The brands found with high cadmium levels in Ross stores include Tacera and Vibe Sportswear.[contextly_sidebar id=”2hYrwgIWmBjwxEyj6CkS5HFRDE3kS5EJ”]\u003c/p>\n\u003cp>Xinwei Xie, chief executive officer at Trend Textile Inc., which owns Tacera, declined to comment when reached by phone. The Skate Group Inc., which owns Vibe Sportswear, did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Papaya said it considers cadmium in its products a serious problem. It operates more than 100 retail locations nationwide.\u003c/p>\n\u003cp>Steven Kim, an attorney representing Papaya, said the company has recalled the products where contamination was found and stopped buying from the manufacturer in China.\u003c/p>\n\u003cp>“Our manufacturers are required to represent and warrant that their products are in legal compliance,” Kim said. “Papaya is very strict and stops doing business with any manufacturer which fails to comply.”\u003c/p>\n\u003cp>Nordstrom spokeswoman Emily Sterken said the company is “reaching out to these vendors to make them aware of the situation and get more information on these items.”\u003c/p>\n\u003cp>The Center for Environmental Health has long used California law to force companies to reduce levels of harmful materials in consumer products, including cadmium and lead in jewelry.\u003c/p>\n\u003cp>Under the state’s Proposition 65, businesses must inform consumers about significant exposures to chemicals that cause cancer or other reproductive harm. The nonprofit has settled Proposition 65 claims against 36 companies, including Gap Inc. and Target Corp., which agreed to not sell jewelry with more than 0.03 percent cadmium.\u003c/p>\n\u003cp>That limit for children’s jewelry took effect after the AP reported in 2010 that some Chinese jewelry manufacturers were substituting cadmium for lead, the use of which Congress clamped down on following a string of imported-product safety scandals.\u003c/p>\n\u003cp>The jewelry industry helped write voluntary U.S. standards following the AP investigation, but the U.S. Consumer Product Safety Commission did not mandate any cadmium limits.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Associated Press writer Justin Pritchard contributed to this report.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Over time, cadmium accumulates in the body and can damage the kidneys and bones. Most exposure happens by ingesting small amounts or by breathing it, most commonly through tobacco, which can contain cadmium. Researchers also have documented some absorption through skin contact, though the phenomenon is not well-studied.\u003c/p>\n\u003cp>Michael Harbut, a practicing doctor who as a university professor has researched cadmium’s cancer-causing properties, noted that contact can trigger skin rashes including psoriasis.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Cadmium is bad,” said Harbut, who teaches at Michigan State University’s College of Human Medicine. “Given a choice between wearing something with cadmium in it, or wearing something without cadmium in it, I would take the product without cadmium.”\u003c/p>\n\u003cp>The Oakland-based nonprofit bought all the test samples in the San Francisco Bay Area this year or last. The extent to which contaminated jewelry is in stores elsewhere isn’t clear, though a national retailer would not typically limit a product to just one region.\u003c/p>\n\u003cp>The center said the problem should not be underestimated because of the limited market sampling.\u003c/p>\n\u003cp>“If you’re the person that buys and is wearing that jewelry, you don’t really care whether it’s a common problem or a rare problem,” said Caroline Cox, senior scientist at the center. “You have a problem.”\u003c/p>\n\u003cp>Brent Cleaveland, executive director of the Fashion Jewelry and Accessories Trade Association, said he does not believe the test results suggest a larger problem. Most major retailers have a stringent system for testing and analyzing what they sell, he said.\u003c/p>\n\u003cp>Most of the tainted items were sold at Ross, which operates more than 1,400 stores in 38 states. One pendant from a necklace chain was 100 percent cadmium, according to the testing.\u003c/p>\n\u003cp>In a written statement, Ross said it is committed to protecting its customers and has “addressed this issue with our supplier.” The retailer would not say whether it pulled suspect jewelry from stores.\u003c/p>\n\u003cp>The brands found with high cadmium levels in Ross stores include Tacera and Vibe Sportswear.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Xinwei Xie, chief executive officer at Trend Textile Inc., which owns Tacera, declined to comment when reached by phone. The Skate Group Inc., which owns Vibe Sportswear, did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Papaya said it considers cadmium in its products a serious problem. It operates more than 100 retail locations nationwide.\u003c/p>\n\u003cp>Steven Kim, an attorney representing Papaya, said the company has recalled the products where contamination was found and stopped buying from the manufacturer in China.\u003c/p>\n\u003cp>“Our manufacturers are required to represent and warrant that their products are in legal compliance,” Kim said. “Papaya is very strict and stops doing business with any manufacturer which fails to comply.”\u003c/p>\n\u003cp>Nordstrom spokeswoman Emily Sterken said the company is “reaching out to these vendors to make them aware of the situation and get more information on these items.”\u003c/p>\n\u003cp>The Center for Environmental Health has long used California law to force companies to reduce levels of harmful materials in consumer products, including cadmium and lead in jewelry.\u003c/p>\n\u003cp>Under the state’s Proposition 65, businesses must inform consumers about significant exposures to chemicals that cause cancer or other reproductive harm. The nonprofit has settled Proposition 65 claims against 36 companies, including Gap Inc. and Target Corp., which agreed to not sell jewelry with more than 0.03 percent cadmium.\u003c/p>\n\u003cp>That limit for children’s jewelry took effect after the AP reported in 2010 that some Chinese jewelry manufacturers were substituting cadmium for lead, the use of which Congress clamped down on following a string of imported-product safety scandals.\u003c/p>\n\u003cp>The jewelry industry helped write voluntary U.S. standards following the AP investigation, but the U.S. Consumer Product Safety Commission did not mandate any cadmium limits.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Associated Press writer Justin Pritchard contributed to this report.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.[contextly_sidebar id=”lms9rSPdk5pG72xqgRdVMiGv0hv7IpdH”]\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it’s the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>“We have sub-populations in the U.S. that don’t really participate in studies so why not just gather all this massive data on the immune system in one central place,” says Butte. “We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.”\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.[contextly_sidebar id=”KPqEb6LD9ky4mDsIDJAEnoEvgzkEna45″]\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. Current treatments consist of risky immunosuppressants that can lead to devastating long-term side effects.[contextly_sidebar id=”ZbtYikLAiggPmeNWkxr4kKECzkkjZf4Z”]\u003c/p>\n\u003cp>UCSF researchers developed the new searchable database in part to boost AD research. Typically, studies done on immune systems are smaller and it’s rare to get 10,000 participants, according to Butte.\u003c/p>\n\u003cp>Plus, the human immune system is a moving target.\u003c/p>\n\u003cp>“It’s a difficult field to study because unlike DNA for example, your immune system changes from morning to night. So which aspect of the immune system scientists focus on, and \u003cem>when\u003c/em> they study it, these are all problems we are getting better at. We just need more studies.”\u003c/p>\n\u003cp>To test their new tool, researchers created a custom control group comprised of women between 18 and 40 years of age and compared it to 56 pregnant women who participated in a prior study tracking immune changes during pregnancy.\u003c/p>\n\u003cp>Using this control group, researchers were able to detect how various immune cells and cell signaling proteins, called cytokines, changed from pre-pregnancy levels— measurements that the original study failed to pick up.\u003c/p>\n\u003cp>Researchers also used the new tool to compare immunity in people from different racial and ethnic backgrounds. The findings showed both known differences as well as new information that could only be seen by combining data from dozens of different studies.\u003c/p>\n\u003cp>For instance, researchers found that regulatory T cells, which suppress the immune response, are present at higher levels in African Americans, compared to all other groups.\u003c/p>\n\u003cp>\u003cstrong>Shareable Science\u003c/strong>\u003c/p>\n\u003cp>Butte sees the searchable database as part of a broader trend in science, promoting open access where more scientists are willing to share their raw data with others.\u003c/p>\n\u003cp>“It’s really hundreds of people who have essentially contributed to this work,” he notes.\u003c/p>\n\u003cp>Butte says he hopes his work will bring immunology to the forefront and inspire others to rethink their approach to the field.\u003c/p>\n\u003cp>“If the field of genetics is able to compile large collections consisting of millions of people,” he wonders, “why does immunology lag behind? I want to get people in the field thinking about larger collections of samples that cut across race, age and gender.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it’s the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>“We have sub-populations in the U.S. that don’t really participate in studies so why not just gather all this massive data on the immune system in one central place,” says Butte. “We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.”\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. 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"content": "\u003cp>https://www.youtube.com/watch?v=lyu7v7nWzfo\u003c/p>\n\u003cp>\u003cem>Part 4 of the \u003c/em>TED Radio Hour \u003cem>episode \u003c/em>\u003ca href=\"http://www.npr.org/programs/ted-radio-hour/485704159/what-makes-us-us\" target=\"_blank\" rel=\"noopener\">What Makes Us ... Us\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth's TED Talk\u003c/strong>\u003c/p>\n\u003cp>When we look around, it feels like we're seeing an objective reality. But neuroscientist Anil Seth says everything we perceive, from objects to emotions, is an act of informed guesswork by the brain.\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.anilseth.com/\">Anil Seth\u003c/a> is a professor of cognitive and computational neuroscience at the University of Sussex, where he studies consciousness and its role in health and disease.\u003c/p>\n\u003cp>He co-directs the \u003ca href=\"http://www.sussex.ac.uk/sackler/\" target=\"_blank\" rel=\"noopener\">Sackler Centre for Consciousness Science\u003c/a> and is the Editor-in-Chief of the academic journal \u003cem>Neuroscience of Consciousness\u003c/em>. Seth was also the 2017 President of the British Science Association (Psychology Section). He is the co-author of \u003ca href=\"http://www.anilseth.com/books\" target=\"_blank\" rel=\"noopener\">\u003cem>30-Second Brain\u003c/em>,\u003c/a> a best-seller that explores how the brain works.\u003c/p>\n\u003cp>Seth is a regular contributor to the \u003cem>New Scientist, The Guardian\u003c/em>, and the BBC.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Anil+Seth%3A+How+Does+Your+Brain+Construct+Your+Conscious+Reality%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>The length of the \u003ca href=\"https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/\" target=\"_blank\" rel=\"noopener\">flu season\u003c/a> may vary depending on where you live, with large cities enduring longer periods of transmission and smaller cities experiencing shorter, but more explosive, spread, a new study suggests.[contextly_sidebar id=\"x5n5Lo7fgVHdWAKOVx3fr6K7JZjGLMsB\"]\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2018/10/04/flu-season-may-stretch-longer-in-big-cities/\" target=\"_blank\" rel=\"noopener\">study \u003c/a>doesn’t assert that one’s risk of contracting influenza varies depending on the size of any given community. Rather, it argues that in less populous places, flu needs the right atmospheric conditions to spread effectively.\u003c/p>\n\u003cp>In large cities, those conditions don’t matter quite as much.\u003c/p>\n\u003cp>“If there’s lots of people and transportation patterns frequently bring them together, it helps the virus find new hosts even when climate conditions aren’t at their most favorable,” explained lead author Benjamin Dalziel, an assistant professor in the department of integrative biology at Oregon State University in Corvallis.\u003c/p>\n\u003cp>The finding suggests a one-size-fits-all approach to flu season preparedness won’t work. If the study is correct, small centers should work on surge capacity — their ability to handle a lot of sick people over a short period of time — while larger cities should find ways to reduce transmission, said Jacco Wallinga, an expert on infectious diseases modeling at the National Institute for Public Health and the Environment in the Netherlands.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This is important for policymakers because it indicates that metropolitan areas should focus on reducing influenza spread, whereas small towns should focus on reducing harm,” Wallinga wrote in a \u003ca href=\"http://science.sciencemag.org/content/362/6410/29\" target=\"_blank\" rel=\"noopener\">commentary \u003c/a>on the paper, which was published alongside it Thursday in the journal Science.[contextly_sidebar id=\"Gn9g9r2BXGVHmmbiJ9A2DrWrh8ktrDcE\"]\u003c/p>\n\u003cp>Influenza is famously unpredictable. It’s not uncommon to hear people who have studied it for decades describe the virus as “humbling.”\u003c/p>\n\u003cp>Experts know there will be a surge of influenza infections at some point in the year; in the Northern Hemisphere that period typically falls in the stretch from late autumn through late winter or early spring. But some years the peak of infections will occur over Christmas and other times the sickest point in the season will come in late February or even March.\u003c/p>\n\u003cp>It’s not fully understood why flu behaves this way. Time spent indoors during the winter, when their immune systems may not be as robust, is thought to be a factor.\u003c/p>\n\u003cp>Dalziel and his co-authors set out to look at the role specific humidity levels — how much moisture there is in the air — play in flu transmission. They used a large amount of data: weekly health insurance claims from people who sought care for influenza-like illness. The researchers had data by ZIP code for six years, from 2002 to 2008, for roughly 603 cities in the United States.\u003c/p>\n\u003cp>What they saw was that in small cities, the curve of a flu season was sharp. Regardless of whether a lot of people got sick in a flu season or whether fewer were struck in a particular year, most of the infections occurred over a short period of time, making for a “spiky” epidemic curve.\u003c/p>\n\u003cp>But the pattern in large cities was different. The curve was lower and longer — more diffuse. It didn’t mean that fewer people got sick, but that infections were spread out over a longer period of time.\u003c/p>\n\u003cp>It meant that flu viruses were still able to spread from person to person in large cities even when climatic conditions weren’t ideal.