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"content": "\u003cp>“We have solved the fake news problem on Wikipedia.”\u003c/p>\n\u003cp>That was the bold assertion from Canadian ER doc and university professor James Heilman, speaking to KQED News last week. Heilman puts in roughly 60 hours weekly editing medical entries on the colossal online encyclopedia. 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Was \u003ca href=\"https://www.google.com/search?q=fake+news&oq=fake+news\" target=\"_blank\">fake news\u003c/a> a factor in Trump's victory? We may never know, but a \u003ca href=\"https://www.buzzfeed.com/craigsilverman/viral-fake-election-news-outperformed-real-news-on-facebook?utm_term=.wkgkYg5z7#.kdEDER4l2\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">Buzzfeed analysis\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> found that the top-20 fake news stories received more Facebook shares, reactions and comments in the three months leading up to the election than the top-20 real news reports. A large majority of the phony stories overtly favored Trump.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>A New Age\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Not too long ago, the barriers to entry for disseminating written information on a mass scale included financial resources enough to pay for millions of dollars worth of reporters, editors, layout designers, press operators, printing equipment, delivery trucks and \u003ca href=\"http://wtvr.com/2016/11/18/when-was-the-last-time-you-saw-a-kid-with-a-paper-route/\" target=\"_blank\">tweens on bikes\u003c/a> with poor aim. Short of that, you're handing out pamphlets on a street corner.\u003c/p>\n\u003cp>But today, you can run your own mass communications operation with little more than computer, a WordPress account and a little savvy about Facebook algorithms. Whether it's done for clicks, tricks or kicks, fake news has become a \u003ca href=\"http://www.npr.org/sections/alltechconsidered/2016/11/23/503146770/npr-finds-the-head-of-a-covert-fake-news-operation-in-the-suburbs\" target=\"_blank\">profitable\u003c/a> cottage industry.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/FioreFakeNews.jpg\">\u003cimg class=\"aligncenter size-large wp-image-295313\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/FioreFakeNews-1020x1020.jpg\" alt=\"fiorefakenews\" width=\"640\" height=\"640\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-1020x1020.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-1180x1180.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-150x150.jpg 150w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wikipedia, being a site that actually \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">invites\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> members of the public to write their own content with no vetting of their qualifications to do so, would seem to be ripe for an onslaught of material laden with inaccuracy and bias.\u003c/span>\u003c/p>\n\u003cp>“We see people attempting to promote alternative medicine, we see people attempting to promote conventional medicine beyond the level of evidence that's available,” said Heilman, the medical editor.\u003c/p>\n\u003cp>But Wikipedia polices the creation of new entries and changes to existing pages with both machine and human interventions.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Pages are \"analyzed by smart bots that deal with a large majority of low-level vandalism and many copyright issues,” Heilman wrote in an email. The \u003c/span>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:New_pages_patrol\" target=\"_blank\">New Pages Patrol, \u003c/a>consisting of seasoned human editors who have made at least 500 uncontested edits to Wikipedia pages, reviews every freshly created page. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wikipedia requires contributors to justify every assertion of fact in an article, and it has blacklisted \u003ca href=\"https://en.wikipedia.org/wiki/MediaWiki_talk:Spam-blacklist#abcnews.com.co\" target=\"_blank\">certain sites\u003c/a> from being used as verification this way. Wikipedians can also put individual pages on watch lists, which will trigger notifications any time an edit is made. For example, the \u003c/span>\u003ca href=\"https://en.wikipedia.org/wiki/HIV/AIDS\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">HIV/AIDS page \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">is currently monitored by almost a thousand editors, any of whom can jump in and quickly challenge changes they deem to be unreliable.