\u003c/p>\n\u003cp>Dalziel, who admitted the big-city pattern wasn’t what he and his colleagues were expecting, said the small city outbreaks were “explosive” while the big city epidemics “smoldered.”\u003c/p>\n\u003cp>Their conclusion was that specific humidity didn’t matter as much in places where large numbers of people live.\u003c/p>\n\u003cp>“The flu is able to spread under a wider envelop of climatic conditions in the metropolises, because of highly organized movement patterns that put people into such close proximity that the specific humidity starts to matter less,” Dalziel said. “In metropolises, flu is able to eke out a living because there’s more highly organized close contact.”\u003c/p>\n\u003cp>Seema Lakdawala, who studies influenza transmission, described the finding as fascinating.\u003c/p>\n\u003cp>“What they’re showing is that the transmission dynamics within intense urban areas is more perpetual,” said Lakdawala, an assistant professor in the department of microbiology and molecular genetics at the University of Pittsburgh School of Medicine.\u003c/p>\n\u003cp>Lakdawala studies how the flu virus is transmitted — through droplets of saliva or mucus that can only travel short distances, or through aerosols, which can hang in the air longer. Her read of this study suggested to her that in smaller places, aerosolized viruses may play more of a role in transmission, and those may be more dependent on climatic conditions. But in large centers where people are more densely packed, transmission over short distances — which is less climate-dependent — can get the job done.[contextly_sidebar id=\"eYd72fXTu5jD6vzseb6AQMPC5fhHGdol\"]\u003c/p>\n\u003cp>“Since I’ve been thinking about the importance and the contribution of short-range versus long-range transmission for so long, to me it really fits,” said Lakdawala, who was not involved in the research.\u003c/p>\n\u003cp>“In intense urban areas, we’re indoors more often. So this idea that there is transmission occurring universally, constantly, in these environments that isn’t necessarily driven by seasonality of humidity is really fascinating,” she said. “And it really fits with what we think is happening — that these long-range transmission events may be more sensitive to humidity conditions, and they may be happening more in less populated areas.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/flu-season-may-stretch-longer-in-big-cities/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The length of the \u003ca href=\"https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/\" target=\"_blank\" rel=\"noopener\">flu season\u003c/a> may vary depending on where you live, with large cities enduring longer periods of transmission and smaller cities experiencing shorter, but more explosive, spread, a new study suggests.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2018/10/04/flu-season-may-stretch-longer-in-big-cities/\" target=\"_blank\" rel=\"noopener\">study \u003c/a>doesn’t assert that one’s risk of contracting influenza varies depending on the size of any given community. Rather, it argues that in less populous places, flu needs the right atmospheric conditions to spread effectively.\u003c/p>\n\u003cp>In large cities, those conditions don’t matter quite as much.\u003c/p>\n\u003cp>“If there’s lots of people and transportation patterns frequently bring them together, it helps the virus find new hosts even when climate conditions aren’t at their most favorable,” explained lead author Benjamin Dalziel, an assistant professor in the department of integrative biology at Oregon State University in Corvallis.\u003c/p>\n\u003cp>The finding suggests a one-size-fits-all approach to flu season preparedness won’t work. If the study is correct, small centers should work on surge capacity — their ability to handle a lot of sick people over a short period of time — while larger cities should find ways to reduce transmission, said Jacco Wallinga, an expert on infectious diseases modeling at the National Institute for Public Health and the Environment in the Netherlands.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is important for policymakers because it indicates that metropolitan areas should focus on reducing influenza spread, whereas small towns should focus on reducing harm,” Wallinga wrote in a \u003ca href=\"http://science.sciencemag.org/content/362/6410/29\" target=\"_blank\" rel=\"noopener\">commentary \u003c/a>on the paper, which was published alongside it Thursday in the journal Science.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Influenza is famously unpredictable. It’s not uncommon to hear people who have studied it for decades describe the virus as “humbling.”\u003c/p>\n\u003cp>Experts know there will be a surge of influenza infections at some point in the year; in the Northern Hemisphere that period typically falls in the stretch from late autumn through late winter or early spring. But some years the peak of infections will occur over Christmas and other times the sickest point in the season will come in late February or even March.\u003c/p>\n\u003cp>It’s not fully understood why flu behaves this way. Time spent indoors during the winter, when their immune systems may not be as robust, is thought to be a factor.\u003c/p>\n\u003cp>Dalziel and his co-authors set out to look at the role specific humidity levels — how much moisture there is in the air — play in flu transmission. They used a large amount of data: weekly health insurance claims from people who sought care for influenza-like illness. The researchers had data by ZIP code for six years, from 2002 to 2008, for roughly 603 cities in the United States.\u003c/p>\n\u003cp>What they saw was that in small cities, the curve of a flu season was sharp. Regardless of whether a lot of people got sick in a flu season or whether fewer were struck in a particular year, most of the infections occurred over a short period of time, making for a “spiky” epidemic curve.\u003c/p>\n\u003cp>But the pattern in large cities was different. The curve was lower and longer — more diffuse. It didn’t mean that fewer people got sick, but that infections were spread out over a longer period of time.\u003c/p>\n\u003cp>It meant that flu viruses were still able to spread from person to person in large cities even when climatic conditions weren’t ideal.\u003c/p>\n\u003cp>Dalziel, who admitted the big-city pattern wasn’t what he and his colleagues were expecting, said the small city outbreaks were “explosive” while the big city epidemics “smoldered.”\u003c/p>\n\u003cp>Their conclusion was that specific humidity didn’t matter as much in places where large numbers of people live.\u003c/p>\n\u003cp>“The flu is able to spread under a wider envelop of climatic conditions in the metropolises, because of highly organized movement patterns that put people into such close proximity that the specific humidity starts to matter less,” Dalziel said. “In metropolises, flu is able to eke out a living because there’s more highly organized close contact.”\u003c/p>\n\u003cp>Seema Lakdawala, who studies influenza transmission, described the finding as fascinating.\u003c/p>\n\u003cp>“What they’re showing is that the transmission dynamics within intense urban areas is more perpetual,” said Lakdawala, an assistant professor in the department of microbiology and molecular genetics at the University of Pittsburgh School of Medicine.\u003c/p>\n\u003cp>Lakdawala studies how the flu virus is transmitted — through droplets of saliva or mucus that can only travel short distances, or through aerosols, which can hang in the air longer. Her read of this study suggested to her that in smaller places, aerosolized viruses may play more of a role in transmission, and those may be more dependent on climatic conditions. But in large centers where people are more densely packed, transmission over short distances — which is less climate-dependent — can get the job done.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Since I’ve been thinking about the importance and the contribution of short-range versus long-range transmission for so long, to me it really fits,” said Lakdawala, who was not involved in the research.\u003c/p>\n\u003cp>“In intense urban areas, we’re indoors more often. So this idea that there is transmission occurring universally, constantly, in these environments that isn’t necessarily driven by seasonality of humidity is really fascinating,” she said. “And it really fits with what we think is happening — that these long-range transmission events may be more sensitive to humidity conditions, and they may be happening more in less populated areas.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/flu-season-may-stretch-longer-in-big-cities/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "some-apps-may-help-curb-insomnia-others-just-put-you-to-sleep",
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"content": "\u003cp>Paige Thesing has struggled with insomnia since high school. “It takes me a really long time to fall asleep — about four hours,” she says. For years, her mornings were groggy and involved a “lot of coffee.”[contextly_sidebar id=”SWkBBNCnUWhPf7KOuvUyV7If0Ca3ug47”]\u003c/p>\n\u003cp>After a year of trying sleep medication prescribed by her doctor, she turned to the internet for alternate solutions. About four months ago, she settled on a mobile phone meditation app called \u003ca href=\"https://www.inscape.life/\" target=\"_blank\" rel=\"noopener\">INSCAPE\u003c/a>.\u003c/p>\n\u003cp>“It’s about a 30-minute soundtrack, and it starts with a woman kind of telling you to relax and instructing your breathing,” explains Thesing. “Then it goes into sounds — relaxing noises. There’s wind chimes, some atmospheric music playing…”\u003c/p>\n\u003cp>She uses the app every night and falls asleep within 15 or 20 minutes. “So, definitely a big improvement from four hours,” she says.\u003c/p>\n\u003cp>Thesing is not alone. Chronic insomnia affects an estimated \u003ca href=\"https://www.ajmc.com/journals/supplement/2006/2006-05-vol12-n8suppl/may06-2307ps214-s220\" target=\"_blank\" rel=\"noopener\">10-15 percent of adults\u003c/a>, and another 25-35 percent struggle with sleep issues occasionally. And like Thesing, a growing number of insomniacs are turning to mobile phone apps to lull them to sleep.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On \u003ca href=\"https://twitter.com/NPRHealth/status/1046884648167624711\" target=\"_blank\" rel=\"noopener\">Twitter\u003c/a> and Facebook, NPR asked its audience if they have used a mobile phone app to help manage insomnia. Nearly 100 people wrote back suggesting a range of apps, including podcasts created to put a listener to sleep.\u003c/p>\n\u003cp>“These are usually relaxation strategies, white noise, meditation,” \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=35378\" target=\"_blank\" rel=\"noopener\">Jason Ong\u003c/a>, an associate professor of neurology specializing in sleep at Northwestern University’s Feinberg School of Medicine. He studies non-pharmacological treatments for various sleep disorders and treats patients at the university’s Sleep Medicine clinic. “It’s not that there’s something wrong with those apps. It’s a reasonable first thing to try.”[contextly_sidebar id=”ljN7S8LuvqENw8QrvBPFbhASn6EIv1oE”]\u003c/p>\n\u003cp>But, he adds, these kinds of apps aren’t based on scientifically-proven solutions, and they don’t really fix the problem of why someone is not sleeping.\u003c/p>\n\u003cp>Ong wanted to do something about that, so a few years ago, he consulted for a team that developed an app that uses a science-based approach to address insomnia called \u003ca href=\"https://www.sleepio.com/cbt-for-insomnia/\" target=\"_blank\" rel=\"noopener\">Sleepio\u003c/a>. (However, he doesn’t have any ongoing financial interest in the product, he says.)\u003c/p>\n\u003cp>Sleepio and a few other apps like \u003ca href=\"http://www.myshuti.com/\" target=\"_blank\" rel=\"noopener\">SHUT-i\u003c/a> and a free one developed by the Veterans Administration use the most sustainable and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/15451764\" target=\"_blank\" rel=\"noopener\">evidence-based\u003c/a> solution for insomnia. It’s a kind of therapy called Cognitive Behavioral Therapy for Insomnia — \u003ca href=\"https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia\" target=\"_blank\" rel=\"noopener\">CBT-I\u003c/a> for short, he says. It helps the patient understand the biology of sleep and gives them a bag of tools and tricks to change their own thought patterns and behaviors to treat their underlying sleep issues.\u003c/p>\n\u003cp>“CBT for insomnia is a specific package … [that] includes different techniques like spending less time in bed [and] what to do if you are in bed and can’t sleep,” says Ong. “It’s teaching you how to change your behavior to better work with your brain to give you confidence that you’re going to be able to sleep on a regular basis.”\u003c/p>\n\u003cp>It may be surprising to us, but our own thought patterns and sleep habits \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621793/\" target=\"_blank\" rel=\"noopener\">affect our biology\u003c/a>, in this case how our brains regulate sleep. “If you modify some of your behaviors, you can work better with how your brain regulates sleep and wake,” he says.\u003c/p>\n\u003cp>The American College of Physicians \u003ca href=\"https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia\" target=\"_blank\" rel=\"noopener\">first recommended\u003c/a> Cognitive Behavioral Therapy for Insomnia as the first-line treatment for insomnia in 2016. “The evidence is quite strong to support the effectiveness of CBT-I treatment and there really aren’t a lot of side effects,” says Ong. And, because it changes behavior, “in the long run CBT-I tends to perform quite well in maintaining the benefits.”\u003c/p>\n\u003cp>In the past the only way for people to get Cognitive Behavioral Therapy for Insomnia was to see a therapist, now they can access the therapy on their mobile phones.\u003c/p>\n\u003cp>“In Sleepio, it’s like an avatar of a real therapist that’s walking the patient through that process,” explains Ong. Sleepio also allows users to keep a sleep diary so the app can use its algorithm to suggest a better bedtime schedule. It also reminds people to get up when they’ve spent too much time in bed trying to fall asleep, for example.[contextly_sidebar id=”wEwpbDeWifEPnKULBpzGtSdpZ0ZUBzcu”]\u003c/p>\n\u003cp>Like a real therapist, the apps that use Cognitive Behavior Therapy for Insomnia also provide practical tools to help the user worry less about their sleep and over time, be less anxious and more confident about their ability get a good night’s rest. “It’s very similar to what we do face-to-face with patients,” adds Ong.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427093/\" target=\"_blank\" rel=\"noopener\">Studies show\u003c/a> that CBT-I delivered digitally through mobile phone apps is effective in treating insomnia. And a \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2704019\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of Sleepio by Ong and the team that developed the product found that participants who used the product reported an improvement in insomnia symptoms and overall wellbeing.\u003c/p>\n\u003cp>“It’s an impressive study in size and scope,” says \u003ca href=\"http://www.johntorousmd.com/\" target=\"_blank\" rel=\"noopener\">John Torous\u003c/a>, the director of digital psychiatry at Beth Israel Deaconess Medical Center. “But like any study, we have to interpret it within reason.”\u003c/p>\n\u003cp>The participants in the study were mostly white and female, he notes, and so it’s hard to generalize the findings to the larger population. And, he adds that the study was designed and funded by Big Health, the company that created the app and is now marketing it.\u003c/p>\n\u003cp>Also, Sleepio is only available on a limited basis. You can get it through employers, health insurance and national health systems at the moment, says Mike Radocchia, the marketing and business development lead at Big Health. Although the company does give it to researchers and charities for free.\u003c/p>\n\u003cp>And while apps that use Cognitive Behavior Therapy for Insomnia cost less than in-person therapy, they can be pricey. A 26-week subscription of SHUTi \u003ca href=\"http://www.myshuti.com/shuti-pricing/\" target=\"_blank\" rel=\"noopener\">costs $149\u003c/a>.\u003c/p>\n\u003cp>That’s why Torous often directs his patients with insomnia to a free app developed by the Veterans Administration called \u003ca href=\"https://mobile.va.gov/app/cbt-i-coach\" target=\"_blank\" rel=\"noopener\">CBT-I Coach\u003c/a>.\u003c/p>\n\u003cp>“Anyone can access it. You don’t have to be a veteran,” Torous says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nextbreathcounseling.com/credentials/\" target=\"_blank\" rel=\"noopener\">Jake Hanks\u003c/a>, a mental health counselor based in Glenwood Springs, Colorado, agrees. “CBT-I Coach would be my absolute favorite,” he says. “It includes a lot of the cognitive restructuring, the true things about sleep that we want patients to keep in mind.” And so, he too, recommends the free app to his patients.\u003c/p>\n\u003cp>However, Torous notes that these apps don’t work for everyone. The recent study by Ong and his colleagues hints at why.\u003c/p>\n\u003cp>“Even in this clinical study, less than 50 percent [of people who were assigned to use the app in a randomized controlled trial] are able to make it through the entire course of CBT delivered through digital platforms,” he notes. “For some people it may be hard to make it through all the sessions of CBT.”\u003c/p>\n\u003cp>This is true of most health and wellness apps, he says. Torous \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616170\" target=\"_blank\" rel=\"noopener\">has studied\u003c/a> this and found that of the 10,000 mental health apps out there, very few are actually being used. “I don’t think we really understand how people are using technology towards their health and recovery,” he notes.[contextly_sidebar id=”LqkvTN1dfENdC3n50jRUdIl6PSPHOHGb”]\u003c/p>\n\u003cp>But in some ways, he says, people with insomnia may be ahead of scientists in figuring out what works well for them.\u003c/p>\n\u003cp>“If you find something that works [for you], I think that’s always a good first step,” he says. “Quick fixes or simple solutions may get you feeling better right away.”\u003c/p>\n\u003cp>But, he notes, insomnia is a complex disorder with many underlying causes. Sometimes it can be caused by a medical condition that’s easily treatable, like a thyroid problem, he adds.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>So, no matter what app you are considering, always talk to your doctor about your sleep issues, he advises. “Until you know the diagnosis or what you’re working with, you don’t want to start treating something that’s not what you think it is.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+Apps+May+Help+Curb+Insomnia%2C+Others+Just+Put+You+To+Sleep&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Paige Thesing has struggled with insomnia since high school. “It takes me a really long time to fall asleep — about four hours,” she says. For years, her mornings were groggy and involved a “lot of coffee.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After a year of trying sleep medication prescribed by her doctor, she turned to the internet for alternate solutions. About four months ago, she settled on a mobile phone meditation app called \u003ca href=\"https://www.inscape.life/\" target=\"_blank\" rel=\"noopener\">INSCAPE\u003c/a>.\u003c/p>\n\u003cp>“It’s about a 30-minute soundtrack, and it starts with a woman kind of telling you to relax and instructing your breathing,” explains Thesing. “Then it goes into sounds — relaxing noises. There’s wind chimes, some atmospheric music playing…”\u003c/p>\n\u003cp>She uses the app every night and falls asleep within 15 or 20 minutes. “So, definitely a big improvement from four hours,” she says.\u003c/p>\n\u003cp>Thesing is not alone. Chronic insomnia affects an estimated \u003ca href=\"https://www.ajmc.com/journals/supplement/2006/2006-05-vol12-n8suppl/may06-2307ps214-s220\" target=\"_blank\" rel=\"noopener\">10-15 percent of adults\u003c/a>, and another 25-35 percent struggle with sleep issues occasionally. And like Thesing, a growing number of insomniacs are turning to mobile phone apps to lull them to sleep.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On \u003ca href=\"https://twitter.com/NPRHealth/status/1046884648167624711\" target=\"_blank\" rel=\"noopener\">Twitter\u003c/a> and Facebook, NPR asked its audience if they have used a mobile phone app to help manage insomnia. Nearly 100 people wrote back suggesting a range of apps, including podcasts created to put a listener to sleep.\u003c/p>\n\u003cp>“These are usually relaxation strategies, white noise, meditation,” \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=35378\" target=\"_blank\" rel=\"noopener\">Jason Ong\u003c/a>, an associate professor of neurology specializing in sleep at Northwestern University’s Feinberg School of Medicine. He studies non-pharmacological treatments for various sleep disorders and treats patients at the university’s Sleep Medicine clinic. “It’s not that there’s something wrong with those apps. It’s a reasonable first thing to try.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But, he adds, these kinds of apps aren’t based on scientifically-proven solutions, and they don’t really fix the problem of why someone is not sleeping.\u003c/p>\n\u003cp>Ong wanted to do something about that, so a few years ago, he consulted for a team that developed an app that uses a science-based approach to address insomnia called \u003ca href=\"https://www.sleepio.com/cbt-for-insomnia/\" target=\"_blank\" rel=\"noopener\">Sleepio\u003c/a>. (However, he doesn’t have any ongoing financial interest in the product, he says.)\u003c/p>\n\u003cp>Sleepio and a few other apps like \u003ca href=\"http://www.myshuti.com/\" target=\"_blank\" rel=\"noopener\">SHUT-i\u003c/a> and a free one developed by the Veterans Administration use the most sustainable and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/15451764\" target=\"_blank\" rel=\"noopener\">evidence-based\u003c/a> solution for insomnia. It’s a kind of therapy called Cognitive Behavioral Therapy for Insomnia — \u003ca href=\"https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia\" target=\"_blank\" rel=\"noopener\">CBT-I\u003c/a> for short, he says. It helps the patient understand the biology of sleep and gives them a bag of tools and tricks to change their own thought patterns and behaviors to treat their underlying sleep issues.\u003c/p>\n\u003cp>“CBT for insomnia is a specific package … [that] includes different techniques like spending less time in bed [and] what to do if you are in bed and can’t sleep,” says Ong. “It’s teaching you how to change your behavior to better work with your brain to give you confidence that you’re going to be able to sleep on a regular basis.”\u003c/p>\n\u003cp>It may be surprising to us, but our own thought patterns and sleep habits \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621793/\" target=\"_blank\" rel=\"noopener\">affect our biology\u003c/a>, in this case how our brains regulate sleep. “If you modify some of your behaviors, you can work better with how your brain regulates sleep and wake,” he says.\u003c/p>\n\u003cp>The American College of Physicians \u003ca href=\"https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia\" target=\"_blank\" rel=\"noopener\">first recommended\u003c/a> Cognitive Behavioral Therapy for Insomnia as the first-line treatment for insomnia in 2016. “The evidence is quite strong to support the effectiveness of CBT-I treatment and there really aren’t a lot of side effects,” says Ong. And, because it changes behavior, “in the long run CBT-I tends to perform quite well in maintaining the benefits.”\u003c/p>\n\u003cp>In the past the only way for people to get Cognitive Behavioral Therapy for Insomnia was to see a therapist, now they can access the therapy on their mobile phones.\u003c/p>\n\u003cp>“In Sleepio, it’s like an avatar of a real therapist that’s walking the patient through that process,” explains Ong. Sleepio also allows users to keep a sleep diary so the app can use its algorithm to suggest a better bedtime schedule. It also reminds people to get up when they’ve spent too much time in bed trying to fall asleep, for example.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Like a real therapist, the apps that use Cognitive Behavior Therapy for Insomnia also provide practical tools to help the user worry less about their sleep and over time, be less anxious and more confident about their ability get a good night’s rest. “It’s very similar to what we do face-to-face with patients,” adds Ong.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427093/\" target=\"_blank\" rel=\"noopener\">Studies show\u003c/a> that CBT-I delivered digitally through mobile phone apps is effective in treating insomnia. And a \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2704019\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of Sleepio by Ong and the team that developed the product found that participants who used the product reported an improvement in insomnia symptoms and overall wellbeing.\u003c/p>\n\u003cp>“It’s an impressive study in size and scope,” says \u003ca href=\"http://www.johntorousmd.com/\" target=\"_blank\" rel=\"noopener\">John Torous\u003c/a>, the director of digital psychiatry at Beth Israel Deaconess Medical Center. “But like any study, we have to interpret it within reason.”\u003c/p>\n\u003cp>The participants in the study were mostly white and female, he notes, and so it’s hard to generalize the findings to the larger population. And, he adds that the study was designed and funded by Big Health, the company that created the app and is now marketing it.\u003c/p>\n\u003cp>Also, Sleepio is only available on a limited basis. You can get it through employers, health insurance and national health systems at the moment, says Mike Radocchia, the marketing and business development lead at Big Health. Although the company does give it to researchers and charities for free.\u003c/p>\n\u003cp>And while apps that use Cognitive Behavior Therapy for Insomnia cost less than in-person therapy, they can be pricey. A 26-week subscription of SHUTi \u003ca href=\"http://www.myshuti.com/shuti-pricing/\" target=\"_blank\" rel=\"noopener\">costs $149\u003c/a>.\u003c/p>\n\u003cp>That’s why Torous often directs his patients with insomnia to a free app developed by the Veterans Administration called \u003ca href=\"https://mobile.va.gov/app/cbt-i-coach\" target=\"_blank\" rel=\"noopener\">CBT-I Coach\u003c/a>.\u003c/p>\n\u003cp>“Anyone can access it. You don’t have to be a veteran,” Torous says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nextbreathcounseling.com/credentials/\" target=\"_blank\" rel=\"noopener\">Jake Hanks\u003c/a>, a mental health counselor based in Glenwood Springs, Colorado, agrees. “CBT-I Coach would be my absolute favorite,” he says. “It includes a lot of the cognitive restructuring, the true things about sleep that we want patients to keep in mind.” And so, he too, recommends the free app to his patients.\u003c/p>\n\u003cp>However, Torous notes that these apps don’t work for everyone. The recent study by Ong and his colleagues hints at why.\u003c/p>\n\u003cp>“Even in this clinical study, less than 50 percent [of people who were assigned to use the app in a randomized controlled trial] are able to make it through the entire course of CBT delivered through digital platforms,” he notes. “For some people it may be hard to make it through all the sessions of CBT.”\u003c/p>\n\u003cp>This is true of most health and wellness apps, he says. Torous \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616170\" target=\"_blank\" rel=\"noopener\">has studied\u003c/a> this and found that of the 10,000 mental health apps out there, very few are actually being used. “I don’t think we really understand how people are using technology towards their health and recovery,” he notes.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But in some ways, he says, people with insomnia may be ahead of scientists in figuring out what works well for them.\u003c/p>\n\u003cp>“If you find something that works [for you], I think that’s always a good first step,” he says. “Quick fixes or simple solutions may get you feeling better right away.”\u003c/p>\n\u003cp>But, he notes, insomnia is a complex disorder with many underlying causes. Sometimes it can be caused by a medical condition that’s easily treatable, like a thyroid problem, he adds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So, no matter what app you are considering, always talk to your doctor about your sleep issues, he advises. “Until you know the diagnosis or what you’re working with, you don’t want to start treating something that’s not what you think it is.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+Apps+May+Help+Curb+Insomnia%2C+Others+Just+Put+You+To+Sleep&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "You Don't Have To Pass Out To Be Blackout Drunk",