\u003c/span>\u003c/p>\n\u003cp>Finally, some administrators can “protect” articles, so that only established editors can make changes. Editors who create consistently problematic content can be kicked off the site.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Heilman emailed me, he had just finished \u003ca href=\"https://en.wikipedia.org/w/index.php?title=Vaccine&type=revision&diff=752549754&oldid=752547510%5D\" target=\"_blank\">reverting\u003c/a> an edit to the Wikipedia \"\u003ca href=\"https://en.wikipedia.org/wiki/Vaccine\" target=\"_blank\">Vaccine\u003c/a>\" page back to its former state, due to a change made in the \"\u003ca href=\"https://en.wikipedia.org/wiki/Vaccine#Adverse_effects\" target=\"_blank\">Adverse effects\u003c/a>\" section. The topic of vaccinations has spawned a lot of misinformation on exaggerated or even nonexistent risks, driving down inoculation rates in some communities. Below is the short-lived edit, followed by the original version that Heilman restored:\u003c/span>\u003c/p>\n\u003cp>\u003cem>There is growing evidence that vaccines trigger autoimmune disease. A mass Hepatitis B vaccination program was halted in France in 1994 following a significant increase in incidence of multiple sclerosis 1-2 years following vaccination. In 2009, GSK's Pandemrix influenza vaccine was proven to trigger narcolepsy in multiple cases across Europe leading to multiple legal claims. Despite this growing evidence the medical establishment maintain that vaccinations given during childhood are generally safe.\u003c/em>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Reversion to previous entry:\u003c/span>\u003c/p>\n\u003cblockquote>\u003cp>Vaccination given during childhood is generally safe. The rate of side effects depends on the vaccine in question. Some common side effects include: fever, pain around the injection site, and muscle aches. Additionally, some individuals may be allergic to ingredients in the vaccine. MMR vaccine is rarely associated with febrile seizures.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>The Election on Wikipedia\u003c/strong>\u003c/p>\n\u003cp>On Sunday, a 28-year-old North Carolina man \u003ca href=\"http://www.usatoday.com/story/news/politics/2016/12/05/pizzagate-shooter-washington-court/94995926/\" target=\"_blank\">shot off his assault weapon\u003c/a> in a Washington D.C. pizza restaurant. Afterward he reportedly told police he wanted to find the truth about a viral fake news story claiming the eatery was involved in a Democratic child prostitution ring. Contrast the rapid \u003ca href=\"https://www.buzzfeed.com/craigsilverman/fever-swamp-election?utm_term=.mmWdD3M53#.qqw71XQ3X\" target=\"_blank\">metastasizing\u003c/a> of the hoax with the \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:Miscellany_for_deletion/Draft:Pizzagate_(conspiracy_theory)\" target=\"_blank\">ongoing Wikipedia discussion\u003c/a> on whether to publish a \u003ca href=\"https://en.wikipedia.org/wiki/Draft:Pizzagate_(conspiracy_theory)\" target=\"_blank\">draft\u003c/a> page on the topic, and you can gain a little appreciation of the deliberate way Wikipedia contributors make decisions.\u003c/p>\n\u003cp>Another election article Wikipedians had to grapple with was “The Impeachment of Donald Trump,” created on Nov. 11. Just three hours after it went live, editors deleted it. The article, based on the opinions of two academics, said Trump's impeachment was “expected to occur sometime after inauguration.\" A handful of editors quickly \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:Articles_for_deletion/Impeachment_of_Donald_Trump\" target=\"_blank\">came to the conclusion\u003c/a> that speculation by two people did not a valid Wikipedia entry make.\u003c/p>\n\u003cp>\u003cstrong>Humans vs. Algorithms\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Facebook, where most of the fake news spread this election season, is now reportedly \u003c/span>\u003ca href=\"http://www.wsj.com/articles/facebook-could-develop-artificial-intelligence-to-weed-out-fake-news-1480608004\">\u003cspan style=\"font-weight: 400\">developing artificial intelligence \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">to cope with the problem. Heilman doesn’t think that will be enough. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“People who are involved in generating fake news -- that's a higher level of vandalism than a computer program can take care of,\" he said. \"The only people who can manage to deal with that in my opinion is human beings.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One reason, he said, is that spotting errors requires layers of knowledge and understanding of the context in which a statement is made.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“You need good faith people who have looked at the whole breadth of literature out there, who have researched the topic in question.