"title": "You Don't Have To Pass Out To Be Blackout Drunk",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Unless you've been blissfully unplugged, you must have come across the term \"blackout\" lately. And you may have thought it means inebriated to the point of unconsciousness. Falling-down drunk. Blotto.[contextly_sidebar id=\"UNiHL8eB1QjUnbIxSw8VWUrjWiq8mQov\"]\u003c/p>\n\u003cp>Supreme Court nominee Brett Kavanaugh appears to think so, based on \u003ca href=\"https://www.washingtonpost.com/news/national/wp/2018/09/27/kavanaugh-hearing-transcript/?utm_term=.953b6f43eb3c\" target=\"_blank\" rel=\"noopener\">this exchange\u003c/a> last Thursday during his fiery self-defense before the Senate Judiciary Committee:\u003c/p>\n\u003cblockquote>\u003cp>\"Have you ever passed out from drinking?\" queried Rachel Mitchell, a sex crimes prosecutor from Phoenix retained by Republicans to ask question at the hearing.\u003c/p>\n\u003cp>\"Passed out would be — no. But I've gone to sleep. But — but I've never blacked out,\" Kavanaugh replied. \"That's the — allegation, and that — that's wrong.\"\u003c/p>\u003c/blockquote>\n\u003cp>But that notion of an alcohol-induced blackout is wrong.\u003c/p>\n\u003cp>A less confusing term might be \"alcohol-induced amnesia.\" It can be total. Hours of experience and events can be totally missing from memory. Or it can be spotty. Either way, it can be hard to impossible for a bystander, or even the inebriated person, to know when it has happened.\u003c/p>\n\u003cp>Misunderstanding blackouts has big implications. The phenomenon could reconcile the disconnect between what psychologist Christine Blasey Ford says she remembers so indelibly about an alleged sexual assault by Kavanaugh one summer evening 36 years ago and Kavanaugh's categorical denial that it ever happened.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>To understand the phenomenon, I talked with Dr. \u003ca href=\"https://www.bu.edu/sph/profile/richard-saitz/\" target=\"_blank\" rel=\"noopener\">Richard Saitz\u003c/a>, chair of Boston University School of Public Health's Department of Community Health Sciences, a veteran researcher of alcohol abuse and an addiction medicine specialist. Our conversation, edited:\u003c/p>\n\u003cp>\u003cstrong>There's been recent confusion about alcohol-related blackouts — what they are and what they aren't. What's been your reaction to the use of the term lately?\u003c/strong>\u003c/p>\n\u003cp>Many people confuse the idea of a blackout with someone who's had so much to drink that they are unarousable — they're not awake and they don't know what's going on. That's not at all the case. A blackout is when you don't remember what happened. You can appear to be completely awake. An observer can't tell when someone is in the midst of not forming a memory.\u003c/p>\n\u003cp>The second common misconception is that having a blackout is characteristic of an alcohol use disorder more commonly called alcoholism — that you only have blackouts if you have an alcohol use disorder. And that's just not true.\u003c/p>\n\u003cp>\u003cstrong>It's a curious phenomenon — a very selective kind of temporary memory impairment. What's going on in there?\u003c/strong>\u003c/p>\n\u003cp>It involves those parts of the brain that are required to take in what's happening and allow you to remember it later. You might remember it two or three minutes later but not 10 hours later or two days later or ever again, because it didn't get permanently encoded by the brain. It probably happens in the hippocampus and it involves the frontal lobes of the brain as well.[contextly_sidebar id=\"nWd7zNE3xlJLE0K0o8Op2Mrh7FV5jCXX\"]\u003c/p>\n\u003cp>\u003cstrong>What touches it off?\u003c/strong>\u003c/p>\n\u003cp>If you drink a substantial amount quickly, you might experience a blackout. Drinking games would be an example of that because that's the point of the game.\u003c/p>\n\u003cp>\u003cstrong>How common are blackouts?\u003c/strong>\u003c/p>\n\u003cp>We don't have great epidemiologic data about this. I've seen the prevalence of blackouts ranging anywhere from 10 percent to up to 50 percent of young people who drink. It's fair to say it's not rare.\u003c/p>\n\u003cp>\u003cstrong>Does blackout seem to explain, at least potentially, the great divergence we heard last week in the testimony of Ford and Kavanaugh?\u003c/strong>\u003c/p>\n\u003cp>It's plausible that if he were drinking heavily and rapidly that he might have a blackout. So it's possible he might have no recollection of what happened.\u003c/p>\n\u003cp>\u003cstrong>What do you think when you hear Kavanaugh say, in response to a question about whether he's ever \"passed out from drinking,\" that he's \"gone to sleep, but ... never blacked out\"?\u003c/strong>\u003c/p>\n\u003cp>I have no knowledge of what Judge Kavanaugh knows about the definition of \"blackout\" versus \"passing out\" versus \"falling asleep after drinking.\" Passed out is not a clinical term and usually people use it to mean that they drank so much that they ended up falling asleep. I'm not sure if he could say that he had a blackout or not. The only way he would know is if somebody later told him that something happened while he was intoxicated and he didn't remember it, and then he believed they were telling the truth. So it's not a particularly easy question to answer unless you know the definition of blackout and your memory has been questioned, or somebody told you about it.[contextly_sidebar id=\"cOFlriGvdakmZZ3kgLOVmpocMiXNOj0A\"]\u003c/p>\n\u003cp>\u003cstrong>Ford placed Kavanaugh's companion, Mark Judge, in the room where the alleged assault occurred. If he also was drinking heavily and also had a blackout, neither of them would remember and nobody else would be in a position to call their attention to it.\u003c/strong>\u003c/p>\n\u003cp>Sure. It's conceivable they both could have had a blackout about the same event, although that begins to get a little bit less likely. If there was someone there to say that something happened, that's the only way you could come close to knowing.\u003c/p>\n\u003cp>\u003cstrong>If you were consulted by the FBI, which is trying to unravel all this, what would you advise them to consider in light of the blackout phenomenon? What should they be alert to?\u003c/strong>\u003c/p>\n\u003cp>They need to be aware that it's certainly possible there could have been something that happened that [Kavanaugh] might have no memory of. So if he says something didn't happen and it was supposed to have happened during a heavy drinking episode, then it's possible he has no memory of it. And so therefore they need to find other evidence or ask someone else, because his denial is questionable.\u003c/p>\n\u003cp>I would also tell them that it's unlikely, at that age and in that context, that this would have happened only once. It's likely he'd have had a blackout on some other occasion. And so there might be evidence of that.\u003c/p>\n\u003cp>\u003cstrong>It seems as though this whole phenomenon of blackouts is a really big public health issue. Because people may do things in that state, such as committing sexual assault, that they don't feel personally responsible for later.\u003c/strong>\u003c/p>\n\u003cp>The real problem with blackouts is that you don't remember. And so you can't learn from your behavior unless someone tells you that you did something terrible.\u003c/p>\n\u003cp>\u003cstrong>Shouldn't public health educators and message-makers address blackouts? Don't teens and young adults need to understand more about this phenomenon? That it's not simply a question of moral failure but it's the way the brain acts in some people, in certain situations?\u003c/strong>\u003c/p>\n\u003cp>You're absolutely right. This is not a moral judgment about whether people are drinking too much or not. This is a toxic biological effect of something that you're taking in that affects your brain in this way and makes it so that you can't remember what happened.\u003c/p>\n\u003cp>This afternoon our school of public health is having a conversation with students and faculty about sexual assault. So it's a teaching opportunity for that. And more broadly, it's a teaching opportunity around alcohol use and heavy drinking.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>A version of this story originally ran on WBUR's \u003c/em>\u003ca href=\"http://www.wbur.org/commonhealth\">CommonHealth\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=You+Don%27t+Have+To+Pass+Out+To+Be+Blackout+Drunk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Unless you've been blissfully unplugged, you must have come across the term \"blackout\" lately. And you may have thought it means inebriated to the point of unconsciousness. Falling-down drunk. Blotto.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Supreme Court nominee Brett Kavanaugh appears to think so, based on \u003ca href=\"https://www.washingtonpost.com/news/national/wp/2018/09/27/kavanaugh-hearing-transcript/?utm_term=.953b6f43eb3c\" target=\"_blank\" rel=\"noopener\">this exchange\u003c/a> last Thursday during his fiery self-defense before the Senate Judiciary Committee:\u003c/p>\n\u003cblockquote>\u003cp>\"Have you ever passed out from drinking?\" queried Rachel Mitchell, a sex crimes prosecutor from Phoenix retained by Republicans to ask question at the hearing.\u003c/p>\n\u003cp>\"Passed out would be — no. But I've gone to sleep. But — but I've never blacked out,\" Kavanaugh replied. \"That's the — allegation, and that — that's wrong.\"\u003c/p>\u003c/blockquote>\n\u003cp>But that notion of an alcohol-induced blackout is wrong.\u003c/p>\n\u003cp>A less confusing term might be \"alcohol-induced amnesia.\" It can be total. Hours of experience and events can be totally missing from memory. Or it can be spotty. Either way, it can be hard to impossible for a bystander, or even the inebriated person, to know when it has happened.\u003c/p>\n\u003cp>Misunderstanding blackouts has big implications. The phenomenon could reconcile the disconnect between what psychologist Christine Blasey Ford says she remembers so indelibly about an alleged sexual assault by Kavanaugh one summer evening 36 years ago and Kavanaugh's categorical denial that it ever happened.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To understand the phenomenon, I talked with Dr. \u003ca href=\"https://www.bu.edu/sph/profile/richard-saitz/\" target=\"_blank\" rel=\"noopener\">Richard Saitz\u003c/a>, chair of Boston University School of Public Health's Department of Community Health Sciences, a veteran researcher of alcohol abuse and an addiction medicine specialist. Our conversation, edited:\u003c/p>\n\u003cp>\u003cstrong>There's been recent confusion about alcohol-related blackouts — what they are and what they aren't. What's been your reaction to the use of the term lately?\u003c/strong>\u003c/p>\n\u003cp>Many people confuse the idea of a blackout with someone who's had so much to drink that they are unarousable — they're not awake and they don't know what's going on. That's not at all the case. A blackout is when you don't remember what happened. You can appear to be completely awake. An observer can't tell when someone is in the midst of not forming a memory.\u003c/p>\n\u003cp>The second common misconception is that having a blackout is characteristic of an alcohol use disorder more commonly called alcoholism — that you only have blackouts if you have an alcohol use disorder. And that's just not true.\u003c/p>\n\u003cp>\u003cstrong>It's a curious phenomenon — a very selective kind of temporary memory impairment. What's going on in there?\u003c/strong>\u003c/p>\n\u003cp>It involves those parts of the brain that are required to take in what's happening and allow you to remember it later. You might remember it two or three minutes later but not 10 hours later or two days later or ever again, because it didn't get permanently encoded by the brain. It probably happens in the hippocampus and it involves the frontal lobes of the brain as well.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>What touches it off?\u003c/strong>\u003c/p>\n\u003cp>If you drink a substantial amount quickly, you might experience a blackout. Drinking games would be an example of that because that's the point of the game.\u003c/p>\n\u003cp>\u003cstrong>How common are blackouts?\u003c/strong>\u003c/p>\n\u003cp>We don't have great epidemiologic data about this. I've seen the prevalence of blackouts ranging anywhere from 10 percent to up to 50 percent of young people who drink. It's fair to say it's not rare.\u003c/p>\n\u003cp>\u003cstrong>Does blackout seem to explain, at least potentially, the great divergence we heard last week in the testimony of Ford and Kavanaugh?\u003c/strong>\u003c/p>\n\u003cp>It's plausible that if he were drinking heavily and rapidly that he might have a blackout. So it's possible he might have no recollection of what happened.\u003c/p>\n\u003cp>\u003cstrong>What do you think when you hear Kavanaugh say, in response to a question about whether he's ever \"passed out from drinking,\" that he's \"gone to sleep, but ... never blacked out\"?\u003c/strong>\u003c/p>\n\u003cp>I have no knowledge of what Judge Kavanaugh knows about the definition of \"blackout\" versus \"passing out\" versus \"falling asleep after drinking.\" Passed out is not a clinical term and usually people use it to mean that they drank so much that they ended up falling asleep. I'm not sure if he could say that he had a blackout or not. The only way he would know is if somebody later told him that something happened while he was intoxicated and he didn't remember it, and then he believed they were telling the truth. So it's not a particularly easy question to answer unless you know the definition of blackout and your memory has been questioned, or somebody told you about it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Ford placed Kavanaugh's companion, Mark Judge, in the room where the alleged assault occurred. If he also was drinking heavily and also had a blackout, neither of them would remember and nobody else would be in a position to call their attention to it.\u003c/strong>\u003c/p>\n\u003cp>Sure. It's conceivable they both could have had a blackout about the same event, although that begins to get a little bit less likely. If there was someone there to say that something happened, that's the only way you could come close to knowing.\u003c/p>\n\u003cp>\u003cstrong>If you were consulted by the FBI, which is trying to unravel all this, what would you advise them to consider in light of the blackout phenomenon? What should they be alert to?\u003c/strong>\u003c/p>\n\u003cp>They need to be aware that it's certainly possible there could have been something that happened that [Kavanaugh] might have no memory of. So if he says something didn't happen and it was supposed to have happened during a heavy drinking episode, then it's possible he has no memory of it. And so therefore they need to find other evidence or ask someone else, because his denial is questionable.\u003c/p>\n\u003cp>I would also tell them that it's unlikely, at that age and in that context, that this would have happened only once. It's likely he'd have had a blackout on some other occasion. And so there might be evidence of that.\u003c/p>\n\u003cp>\u003cstrong>It seems as though this whole phenomenon of blackouts is a really big public health issue. Because people may do things in that state, such as committing sexual assault, that they don't feel personally responsible for later.\u003c/strong>\u003c/p>\n\u003cp>The real problem with blackouts is that you don't remember. And so you can't learn from your behavior unless someone tells you that you did something terrible.\u003c/p>\n\u003cp>\u003cstrong>Shouldn't public health educators and message-makers address blackouts? Don't teens and young adults need to understand more about this phenomenon? That it's not simply a question of moral failure but it's the way the brain acts in some people, in certain situations?\u003c/strong>\u003c/p>\n\u003cp>You're absolutely right. This is not a moral judgment about whether people are drinking too much or not. This is a toxic biological effect of something that you're taking in that affects your brain in this way and makes it so that you can't remember what happened.\u003c/p>\n\u003cp>This afternoon our school of public health is having a conversation with students and faculty about sexual assault. So it's a teaching opportunity for that. And more broadly, it's a teaching opportunity around alcohol use and heavy drinking.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>A version of this story originally ran on WBUR's \u003c/em>\u003ca href=\"http://www.wbur.org/commonhealth\">CommonHealth\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=You+Don%27t+Have+To+Pass+Out+To+Be+Blackout+Drunk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Sexual Assault And Harassment May Have Lasting Health Repercussions For Women",
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"content": "\u003cp>The trauma of sexual assault or harassment is not only hard to forget; it may also leave lasting effects on a woman's health. This finding of a study \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4886\" target=\"_blank\" rel=\"noopener\">published Wednesday\u003c/a> adds support to a growing body of evidence suggesting the link.[contextly_sidebar id=\"HEpAUbCt2g19YW7Y7Rht6rrTaYElddh0\"]\u003c/p>\n\u003cp>In the study of roughly 300 middle-aged women, an experience of sexual assault was associated with anxiety, depression and poor sleep. A history of workplace sexual harassment was also associated with poor sleep and with an increased risk of developing high blood pressure.\u003c/p>\n\u003cp>\"These are experiences that [a woman] could have had long ago ... and it can have this long arm of influence throughout a woman's life,\" says \u003ca href=\"https://www.publichealth.pitt.edu/home/directory/rebecca-thurston\">Rebecca Thurston\u003c/a>, lead author of the study, and a research psychologist and director of the Women's Behavioral Health Laboratory at the University of Pittsburgh.\u003c/p>\n\u003cp>The study data come from a survey of healthy women between ages 40 and 60 who had been recruited for a study on menopause and cardiovascular disease — not sexual harassment or assault. They all had their blood pressure checked at study visits, as well as height and weight.\u003c/p>\n\u003cp>Among other questions, the survey asked the women if they had ever experienced sexual harassment at work. Participants were also asked if they had ever \"been made or pressured into having some type of unwanted sexual contact.\" The women were not asked when those events occurred.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Twenty-two percent reported a history of sexual assault, and 19 percent said they'd experienced workplace sexual harassment.\u003c/p>\n\u003cp>Though the sample size was small, the results are statistically significant. Women who had experienced sexual assault had on average an almost threefold increased risk of developing depressive symptoms, compared to women who hadn't. They also had a greater incidence of clinically significant anxiety.[contextly_sidebar id=\"IsNCC9ByhjKnhi0QhEGUW78GbGlaWQIA\"]\u003c/p>\n\u003cp>About 1 in 4 women who had been sexually assaulted met criteria for depression, while approximately 1 in 10 who had not were depressed.\u003c/p>\n\u003cp>Those who experienced sexual harassment at work had a twofold increased risk compared to women who hadn't of developing high blood pressure. Poor sleep was more common, too.\u003c/p>\n\u003cp>\"These [traumatic experiences] are clearly critical things that happen to people early on, that have these really long-lasting effects,\" says \u003ca href=\"https://directory.sph.umn.edu/bio/sph-a-z/susan-mason\" target=\"_blank\" rel=\"noopener\">Susan Mason\u003c/a>, an assistant professor of epidemiology at the University of Minnesota who studies the effects of trauma. \"These really shape people's life trajectories.\"\u003c/p>\n\u003cp>Mason was not involved in this study, but says the findings dovetail with other research on the relationship between trauma and physical or mental health later in life. Intimate partner violence, for example, has been associated with the development of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23248189\" target=\"_blank\" rel=\"noopener\">diabetes\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22717307\" target=\"_blank\" rel=\"noopener\">high blood pressure\u003c/a>.\u003c/p>\n\u003cp>Wednesday's study is particularly noteworthy, Mason says, because it includes clinical data — in-office blood pressure checks, for example, and validated diagnostic tools for depression and anxiety — rather than depending exclusively on self-reported diagnoses.\u003c/p>\n\u003cp>Clinicians don't have the ability to corroborate women's memories of sexual assault or harassment, however. Thurston points to literature on the way traumatic memories are processed that demonstrates that discrete events like a sexual assault often remain vivid in a way other memories don't. This is why, she says, she trusts the study participants who say they've been through these experiences.[contextly_sidebar id=\"aop33xdUj0MLT7LwmTHbeoNCW1mJ7lyp\"]\u003c/p>\n\u003cp>\"If the patient thinks it's important, it's important,\" says Dr. Valerie Gilchrist, chair of the department of family medicine at the University of Wisconsin who has written about screening for sexual violence in primary care.\u003c/p>\n\u003cp>She recommends that clinicians ask patients if they've experienced sexual assault, particularly patients who are experiencing significant stress or have difficulty with pelvic exams. Authors note that sexual assault and harassment seemed to be less common in this group of women than in national estimates.\u003c/p>\n\u003cp>The prevalence in their cohort was significantly lower than a \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm\" target=\"_blank\" rel=\"noopener\">2014 estimate from the Centers for Disease Control and Prevention\u003c/a>, which found that 19 percent of American women had been raped, and almost 44 percent had experienced another form of sexual violence.\u003c/p>\n\u003cp>Thurston thinks this is because the study excluded a fair number of women for reasons related to its original intent of researching menopause and cardiovascular disease. Women taking medications for depression were not included, for example, as well as those with serious medical problems.\u003c/p>\n\u003cp>\"Sexual assault and sexual abuse are much more common than people think,\" Thurston says. These are \"key toxic stressors for women.\"\u003c/p>\n\u003cp>While researchers weren't surprised that sexual assault and harassment seemed to be related to the development of mood disorders and poor sleep, they were impressed by the strength of the association.\u003c/p>\n\u003cp>\"These should be urgent public health priorities,\" Mason says. \"How do we address the fundamental ways that our social structure affects health?\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Sexual+Assault+And+Harassment+May+Have+Lasting+Health+Repercussions+For+Women&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The trauma of sexual assault or harassment is not only hard to forget; it may also leave lasting effects on a woman's health. This finding of a study \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4886\" target=\"_blank\" rel=\"noopener\">published Wednesday\u003c/a> adds support to a growing body of evidence suggesting the link.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In the study of roughly 300 middle-aged women, an experience of sexual assault was associated with anxiety, depression and poor sleep. A history of workplace sexual harassment was also associated with poor sleep and with an increased risk of developing high blood pressure.\u003c/p>\n\u003cp>\"These are experiences that [a woman] could have had long ago ... and it can have this long arm of influence throughout a woman's life,\" says \u003ca href=\"https://www.publichealth.pitt.edu/home/directory/rebecca-thurston\">Rebecca Thurston\u003c/a>, lead author of the study, and a research psychologist and director of the Women's Behavioral Health Laboratory at the University of Pittsburgh.\u003c/p>\n\u003cp>The study data come from a survey of healthy women between ages 40 and 60 who had been recruited for a study on menopause and cardiovascular disease — not sexual harassment or assault. They all had their blood pressure checked at study visits, as well as height and weight.\u003c/p>\n\u003cp>Among other questions, the survey asked the women if they had ever experienced sexual harassment at work. Participants were also asked if they had ever \"been made or pressured into having some type of unwanted sexual contact.\" The women were not asked when those events occurred.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Twenty-two percent reported a history of sexual assault, and 19 percent said they'd experienced workplace sexual harassment.\u003c/p>\n\u003cp>Though the sample size was small, the results are statistically significant. Women who had experienced sexual assault had on average an almost threefold increased risk of developing depressive symptoms, compared to women who hadn't. They also had a greater incidence of clinically significant anxiety.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>About 1 in 4 women who had been sexually assaulted met criteria for depression, while approximately 1 in 10 who had not were depressed.\u003c/p>\n\u003cp>Those who experienced sexual harassment at work had a twofold increased risk compared to women who hadn't of developing high blood pressure. Poor sleep was more common, too.\u003c/p>\n\u003cp>\"These [traumatic experiences] are clearly critical things that happen to people early on, that have these really long-lasting effects,\" says \u003ca href=\"https://directory.sph.umn.edu/bio/sph-a-z/susan-mason\" target=\"_blank\" rel=\"noopener\">Susan Mason\u003c/a>, an assistant professor of epidemiology at the University of Minnesota who studies the effects of trauma. \"These really shape people's life trajectories.\"\u003c/p>\n\u003cp>Mason was not involved in this study, but says the findings dovetail with other research on the relationship between trauma and physical or mental health later in life. Intimate partner violence, for example, has been associated with the development of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23248189\" target=\"_blank\" rel=\"noopener\">diabetes\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22717307\" target=\"_blank\" rel=\"noopener\">high blood pressure\u003c/a>.\u003c/p>\n\u003cp>Wednesday's study is particularly noteworthy, Mason says, because it includes clinical data — in-office blood pressure checks, for example, and validated diagnostic tools for depression and anxiety — rather than depending exclusively on self-reported diagnoses.\u003c/p>\n\u003cp>Clinicians don't have the ability to corroborate women's memories of sexual assault or harassment, however. Thurston points to literature on the way traumatic memories are processed that demonstrates that discrete events like a sexual assault often remain vivid in a way other memories don't. This is why, she says, she trusts the study participants who say they've been through these experiences.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If the patient thinks it's important, it's important,\" says Dr. Valerie Gilchrist, chair of the department of family medicine at the University of Wisconsin who has written about screening for sexual violence in primary care.\u003c/p>\n\u003cp>She recommends that clinicians ask patients if they've experienced sexual assault, particularly patients who are experiencing significant stress or have difficulty with pelvic exams. Authors note that sexual assault and harassment seemed to be less common in this group of women than in national estimates.\u003c/p>\n\u003cp>The prevalence in their cohort was significantly lower than a \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm\" target=\"_blank\" rel=\"noopener\">2014 estimate from the Centers for Disease Control and Prevention\u003c/a>, which found that 19 percent of American women had been raped, and almost 44 percent had experienced another form of sexual violence.\u003c/p>\n\u003cp>Thurston thinks this is because the study excluded a fair number of women for reasons related to its original intent of researching menopause and cardiovascular disease. Women taking medications for depression were not included, for example, as well as those with serious medical problems.\u003c/p>\n\u003cp>\"Sexual assault and sexual abuse are much more common than people think,\" Thurston says. These are \"key toxic stressors for women.\"\u003c/p>\n\u003cp>While researchers weren't surprised that sexual assault and harassment seemed to be related to the development of mood disorders and poor sleep, they were impressed by the strength of the association.\u003c/p>\n\u003cp>\"These should be urgent public health priorities,\" Mason says. \"How do we address the fundamental ways that our social structure affects health?\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Sexual+Assault+And+Harassment+May+Have+Lasting+Health+Repercussions+For+Women&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.[contextly_sidebar id=\"KMLJnak6yPOdRS3TfVoiDTc6a7Cm51Xf\"]\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.[contextly_sidebar id=\"Kw9tNYwAAP3TxDDlzs24FDdim0qufSVP\"]\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)[contextly_sidebar id=\"XHhLlvPBCoPTlN54jyme2G0wpse1GITN\"]\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.[contextly_sidebar id=\"KGoxoWR6m8MUKnLishPvyacpod0HWpt7\"]\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.[contextly_sidebar id=\"8bFNH4xsL9O8lTSDRHnxnqtYwxOF2Z5k\"]\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Think You Don't Need A Flu Shot? Here Are 5 Reasons To Change Your Mind",
"title": "Think You Don't Need A Flu Shot? Here Are 5 Reasons To Change Your Mind",
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"content": "\u003cp>There are a lot of misconceptions out there about the flu shot.\u003c/p>\n\u003cp>But following a winter in which more than 80,000 people died from flu-related illnesses in the U.S. — the highest death toll in more than 40 years — infectious disease experts are ramping up efforts to get the word out.[contextly_sidebar id=\"d8sAsPjwUq9P6K71Bm4vRaAmUWmUHYSs\"]\u003c/p>\n\u003cp>\"Flu vaccinations save lives,\" Surgeon General Jerome Adams told the crowd at an event to kick off flu vaccine awareness last week at the National Press Club in Washington, D.C. \"That's why it's so important for everyone 6 months and older to get a flu vaccine every year.\"\u003c/p>\n\u003cp>But many Americans ignore this advice. The U.S. \u003ca href=\"https://www.cdc.gov/flu/fluvaxview/reportshtml/trends/index.html\">vaccination rate\u003c/a> hovers at about 47 percent a year. This is far below the \u003ca href=\"https://www.healthypeople.gov/sites/default/files/HP2020_IID_and_GH_Progress_Review_Slides.pdf\">70 percent target\u003c/a>. And college students are among the least vaccinated.\u003c/p>\n\u003cp>\"We have long known that college students are at a particularly high risk of getting and spreading flu viruses,\" says \u003ca href=\"https://weillcornell.org/lisaipp\">Lisa Ipp\u003c/a>, an adolescent medicine specialist at Weill Cornell Medicine. \"Yet, on U.S. college campuses, flu vaccination rates remain strikingly low,\" \u003ca href=\"https://nfid.wordpress.com/2017/12/06/why-arent-college-students-getting-flu-shots/\">she writes in a 2017 post\u003c/a> published by the National Foundation for Infectious Disease. The group sponsored a \u003ca href=\"http://www.nfid.org/publications/reports/college-flu-summit-report.pdf\">survey\u003c/a> of college students and found that only between 8 and 39 percent of students get the vaccine.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So why aren't people getting the vaccine? The college survey data point to a mix of misperception and fear.[contextly_sidebar id=\"1GYhiWSWE3AU14flVCzzeer5d84YkhaR\"]\u003c/p>\n\u003cp>For instance, among students who don't get the vaccine, 36 percent say that they are healthy and don't need it, and 30 percent say they don't think the vaccine is effective. Then, there's the fear: 31 percent say they don't like needles.\u003c/p>\n\u003cp>So, let's do a reality check. If you're on the fence about a flu shot, here are five arguments to twist your arm.\u003c/p>\n\u003cp>\u003cstrong>1. You are vulnerable.\u003c/strong>\u003c/p>\n\u003cp>People 65 and older are at higher risk of flu-related complications, but the flu can knock young, healthy people off their feet, too. It does every year.\u003c/p>\n\u003cp>\"The flu can, on occasion, take a young, healthy person and put them in the intensive care unit,\" says \u003ca href=\"http://www.nfid.org/newsroom/press-releases/2015-press-releases/nfid-selects-william-schaffner-as-new-medical-director.pdf\">William Schaffner\u003c/a>, medical director at the NFID.\u003c/p>\n\u003cp>And, even when it's not that severe, it's still bad. \"If you get the flu, you're [down] for the count for about a week,\" Ipp tells her college-age patients.\u003c/p>\n\u003cp>Here's a sobering thought: Healthy children die from flu, too. According to the CDC, \u003ca href=\"https://www.cdc.gov/flu/spotlights/reported-flu-children-deaths.htm\">172 American children and teens\u003c/a> (under the age of 18) died from the flu last winter. Eighty percent of them had not received a flu vaccine. And about half had no underlying illnesses before getting the flu. In other words, they'd been healthy children.