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Katherine Maher, executive director of the Wikimedia Foundation, thinks\u003c/span> \u003cspan style=\"font-weight: 400\">the main problem with Facebook’s newsfeed is that the reasons it serves up certain stories are opaque.\u003c/span>\u003c/p>\n\u003cp>\"Are you receiving the information because it’s accurate, timely or important?\" she says. \"Or just because a lot of other people have been sharing it, regardless of its validity?\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When people have that information, she believes, they're smart enough to make an informed decision as to whether that which has been placed before them is relevant or meaningless. \u003c/span>\u003c/p>\n\u003cp>Heilman, too, thinks \"Facebook and Twitter could learn a lot from the mechanisms Wikipedia has put into place.\"\u003c/p>\n\u003cp>But even Wikipedians acknowledge that they, too, have a lot of work to do when it comes to halting the spread of unvetted information. For example, just a small fraction of Wikipedia's health articles—\u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=FA-Class%20featured%20health%20articles\" target=\"_blank\">63\u003c/a>—have received the highest quality grade by section editors. A page called \u003ca href=\"https://en.wikipedia.org/wiki/Reliability_of_Wikipedia\" target=\"_blank\">Reliability of Wikipedia\u003c/a> points out the good and the bad. And the site keeps a \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:List_of_hoaxes_on_Wikipedia\" target=\"_blank\">list of hoaxes\u003c/a> that have appeared on its pages, a number of which stayed visible for many years.\u003c/p>\n\u003cp>In the months and maybe years ahead, Wikipedians -- and anyone involved in the gathering and dissemination of fact-based information, actually -- could have their work cut out for them. If the president-elect's own proclivity for \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2016/nov/28/donald-trump/donald-trumps-pants-fire-claim-millions-illegal-vo/\" target=\"_blank\">creating news out of whole cloth\u003c/a> is any indication, this problem is not going away.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=4hHL_6s5eR8\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>“We have solved the fake news problem on Wikipedia.”\u003c/p>\n\u003cp>That was the bold assertion from Canadian ER doc and university professor James Heilman, speaking to KQED News last week. Heilman puts in roughly 60 hours weekly editing medical entries on the colossal online encyclopedia. He's the founder of \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine\" target=\"_blank\">WikiProject Medicine\u003c/a>, a group of several hundred editors who have taken on the mission of making the site's medical pages more thorough and \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/28/how-accurate-is-wikipedias-medical-information/\" target=\"_blank\">accurate\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'People who are involved in generating fake news -- that's a higher level of vandalism than a computer program can take care of.'\u003ccite>James Heilman, WikiProject Medicine\u003c/cite>\u003c/aside>\n\u003cp>Fake news—fabricated reports related to current events—has received a lot of attention in the wake of President-elect Donald Trump’s unexpected victory over non-President-elect Hillary Clinton.\u003c/p>\n\u003cp>Pundits and polls had assured the country that Clinton would be busy polishing her inaugural address by now. Was \u003ca href=\"https://www.google.com/search?q=fake+news&oq=fake+news\" target=\"_blank\">fake news\u003c/a> a factor in Trump's victory? We may never know, but a \u003ca href=\"https://www.buzzfeed.com/craigsilverman/viral-fake-election-news-outperformed-real-news-on-facebook?utm_term=.wkgkYg5z7#.kdEDER4l2\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">Buzzfeed analysis\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> found that the top-20 fake news stories received more Facebook shares, reactions and comments in the three months leading up to the election than the top-20 real news reports. A large majority of the phony stories overtly favored Trump.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>A New Age\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Not too long ago, the barriers to entry for disseminating written information on a mass scale included financial resources enough to pay for millions of dollars worth of reporters, editors, layout designers, press operators, printing equipment, delivery trucks and \u003ca href=\"http://wtvr.com/2016/11/18/when-was-the-last-time-you-saw-a-kid-with-a-paper-route/\" target=\"_blank\">tweens on bikes\u003c/a> with poor aim. Short of that, you're handing out pamphlets on a street corner.