[contextly_sidebar id=\"uR6a8xg4qkSfioEgDzzDZvzsgwhTq8sS\"]\u003c/p>\n\u003cp>And there's this: The flu doesn't just make you feel lousy. It can \u003ca href=\"https://www.npr.org/sections/health-shots/2018/01/24/579997381/aw-seriously-the-flu-can-trigger-a-heart-attack-too\">increase the risk of having a heart attack\u003c/a>, according to a study published this year.\u003c/p>\n\u003cp>\u003cstrong>2. Getting a flu shot is your civic duty.\u003c/strong>\u003c/p>\n\u003cp>\"Nobody wants to be the dreaded spreader,\" says Schaffner. But everybody gets the flu from somebody else. According to the Centers for Disease Control and Prevention, people who have caught the flu virus are contagious one day before they start to feel sick and for up to seven days after. (Check out our \u003ca href=\"https://www.npr.org/sections/health-shots/2018/02/20/585143079/how-long-are-you-contagious-with-the-flu\">video on flu contagion \u003c/a>if you really need to be convinced!)\u003c/p>\n\u003cp>So getting the flu shot will help protect your family, friends and co-workers. \"It's the socially correct thing to do,\" Schaffner says.\u003c/p>\n\u003cp>\u003cstrong>3. You can still get the flu, but you won't be as sick.\u003c/strong>\u003c/p>\n\u003cp>After last winter's severe season, some people are skeptical. They say: \"I got the flu shot, but I still caught the flu.\"\u003c/p>\n\u003cp>In fact, the 2017-18 season was the deadliest in more than 40 years. \"We had a very vicious virus, the so-called H3N2 influenza strain,\" says Schaffner.[contextly_sidebar id=\"TFcjOHNAbBl7nUaIFKyNSb1xwI4w06NI\"]\u003c/p>\n\u003cp>And yes, it's true that the vaccine does not offer complete protection. The CDC estimates that flu vaccination \u003ca href=\"https://www.cdc.gov/flu/about/qa/vaccineeffect.htm\">reduces the risk of the virus\u003c/a> by about 40 to 60 percent. Think of it this way: If you catch the flu, the vaccine does still offer some protection. It cushions the blow. \"Your illness is likely to be milder\" if you've had a flu shot, says Schaffner. You're less likely to get pneumonia, which is a major complication of the flu, and less likely to be hospitalized.\u003c/p>\n\u003cp>\u003cstrong>4. Pregnant women who get the flu shot protect their babies from flu.\u003c/strong>\u003c/p>\n\u003cp>Women who are pregnant should be vaccinated to protect themselves. The vaccine also offers protection after babies are born. \"[Women] can pass the protection on, across the placenta,\" Schaffner explains. And this will protect their baby during the first six months of life, until the baby is old enough to be vaccinated.\u003c/p>\n\u003cp>\u003cstrong>5. You\u003c/strong>\u003cem>\u003cstrong> cannot\u003c/strong>\u003c/em>\u003cstrong> get flu from the flu vaccine.\u003c/strong>\u003c/p>\n\u003cp>It's still a common misperception: the idea that you can get the flu from the flu shot.\u003c/p>\n\u003cp>The NFID-sponsored survey of college students found that close to 60 percent of students seem to think that the flu vaccine can cause flu. \"That's, of course, incorrect,\" says Schaffner.\u003c/p>\n\u003cp>The most common side effects are a sore arm, and perhaps a little swelling. \"A very small proportion of people, 1 to 2 percent, get a degree of fever,\" Schaffner says. That's not the flu, he explains. \"That's the body reacting to the vaccine.\"\u003c/p>\n\u003cp>Because the flu is unpredictable, it's too soon to know what to expect this winter. But Schaffner has this advice: Don't wait. \"The time to get vaccinated is right now,\" he says.\u003c/p>\n\u003cp>If that doesn't move you, maybe a little reward will. The survey data of college students found that incentives are a good idea. Think: free food, free entertainment or a gift card for a free coffee. Ipp found about 60 percent of students said these types of incentives would increase the likelihood of their getting the flu vaccine.\u003c/p>\n\u003cp>Another way to nudge people? Make it super convenient. On the campus of George Washington University, the medical director of the student health center has organized flu-clinic pop-ups in venues where students hang out, such as the library. \"We don't wait for them to come to us,\" \u003ca href=\"https://healthcenter.gwu.edu/isabel-goldenberg-md\">Isabel Goldenberg\u003c/a> told us\u003cem>.\u003c/em>\u003c/p>\n\u003cp>For workers in offices, flu clinics at the workplace can be an effective way to encourage vaccination, too.\u003c/p>\n\u003cp>What about the use of social media to motivate people? \"I've had the flu, which was horrible,\" Max Webb, a student at George Washington University, told me. He thinks if people shared their flu stories, it could help nudge people in their social networks to get the flu shot.\u003c/p>\n\u003cp>And what would you name this campaign, I asked Webb? \"Say boo to the flu,\" Web replied. Or simply, #boo2flu.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Kinda catchy.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Think+You+Don%27t+Need+A+Flu+Shot%3F+Here+Are+5+Reasons+To+Change+Your+Mind&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There are a lot of misconceptions out there about the flu shot.\u003c/p>\n\u003cp>But following a winter in which more than 80,000 people died from flu-related illnesses in the U.S. — the highest death toll in more than 40 years — infectious disease experts are ramping up efforts to get the word out.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Flu vaccinations save lives,\" Surgeon General Jerome Adams told the crowd at an event to kick off flu vaccine awareness last week at the National Press Club in Washington, D.C. \"That's why it's so important for everyone 6 months and older to get a flu vaccine every year.\"\u003c/p>\n\u003cp>But many Americans ignore this advice. The U.S. \u003ca href=\"https://www.cdc.gov/flu/fluvaxview/reportshtml/trends/index.html\">vaccination rate\u003c/a> hovers at about 47 percent a year. This is far below the \u003ca href=\"https://www.healthypeople.gov/sites/default/files/HP2020_IID_and_GH_Progress_Review_Slides.pdf\">70 percent target\u003c/a>. And college students are among the least vaccinated.\u003c/p>\n\u003cp>\"We have long known that college students are at a particularly high risk of getting and spreading flu viruses,\" says \u003ca href=\"https://weillcornell.org/lisaipp\">Lisa Ipp\u003c/a>, an adolescent medicine specialist at Weill Cornell Medicine. \"Yet, on U.S. college campuses, flu vaccination rates remain strikingly low,\" \u003ca href=\"https://nfid.wordpress.com/2017/12/06/why-arent-college-students-getting-flu-shots/\">she writes in a 2017 post\u003c/a> published by the National Foundation for Infectious Disease. The group sponsored a \u003ca href=\"http://www.nfid.org/publications/reports/college-flu-summit-report.pdf\">survey\u003c/a> of college students and found that only between 8 and 39 percent of students get the vaccine.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So why aren't people getting the vaccine? The college survey data point to a mix of misperception and fear.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>For instance, among students who don't get the vaccine, 36 percent say that they are healthy and don't need it, and 30 percent say they don't think the vaccine is effective. Then, there's the fear: 31 percent say they don't like needles.\u003c/p>\n\u003cp>So, let's do a reality check. If you're on the fence about a flu shot, here are five arguments to twist your arm.\u003c/p>\n\u003cp>\u003cstrong>1. You are vulnerable.\u003c/strong>\u003c/p>\n\u003cp>People 65 and older are at higher risk of flu-related complications, but the flu can knock young, healthy people off their feet, too. It does every year.\u003c/p>\n\u003cp>\"The flu can, on occasion, take a young, healthy person and put them in the intensive care unit,\" says \u003ca href=\"http://www.nfid.org/newsroom/press-releases/2015-press-releases/nfid-selects-william-schaffner-as-new-medical-director.pdf\">William Schaffner\u003c/a>, medical director at the NFID.\u003c/p>\n\u003cp>And, even when it's not that severe, it's still bad. \"If you get the flu, you're [down] for the count for about a week,\" Ipp tells her college-age patients.\u003c/p>\n\u003cp>Here's a sobering thought: Healthy children die from flu, too. According to the CDC, \u003ca href=\"https://www.cdc.gov/flu/spotlights/reported-flu-children-deaths.htm\">172 American children and teens\u003c/a> (under the age of 18) died from the flu last winter. Eighty percent of them had not received a flu vaccine. And about half had no underlying illnesses before getting the flu. In other words, they'd been healthy children.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And there's this: The flu doesn't just make you feel lousy. It can \u003ca href=\"https://www.npr.org/sections/health-shots/2018/01/24/579997381/aw-seriously-the-flu-can-trigger-a-heart-attack-too\">increase the risk of having a heart attack\u003c/a>, according to a study published this year.\u003c/p>\n\u003cp>\u003cstrong>2. Getting a flu shot is your civic duty.\u003c/strong>\u003c/p>\n\u003cp>\"Nobody wants to be the dreaded spreader,\" says Schaffner. But everybody gets the flu from somebody else. According to the Centers for Disease Control and Prevention, people who have caught the flu virus are contagious one day before they start to feel sick and for up to seven days after. (Check out our \u003ca href=\"https://www.npr.org/sections/health-shots/2018/02/20/585143079/how-long-are-you-contagious-with-the-flu\">video on flu contagion \u003c/a>if you really need to be convinced!)\u003c/p>\n\u003cp>So getting the flu shot will help protect your family, friends and co-workers. \"It's the socially correct thing to do,\" Schaffner says.\u003c/p>\n\u003cp>\u003cstrong>3. You can still get the flu, but you won't be as sick.\u003c/strong>\u003c/p>\n\u003cp>After last winter's severe season, some people are skeptical. They say: \"I got the flu shot, but I still caught the flu.\"\u003c/p>\n\u003cp>In fact, the 2017-18 season was the deadliest in more than 40 years. \"We had a very vicious virus, the so-called H3N2 influenza strain,\" says Schaffner.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And yes, it's true that the vaccine does not offer complete protection. The CDC estimates that flu vaccination \u003ca href=\"https://www.cdc.gov/flu/about/qa/vaccineeffect.htm\">reduces the risk of the virus\u003c/a> by about 40 to 60 percent. Think of it this way: If you catch the flu, the vaccine does still offer some protection. It cushions the blow. \"Your illness is likely to be milder\" if you've had a flu shot, says Schaffner. You're less likely to get pneumonia, which is a major complication of the flu, and less likely to be hospitalized.\u003c/p>\n\u003cp>\u003cstrong>4. Pregnant women who get the flu shot protect their babies from flu.\u003c/strong>\u003c/p>\n\u003cp>Women who are pregnant should be vaccinated to protect themselves. The vaccine also offers protection after babies are born. \"[Women] can pass the protection on, across the placenta,\" Schaffner explains. And this will protect their baby during the first six months of life, until the baby is old enough to be vaccinated.\u003c/p>\n\u003cp>\u003cstrong>5. You\u003c/strong>\u003cem>\u003cstrong> cannot\u003c/strong>\u003c/em>\u003cstrong> get flu from the flu vaccine.\u003c/strong>\u003c/p>\n\u003cp>It's still a common misperception: the idea that you can get the flu from the flu shot.\u003c/p>\n\u003cp>The NFID-sponsored survey of college students found that close to 60 percent of students seem to think that the flu vaccine can cause flu. \"That's, of course, incorrect,\" says Schaffner.\u003c/p>\n\u003cp>The most common side effects are a sore arm, and perhaps a little swelling. \"A very small proportion of people, 1 to 2 percent, get a degree of fever,\" Schaffner says. That's not the flu, he explains. \"That's the body reacting to the vaccine.\"\u003c/p>\n\u003cp>Because the flu is unpredictable, it's too soon to know what to expect this winter. But Schaffner has this advice: Don't wait. \"The time to get vaccinated is right now,\" he says.\u003c/p>\n\u003cp>If that doesn't move you, maybe a little reward will. The survey data of college students found that incentives are a good idea. Think: free food, free entertainment or a gift card for a free coffee. Ipp found about 60 percent of students said these types of incentives would increase the likelihood of their getting the flu vaccine.\u003c/p>\n\u003cp>Another way to nudge people? Make it super convenient. On the campus of George Washington University, the medical director of the student health center has organized flu-clinic pop-ups in venues where students hang out, such as the library. \"We don't wait for them to come to us,\" \u003ca href=\"https://healthcenter.gwu.edu/isabel-goldenberg-md\">Isabel Goldenberg\u003c/a> told us\u003cem>.\u003c/em>\u003c/p>\n\u003cp>For workers in offices, flu clinics at the workplace can be an effective way to encourage vaccination, too.\u003c/p>\n\u003cp>What about the use of social media to motivate people? \"I've had the flu, which was horrible,\" Max Webb, a student at George Washington University, told me. He thinks if people shared their flu stories, it could help nudge people in their social networks to get the flu shot.\u003c/p>\n\u003cp>And what would you name this campaign, I asked Webb? \"Say boo to the flu,\" Web replied. Or simply, #boo2flu.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kinda catchy.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Think+You+Don%27t+Need+A+Flu+Shot%3F+Here+Are+5+Reasons+To+Change+Your+Mind&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Rare Case, Patient Developed Resistance to CAR-T and Died",
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"content": "\u003cp class=\"danger-zone\">To make CAR-T therapies, the pioneering cancer treatments, scientists introduce a gene into the body’s immune cells that \u003ca href=\"https://www.statnews.com/2016/12/06/cancer-car-t-factory/\" target=\"_blank\" rel=\"noopener\">turns them into cancer-homing attackers\u003c/a>. But in one case described by scientists Monday, the gene was inadvertently delivered to a cancer cell instead, camouflaging it from the therapy and allowing the cancer to develop resistance to treatment.[contextly_sidebar id=\"2oDy3tMb8Wl0Nea5cfkgpFgdjClpiQ4V\"]\u003c/p>\n\u003cp class=\"danger-zone\">The patient ultimately died.\u003c/p>\n\u003cp class=\"danger-zone\">The case, \u003ca href=\"https://www.nature.com/articles/s41591-018-0201-9\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> in the journal Nature Medicine, appears to have been exceedingly rare — one occurrence among \u003ca href=\"https://www.statnews.com/2018/07/17/car-t-bottleneck-cell-collection-centers-feel-crunch/\" target=\"_blank\" rel=\"noopener\">the hundreds of cases\u003c/a> of CAR-T treatment that have been examined.\u003c/p>\n\u003cp class=\"\">But as the treatments become more widely used, experts say, the case also points to the importance of researchers understanding all the ways in which \u003ca href=\"https://www.statnews.com/2017/10/27/car-t-kite-cell-journey/\" rel=\"noopener\">the process of making them\u003c/a> can go wrong.\u003c/p>\n\u003cp class=\"\">“We’re going to need papers like this one” to identify how cancers can become resistant to CAR-Ts, said Dr. \u003ca href=\"https://faculty.mdanderson.org/profiles/jason_westin.html\" target=\"_blank\" rel=\"noopener\">Jason Westin\u003c/a>, who leads the aggressive lymphoma team at MD Anderson Cancer Center and who was not involved in the new report. “But this CAR-T data is one of the most exciting things we’ve seen in cancer in forever. Having rare theoretical things that actually happen is concerning, but it should in no way temper the potential for the future of CAR-T cells.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study’s authors have discussed the case, which occurred about five years ago, at scientific meetings, helping to spread awareness. And the process of manufacturing CAR-Ts has improved over that time, reducing the chance that a cancer cell inadvertently receives the gene meant for immune cells.[contextly_sidebar id=\"sNFqnG5MPMrhzsMuBzMQ3TNcRwq8tXmr\"]\u003c/p>\n\u003cp>“We’re getting much better at getting a purer starting population” of immune cells, said \u003ca href=\"https://www.med.upenn.edu/apps/faculty/index.php/g20001883/p8587263\" target=\"_blank\" rel=\"noopener\">Jos Melenhorst\u003c/a>, an immunology expert at the University of Pennsylvania and one of the authors of the report.\u003c/p>\n\u003cp>The subject of the newly described case was a 20-year-old man with B cell acute lymphoblastic leukemia. He was participating in a Phase 1 clinical trial for a CAR-T product then called CTL019, which \u003ca href=\"https://www.pennmedicine.org/news/news-releases/2017/august/fda-approves-personalized-cellular-therapy-for-advanced-leukemia\" target=\"_blank\" rel=\"noopener\">was developed\u003c/a> by researchers at Penn and Children’s Hospital of Philadelphia.\u003c/p>\n\u003cp>As with any CAR-T patient, the man had immune cells called T cells scooped out from his blood through a process called apheresis. Then, those cells were supercharged with a gene that codes for a receptor (the CAR in CAR-T) that turns the cells into bloodhounds on the scent for a specific marker on cancer cells — in this case, a protein called CD19.\u003c/p>\n\u003cp>The patient was infused with a phalanx of the killer T cells, which then swarmed and annihilated the cancer cells. Within a month, his cancer seemed to be in complete remission, Melenhorst said.\u003c/p>\n\u003cp>But as researchers tracked the patient, they noticed something odd. They kept seeing signs of CAR-marked cells, but it wasn’t the body’s T cells expressing CAR anymore.\u003c/p>\n\u003cp>They ran a battery of experiments and confirmed their suspicions: a leukemic B cell had gotten lumped together with the T cells during the manufacturing process and had also taken up the CAR gene. As a result, the leukemia cell was expressing the CAR, which then attached to the CD19 markers, effectively shielding it from the CD19-sniffing machinery of the boosted T cells. It was as if in a game of musical chairs the targeted seat was already filled by the time the music stopped.[contextly_sidebar id=\"nOqcMe5IVLJeCcUCHhq3Pk58784HwGoF\"]\u003c/p>\n\u003cp>“The CAR-T cell couldn’t bind to the CD19 molecule, and thereby it was essentially hiding in plain sight,” Melenhorst said.\u003c/p>\n\u003cp>As the T cells attacked the rest of the leukemia cells, this cell laid low for the most part, slowly proliferating into more resistant cancer cells over time. After about nine months, the patient’s cancer — now resistant to CAR-T — had fully returned. He ultimately died from complications from his leukemia.\u003c/p>\n\u003cp>Melenhorst noted that the case reaches back to the early days of clinical CAR-T use and that improvements in technology since then have allowed manufacturers to ensure that the cells into which they are introducing the CAR gene are less likely to include B cells.\u003c/p>\n\u003cp>A version of the treatment the patient received was \u003ca href=\"https://www.statnews.com/2017/08/30/novartis-car-t-cancer-approved/\" rel=\"noopener\">ultimately approved\u003c/a> as Novartis’s Kymriah in 2017; the paper published Monday includes some authors from Novartis Institutes for BioMedical Research. In a statement, Novartis noted that the manufacturing process used in the case described in the paper was done at Penn and differs from the company’s manufacturing process, which was used in later clinical trials and now for commercial use.\u003c/p>\n\u003cp>“We are not aware of any cases of this happening in the more than 400 patients treated with CTL019/Kymriah manufactured by Novartis for clinical trials or the commercial setting,” the statement said.[contextly_sidebar id=\"DMUx1aVKuHIZSHJYTfdQfqpmBWfT4XxH\"]\u003c/p>\n\u003cp>The company said it has checks throughout the process to clear out B cells and that it is following Kymriah patients for 15 years.\u003c/p>\n\u003cp>“Novartis is continually making improvements to our Kymriah manufacturing process to reduce variability and safely deliver this transformational, personalized treatment to patients in need around the world,” the statement said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/01/car-t-resistance-cancer-cell-hiding/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">To make CAR-T therapies, the pioneering cancer treatments, scientists introduce a gene into the body’s immune cells that \u003ca href=\"https://www.statnews.com/2016/12/06/cancer-car-t-factory/\" target=\"_blank\" rel=\"noopener\">turns them into cancer-homing attackers\u003c/a>. But in one case described by scientists Monday, the gene was inadvertently delivered to a cancer cell instead, camouflaging it from the therapy and allowing the cancer to develop resistance to treatment.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">The patient ultimately died.\u003c/p>\n\u003cp class=\"danger-zone\">The case, \u003ca href=\"https://www.nature.com/articles/s41591-018-0201-9\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> in the journal Nature Medicine, appears to have been exceedingly rare — one occurrence among \u003ca href=\"https://www.statnews.com/2018/07/17/car-t-bottleneck-cell-collection-centers-feel-crunch/\" target=\"_blank\" rel=\"noopener\">the hundreds of cases\u003c/a> of CAR-T treatment that have been examined.\u003c/p>\n\u003cp class=\"\">But as the treatments become more widely used, experts say, the case also points to the importance of researchers understanding all the ways in which \u003ca href=\"https://www.statnews.com/2017/10/27/car-t-kite-cell-journey/\" rel=\"noopener\">the process of making them\u003c/a> can go wrong.\u003c/p>\n\u003cp class=\"\">“We’re going to need papers like this one” to identify how cancers can become resistant to CAR-Ts, said Dr. \u003ca href=\"https://faculty.mdanderson.org/profiles/jason_westin.html\" target=\"_blank\" rel=\"noopener\">Jason Westin\u003c/a>, who leads the aggressive lymphoma team at MD Anderson Cancer Center and who was not involved in the new report. “But this CAR-T data is one of the most exciting things we’ve seen in cancer in forever. Having rare theoretical things that actually happen is concerning, but it should in no way temper the potential for the future of CAR-T cells.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study’s authors have discussed the case, which occurred about five years ago, at scientific meetings, helping to spread awareness. And the process of manufacturing CAR-Ts has improved over that time, reducing the chance that a cancer cell inadvertently receives the gene meant for immune cells.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“We’re getting much better at getting a purer starting population” of immune cells, said \u003ca href=\"https://www.med.upenn.edu/apps/faculty/index.php/g20001883/p8587263\" target=\"_blank\" rel=\"noopener\">Jos Melenhorst\u003c/a>, an immunology expert at the University of Pennsylvania and one of the authors of the report.\u003c/p>\n\u003cp>The subject of the newly described case was a 20-year-old man with B cell acute lymphoblastic leukemia. He was participating in a Phase 1 clinical trial for a CAR-T product then called CTL019, which \u003ca href=\"https://www.pennmedicine.org/news/news-releases/2017/august/fda-approves-personalized-cellular-therapy-for-advanced-leukemia\" target=\"_blank\" rel=\"noopener\">was developed\u003c/a> by researchers at Penn and Children’s Hospital of Philadelphia.\u003c/p>\n\u003cp>As with any CAR-T patient, the man had immune cells called T cells scooped out from his blood through a process called apheresis. Then, those cells were supercharged with a gene that codes for a receptor (the CAR in CAR-T) that turns the cells into bloodhounds on the scent for a specific marker on cancer cells — in this case, a protein called CD19.\u003c/p>\n\u003cp>The patient was infused with a phalanx of the killer T cells, which then swarmed and annihilated the cancer cells. Within a month, his cancer seemed to be in complete remission, Melenhorst said.\u003c/p>\n\u003cp>But as researchers tracked the patient, they noticed something odd. They kept seeing signs of CAR-marked cells, but it wasn’t the body’s T cells expressing CAR anymore.\u003c/p>\n\u003cp>They ran a battery of experiments and confirmed their suspicions: a leukemic B cell had gotten lumped together with the T cells during the manufacturing process and had also taken up the CAR gene. As a result, the leukemia cell was expressing the CAR, which then attached to the CD19 markers, effectively shielding it from the CD19-sniffing machinery of the boosted T cells. It was as if in a game of musical chairs the targeted seat was already filled by the time the music stopped.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“The CAR-T cell couldn’t bind to the CD19 molecule, and thereby it was essentially hiding in plain sight,” Melenhorst said.\u003c/p>\n\u003cp>As the T cells attacked the rest of the leukemia cells, this cell laid low for the most part, slowly proliferating into more resistant cancer cells over time. After about nine months, the patient’s cancer — now resistant to CAR-T — had fully returned. He ultimately died from complications from his leukemia.\u003c/p>\n\u003cp>Melenhorst noted that the case reaches back to the early days of clinical CAR-T use and that improvements in technology since then have allowed manufacturers to ensure that the cells into which they are introducing the CAR gene are less likely to include B cells.\u003c/p>\n\u003cp>A version of the treatment the patient received was \u003ca href=\"https://www.statnews.com/2017/08/30/novartis-car-t-cancer-approved/\" rel=\"noopener\">ultimately approved\u003c/a> as Novartis’s Kymriah in 2017; the paper published Monday includes some authors from Novartis Institutes for BioMedical Research. In a statement, Novartis noted that the manufacturing process used in the case described in the paper was done at Penn and differs from the company’s manufacturing process, which was used in later clinical trials and now for commercial use.\u003c/p>\n\u003cp>“We are not aware of any cases of this happening in the more than 400 patients treated with CTL019/Kymriah manufactured by Novartis for clinical trials or the commercial setting,” the statement said.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The company said it has checks throughout the process to clear out B cells and that it is following Kymriah patients for 15 years.\u003c/p>\n\u003cp>“Novartis is continually making improvements to our Kymriah manufacturing process to reduce variability and safely deliver this transformational, personalized treatment to patients in need around the world,” the statement said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/01/car-t-resistance-cancer-cell-hiding/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In her testimony to a Senate committee, the woman who accused Brett Kavanaugh of sexually assaulting her when they were teenagers dipped briefly into the mechanics of memory. Experts say she got it pretty much right.[contextly_sidebar id=\"MgBzvQhdBHjEstqurrr3K1yckpneYUdI\"]\u003c/p>\n\u003cp>When asked Thursday how she could be sure it was Kavanaugh who put a hand over her mouth to keep her quiet, psychologist Christine Blasey Ford cited levels of chemical messengers called norepinephrine and epinephrine in her brain at the time of the alleged attack.\u003c/p>\n\u003cp>She said those chemicals helped encode memories in a brain region called the hippocampus, so that the main memory was “locked there” while other details “kind of drift.”\u003c/p>\n\u003cp>Later, she said a memory of Kavanaugh and another teen laughing during the assault was “indelible in the hippocampus.”\u003c/p>\n\u003cp>Memories are not highly detailed recordings of events retrieved with perfect accuracy. They are shaped by beliefs and expectations. For that reason, experts told The Associated Press last week that both Ford and Kavanaugh, who denies that any assault happened, may both firmly believe what they say.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Which one believes his or her version more strongly is no tipoff to what really happened, experts say.\u003c/p>\n\u003cp>“Confidence is not a good guide to whether or not someone is telling the truth,” said Nora Newcombe, a psychology professor at Temple University in Philadelphia. “If they think they’re telling the truth, they could plausibly both be confident about it.”[contextly_sidebar id=\"amJ6lQEUSDSPlTWgnGoBA7CSFAZGM5RJ\"]\u003c/p>\n\u003cp>In a situation where a woman fears being raped by a man, her memories might be shaped by that fear into a recollection that overestimates the threat, whereas the man might consider it “just playing around” and forget it, said David Rubin, a professor of psychology and neuroscience at Duke University.\u003c/p>\n\u003cp>And both people could be completely honest about their recollections, he said.\u003c/p>\n\u003cp>Rubin noted the obvious fact that people can forget things they did while drunk. But he said the man in that scenario could forget about the event even if he had been sober.\u003c/p>\n\u003cp>Experts in memory and the brain said Ford’s quick tour of memory machinery was generally correct. Levels of the brain substances she cited go up when a person is alarmed, and they help memories become laid down more strongly in the hippocampus, said Elizabeth Phelps, a Harvard University psychologist.\u003c/p>\n\u003cp>That helps people vividly recall central parts of an emotional experience, while details are typically lost, said Lila Davachi of Columbia University.\u003c/p>\n\u003cp>While it’s clear the hippocampus is key to the initial laying down of memory, there’s some debate about its role in long-term memory, Phelps said. Various pieces of an experience — sounds, sights and thoughts — are perceived in different parts of the brain. And initially the hippocampus serves as sort of the center of a web that holds those perceptions together as a memory, she said.\u003c/p>\n\u003cp>After years pass and the memory becomes consolidated, it’s not clear whether the hippocampus continues to play that central role, or whether the various parts of a memory are connected by other means, she said.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Associated Press Health & Science Department receives \u003ca href=\"http://bit.ly/2G0n9w6\" target=\"_blank\" rel=\"noopener\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In her testimony to a Senate committee, the woman who accused Brett Kavanaugh of sexually assaulting her when they were teenagers dipped briefly into the mechanics of memory. Experts say she got it pretty much right.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>When asked Thursday how she could be sure it was Kavanaugh who put a hand over her mouth to keep her quiet, psychologist Christine Blasey Ford cited levels of chemical messengers called norepinephrine and epinephrine in her brain at the time of the alleged attack.\u003c/p>\n\u003cp>She said those chemicals helped encode memories in a brain region called the hippocampus, so that the main memory was “locked there” while other details “kind of drift.”\u003c/p>\n\u003cp>Later, she said a memory of Kavanaugh and another teen laughing during the assault was “indelible in the hippocampus.”