\u003c/p>\n\u003cp>But today, you can run your own mass communications operation with little more than computer, a WordPress account and a little savvy about Facebook algorithms. Whether it's done for clicks, tricks or kicks, fake news has become a \u003ca href=\"http://www.npr.org/sections/alltechconsidered/2016/11/23/503146770/npr-finds-the-head-of-a-covert-fake-news-operation-in-the-suburbs\" target=\"_blank\">profitable\u003c/a> cottage industry.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/FioreFakeNews.jpg\">\u003cimg class=\"aligncenter size-large wp-image-295313\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/FioreFakeNews-1020x1020.jpg\" alt=\"fiorefakenews\" width=\"640\" height=\"640\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-1020x1020.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-1180x1180.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-150x150.jpg 150w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wikipedia, being a site that actually \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">invites\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> members of the public to write their own content with no vetting of their qualifications to do so, would seem to be ripe for an onslaught of material laden with inaccuracy and bias.\u003c/span>\u003c/p>\n\u003cp>“We see people attempting to promote alternative medicine, we see people attempting to promote conventional medicine beyond the level of evidence that's available,” said Heilman, the medical editor.\u003c/p>\n\u003cp>But Wikipedia polices the creation of new entries and changes to existing pages with both machine and human interventions.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Pages are \"analyzed by smart bots that deal with a large majority of low-level vandalism and many copyright issues,” Heilman wrote in an email. The \u003c/span>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:New_pages_patrol\" target=\"_blank\">New Pages Patrol, \u003c/a>consisting of seasoned human editors who have made at least 500 uncontested edits to Wikipedia pages, reviews every freshly created page. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wikipedia requires contributors to justify every assertion of fact in an article, and it has blacklisted \u003ca href=\"https://en.wikipedia.org/wiki/MediaWiki_talk:Spam-blacklist#abcnews.com.co\" target=\"_blank\">certain sites\u003c/a> from being used as verification this way. Wikipedians can also put individual pages on watch lists, which will trigger notifications any time an edit is made. For example, the \u003c/span>\u003ca href=\"https://en.wikipedia.org/wiki/HIV/AIDS\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">HIV/AIDS page \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">is currently monitored by almost a thousand editors, any of whom can jump in and quickly challenge changes they deem to be unreliable.\u003c/span>\u003c/p>\n\u003cp>Finally, some administrators can “protect” articles, so that only established editors can make changes. Editors who create consistently problematic content can be kicked off the site.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Heilman emailed me, he had just finished \u003ca href=\"https://en.wikipedia.org/w/index.php?title=Vaccine&type=revision&diff=752549754&oldid=752547510%5D\" target=\"_blank\">reverting\u003c/a> an edit to the Wikipedia \"\u003ca href=\"https://en.wikipedia.org/wiki/Vaccine\" target=\"_blank\">Vaccine\u003c/a>\" page back to its former state, due to a change made in the \"\u003ca href=\"https://en.wikipedia.org/wiki/Vaccine#Adverse_effects\" target=\"_blank\">Adverse effects\u003c/a>\" section. The topic of vaccinations has spawned a lot of misinformation on exaggerated or even nonexistent risks, driving down inoculation rates in some communities. Below is the short-lived edit, followed by the original version that Heilman restored:\u003c/span>\u003c/p>\n\u003cp>\u003cem>There is growing evidence that vaccines trigger autoimmune disease. A mass Hepatitis B vaccination program was halted in France in 1994 following a significant increase in incidence of multiple sclerosis 1-2 years following vaccination. In 2009, GSK's Pandemrix influenza vaccine was proven to trigger narcolepsy in multiple cases across Europe leading to multiple legal claims. Despite this growing evidence the medical establishment maintain that vaccinations given during childhood are generally safe.