\u003c/p>\n\u003cp>Memories are not highly detailed recordings of events retrieved with perfect accuracy. They are shaped by beliefs and expectations. For that reason, experts told The Associated Press last week that both Ford and Kavanaugh, who denies that any assault happened, may both firmly believe what they say.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Which one believes his or her version more strongly is no tipoff to what really happened, experts say.\u003c/p>\n\u003cp>“Confidence is not a good guide to whether or not someone is telling the truth,” said Nora Newcombe, a psychology professor at Temple University in Philadelphia. “If they think they’re telling the truth, they could plausibly both be confident about it.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In a situation where a woman fears being raped by a man, her memories might be shaped by that fear into a recollection that overestimates the threat, whereas the man might consider it “just playing around” and forget it, said David Rubin, a professor of psychology and neuroscience at Duke University.\u003c/p>\n\u003cp>And both people could be completely honest about their recollections, he said.\u003c/p>\n\u003cp>Rubin noted the obvious fact that people can forget things they did while drunk. But he said the man in that scenario could forget about the event even if he had been sober.\u003c/p>\n\u003cp>Experts in memory and the brain said Ford’s quick tour of memory machinery was generally correct. Levels of the brain substances she cited go up when a person is alarmed, and they help memories become laid down more strongly in the hippocampus, said Elizabeth Phelps, a Harvard University psychologist.\u003c/p>\n\u003cp>That helps people vividly recall central parts of an emotional experience, while details are typically lost, said Lila Davachi of Columbia University.\u003c/p>\n\u003cp>While it’s clear the hippocampus is key to the initial laying down of memory, there’s some debate about its role in long-term memory, Phelps said. Various pieces of an experience — sounds, sights and thoughts — are perceived in different parts of the brain. And initially the hippocampus serves as sort of the center of a web that holds those perceptions together as a memory, she said.\u003c/p>\n\u003cp>After years pass and the memory becomes consolidated, it’s not clear whether the hippocampus continues to play that central role, or whether the various parts of a memory are connected by other means, she said.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Associated Press Health & Science Department receives \u003ca href=\"http://bit.ly/2G0n9w6\" target=\"_blank\" rel=\"noopener\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Puppies Are Making People Sick — And it’s People’s Fault",
"title": "Puppies Are Making People Sick — And it’s People’s Fault",
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"content": "\u003cp>Antibiotic-resistant bacteria that have infected more than 100 people and that have been linked to pet store puppies appear to have spread at least in part because healthy dogs were given \u003ca href=\"https://www.statnews.com/2018/09/14/gottlieb-idea-antibiotic-resistance/\" target=\"_blank\" rel=\"noopener\">antibiotics \u003c/a>— a decision that all but surely fostered \u003ca href=\"https://www.statnews.com/2017/01/12/nevada-woman-superbug-resistant/\" target=\"_blank\" rel=\"noopener\">antibiotic resistance\u003c/a>.[contextly_sidebar id=\"HDE34Sd5YWLlXCnShh6EZNM8CydbBxW9\"]\u003c/p>\n\u003cp>“This is shocking,” said Lance Price, head of George Washington University’s Antibiotic Resistance Action Center. “This is an important study that’s shining a light on something that we need to spend more time on.”\u003c/p>\n\u003cp>More than half of the puppies in a sample of roughly 150 dogs studied as part of the outbreak investigation were given antibiotics not because they were sick, but to keep them from becoming so, according to a new \u003ca href=\"https://www.cdc.gov/mmwr/volumes/67/wr/mm6737a3.htm?s_cid=mm6737a3_w\" target=\"_blank\" rel=\"noopener\">study \u003c/a>published Thursday. The technique, called prophylaxis, has been widely used in food animal production and is blamed for fueling antibiotic resistance.\u003c/p>\n\u003cp>“We just have to change how we’re thinking about antibiotics,” warned \u003ca href=\"https://www.statnews.com/2018/03/19/antibiotics-food-animals-superbugs/\" target=\"_blank\" rel=\"noopener\">Matthew Wellington\u003c/a>, antibiotics program director for U.S. PIRG, the Public Interest Research Group.\u003c/p>\n\u003cp>The outbreak of the bacteria, Campylobacter jejuni, which causes diarrheal disease, started in early 2016 and continued until February of this year. People from 18 states fell ill, including 29 pet store employees. The investigation, which began in August of 2017, discovered that puppies were the source of the problem.\u003c/p>\n\u003cp>Thursday’s study was published in Morbidity and Mortality Weekly Report, a journal produced by the Centers for Disease Control and Prevention. It revealed how many antibiotics the dogs had been given as well as the results of testing done on bacterial samples — known as isolates — from 10 of the sick people and eight of the puppies to see which drugs might kill the bacteria.[contextly_sidebar id=\"q4wh1QIIYj2SgExEJSBT0dpA9hyykGIx\"]\u003c/p>\n\u003cp>“Outbreak isolates were resistant by antibiotic susceptibility testing to all antibiotics commonly used to treat Campylobacter infections,” the authors reported.\u003c/p>\n\u003cp>“This outbreak demonstrates that puppies can be a source of multidrug-resistant Campylobacter infections in humans, warranting a closer look at antimicrobial use in the commercial dog industry.”\u003c/p>\n\u003cp>The outbreak involved six pet store chains, but the problem likely is a broader one, the study showed. Officials in four states visited 20 pet stores and collected antibiotic administration records for about 150 puppies. Of those, 95 percent had received at least one course of drugs —\u003cbr>\nand many received more than one — before reaching the store or while at the store. Sixteen different types of antibiotics were used. And about half the treated dogs were not sick — they were given the drugs to prevent illness.\u003c/p>\n\u003cp>Senior author Mark Laughlin, a veterinarian with CDC’s division of foodborne, waterborne and environmental diseases, said investigators were taken aback by the scale of antibiotic use in the industry.\u003c/p>\n\u003cp>“We were surprised to see the large number of different types of drugs and the large number of courses that the dogs were exposed to. These are pretty young animals on the whole,” he told STAT.\u003c/p>\n\u003cp>Initially the CDC thought it might be able to trace the infections to a single source — one breeder or commercial breeding facility where the bacterium had spread. But as the investigators learned more about the byzantine world of the breeding and distribution of dogs sold in pet stores, it became clear there wasn’t a single source.\u003c/p>\n\u003cp>In effect, the system was creating the problem. “These dogs were coming from a large variety of sources,” Laughlin said.[contextly_sidebar id=\"y0nEJMe3DFJWuNjaVc0QYWLkG8UyuJYo\"]\u003c/p>\n\u003cp>Price wasn’t impressed. “If your system requires a constant or regular dose of antibiotics to keep the animals healthy, your system’s broken. You’ve designed a system that makes sick animals,” he said.\u003c/p>\n\u003cp>Wellington agreed. “Antibiotics should only be used to treat illness, not to compensate for poor practices — whether it’s trucking dogs long distances and having poor hygiene in the process along the way,” he said. “These are lifesaving medicines that should only be used to treat sick animals or sick people.”\u003c/p>\n\u003cp>Campylobacter jejuni is a common infection; the CDC estimates that about 1.3 million cases occur every year in the U.S. Fortunately most people recover without needing medical care.\u003c/p>\n\u003cp>Both Wellington and Price have been vocal critics of misuse of antibiotics in food animal production. But use of the drugs in the commercial dog industry wasn’t on their radar.\u003c/p>\n\u003cp>Price was startled by the report. “For me, this is an indication that they need to be raising these animals differently. They’re creating this terrible distribution system for multidrug-resistant bacteria,” he said.\u003c/p>\n\u003cp>The reality is that, although the outbreak appears to have ended, there could well be ongoing cases because the practices that led to puppies becoming infected with multidrug resistant drugs are still being used.\u003c/p>\n\u003cp>Laughlin said the CDC is working with veterinarian associations and the commercial dog industry, which he said was concerned and keen to make changes.\u003c/p>\n\u003cp>They must, Wellington insisted.\u003c/p>\n\u003cp>“This is one of the clearest examples I’ve seen where resistant bacteria are originating in animals from antibiotic overuse, and they’re passing directly to people and spreading rapidly,” he said. “So I think this is one of those situations where it’s incredibly clear that this is a problem we need to solve.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/09/20/antibiotics-resistant-bacteria-puppies-people/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Antibiotic-resistant bacteria that have infected more than 100 people and that have been linked to pet store puppies appear to have spread at least in part because healthy dogs were given \u003ca href=\"https://www.statnews.com/2018/09/14/gottlieb-idea-antibiotic-resistance/\" target=\"_blank\" rel=\"noopener\">antibiotics \u003c/a>— a decision that all but surely fostered \u003ca href=\"https://www.statnews.com/2017/01/12/nevada-woman-superbug-resistant/\" target=\"_blank\" rel=\"noopener\">antibiotic resistance\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“This is shocking,” said Lance Price, head of George Washington University’s Antibiotic Resistance Action Center. “This is an important study that’s shining a light on something that we need to spend more time on.”\u003c/p>\n\u003cp>More than half of the puppies in a sample of roughly 150 dogs studied as part of the outbreak investigation were given antibiotics not because they were sick, but to keep them from becoming so, according to a new \u003ca href=\"https://www.cdc.gov/mmwr/volumes/67/wr/mm6737a3.htm?s_cid=mm6737a3_w\" target=\"_blank\" rel=\"noopener\">study \u003c/a>published Thursday. The technique, called prophylaxis, has been widely used in food animal production and is blamed for fueling antibiotic resistance.\u003c/p>\n\u003cp>“We just have to change how we’re thinking about antibiotics,” warned \u003ca href=\"https://www.statnews.com/2018/03/19/antibiotics-food-animals-superbugs/\" target=\"_blank\" rel=\"noopener\">Matthew Wellington\u003c/a>, antibiotics program director for U.S. PIRG, the Public Interest Research Group.\u003c/p>\n\u003cp>The outbreak of the bacteria, Campylobacter jejuni, which causes diarrheal disease, started in early 2016 and continued until February of this year. People from 18 states fell ill, including 29 pet store employees. The investigation, which began in August of 2017, discovered that puppies were the source of the problem.\u003c/p>\n\u003cp>Thursday’s study was published in Morbidity and Mortality Weekly Report, a journal produced by the Centers for Disease Control and Prevention. It revealed how many antibiotics the dogs had been given as well as the results of testing done on bacterial samples — known as isolates — from 10 of the sick people and eight of the puppies to see which drugs might kill the bacteria.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Outbreak isolates were resistant by antibiotic susceptibility testing to all antibiotics commonly used to treat Campylobacter infections,” the authors reported.\u003c/p>\n\u003cp>“This outbreak demonstrates that puppies can be a source of multidrug-resistant Campylobacter infections in humans, warranting a closer look at antimicrobial use in the commercial dog industry.”\u003c/p>\n\u003cp>The outbreak involved six pet store chains, but the problem likely is a broader one, the study showed. Officials in four states visited 20 pet stores and collected antibiotic administration records for about 150 puppies. Of those, 95 percent had received at least one course of drugs —\u003cbr>\nand many received more than one — before reaching the store or while at the store. Sixteen different types of antibiotics were used. And about half the treated dogs were not sick — they were given the drugs to prevent illness.\u003c/p>\n\u003cp>Senior author Mark Laughlin, a veterinarian with CDC’s division of foodborne, waterborne and environmental diseases, said investigators were taken aback by the scale of antibiotic use in the industry.\u003c/p>\n\u003cp>“We were surprised to see the large number of different types of drugs and the large number of courses that the dogs were exposed to. These are pretty young animals on the whole,” he told STAT.\u003c/p>\n\u003cp>Initially the CDC thought it might be able to trace the infections to a single source — one breeder or commercial breeding facility where the bacterium had spread. But as the investigators learned more about the byzantine world of the breeding and distribution of dogs sold in pet stores, it became clear there wasn’t a single source.\u003c/p>\n\u003cp>In effect, the system was creating the problem. “These dogs were coming from a large variety of sources,” Laughlin said.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Price wasn’t impressed. “If your system requires a constant or regular dose of antibiotics to keep the animals healthy, your system’s broken. You’ve designed a system that makes sick animals,” he said.\u003c/p>\n\u003cp>Wellington agreed. “Antibiotics should only be used to treat illness, not to compensate for poor practices — whether it’s trucking dogs long distances and having poor hygiene in the process along the way,” he said. “These are lifesaving medicines that should only be used to treat sick animals or sick people.”\u003c/p>\n\u003cp>Campylobacter jejuni is a common infection; the CDC estimates that about 1.3 million cases occur every year in the U.S. Fortunately most people recover without needing medical care.\u003c/p>\n\u003cp>Both Wellington and Price have been vocal critics of misuse of antibiotics in food animal production. But use of the drugs in the commercial dog industry wasn’t on their radar.\u003c/p>\n\u003cp>Price was startled by the report. “For me, this is an indication that they need to be raising these animals differently. They’re creating this terrible distribution system for multidrug-resistant bacteria,” he said.\u003c/p>\n\u003cp>The reality is that, although the outbreak appears to have ended, there could well be ongoing cases because the practices that led to puppies becoming infected with multidrug resistant drugs are still being used.\u003c/p>\n\u003cp>Laughlin said the CDC is working with veterinarian associations and the commercial dog industry, which he said was concerned and keen to make changes.\u003c/p>\n\u003cp>They must, Wellington insisted.\u003c/p>\n\u003cp>“This is one of the clearest examples I’ve seen where resistant bacteria are originating in animals from antibiotic overuse, and they’re passing directly to people and spreading rapidly,” he said. “So I think this is one of those situations where it’s incredibly clear that this is a problem we need to solve.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/09/20/antibiotics-resistant-bacteria-puppies-people/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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},
"rightnowish": {
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"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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