\u003c/em>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Reversion to previous entry:\u003c/span>\u003c/p>\n\u003cblockquote>\u003cp>Vaccination given during childhood is generally safe. The rate of side effects depends on the vaccine in question. Some common side effects include: fever, pain around the injection site, and muscle aches. Additionally, some individuals may be allergic to ingredients in the vaccine. MMR vaccine is rarely associated with febrile seizures.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>The Election on Wikipedia\u003c/strong>\u003c/p>\n\u003cp>On Sunday, a 28-year-old North Carolina man \u003ca href=\"http://www.usatoday.com/story/news/politics/2016/12/05/pizzagate-shooter-washington-court/94995926/\" target=\"_blank\">shot off his assault weapon\u003c/a> in a Washington D.C. pizza restaurant. Afterward he reportedly told police he wanted to find the truth about a viral fake news story claiming the eatery was involved in a Democratic child prostitution ring. Contrast the rapid \u003ca href=\"https://www.buzzfeed.com/craigsilverman/fever-swamp-election?utm_term=.mmWdD3M53#.qqw71XQ3X\" target=\"_blank\">metastasizing\u003c/a> of the hoax with the \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:Miscellany_for_deletion/Draft:Pizzagate_(conspiracy_theory)\" target=\"_blank\">ongoing Wikipedia discussion\u003c/a> on whether to publish a \u003ca href=\"https://en.wikipedia.org/wiki/Draft:Pizzagate_(conspiracy_theory)\" target=\"_blank\">draft\u003c/a> page on the topic, and you can gain a little appreciation of the deliberate way Wikipedia contributors make decisions.\u003c/p>\n\u003cp>Another election article Wikipedians had to grapple with was “The Impeachment of Donald Trump,” created on Nov. 11. Just three hours after it went live, editors deleted it. The article, based on the opinions of two academics, said Trump's impeachment was “expected to occur sometime after inauguration.\" A handful of editors quickly \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:Articles_for_deletion/Impeachment_of_Donald_Trump\" target=\"_blank\">came to the conclusion\u003c/a> that speculation by two people did not a valid Wikipedia entry make.\u003c/p>\n\u003cp>\u003cstrong>Humans vs. Algorithms\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Facebook, where most of the fake news spread this election season, is now reportedly \u003c/span>\u003ca href=\"http://www.wsj.com/articles/facebook-could-develop-artificial-intelligence-to-weed-out-fake-news-1480608004\">\u003cspan style=\"font-weight: 400\">developing artificial intelligence \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">to cope with the problem. Heilman doesn’t think that will be enough. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“People who are involved in generating fake news -- that's a higher level of vandalism than a computer program can take care of,\" he said. \"The only people who can manage to deal with that in my opinion is human beings.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One reason, he said, is that spotting errors requires layers of knowledge and understanding of the context in which a statement is made.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“You need good faith people who have looked at the whole breadth of literature out there, who have researched the topic in question.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Katherine Maher, executive director of the Wikimedia Foundation, thinks\u003c/span> \u003cspan style=\"font-weight: 400\">the main problem with Facebook’s newsfeed is that the reasons it serves up certain stories are opaque.\u003c/span>\u003c/p>\n\u003cp>\"Are you receiving the information because it’s accurate, timely or important?\" she says. \"Or just because a lot of other people have been sharing it, regardless of its validity?\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When people have that information, she believes, they're smart enough to make an informed decision as to whether that which has been placed before them is relevant or meaningless. \u003c/span>\u003c/p>\n\u003cp>Heilman, too, thinks \"Facebook and Twitter could learn a lot from the mechanisms Wikipedia has put into place.\"\u003c/p>\n\u003cp>But even Wikipedians acknowledge that they, too, have a lot of work to do when it comes to halting the spread of unvetted information. For example, just a small fraction of Wikipedia's health articles—\u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=FA-Class%20featured%20health%20articles\" target=\"_blank\">63\u003c/a>—have received the highest quality grade by section editors. A page called \u003ca href=\"https://en.wikipedia.org/wiki/Reliability_of_Wikipedia\" target=\"_blank\">Reliability of Wikipedia\u003c/a> points out the good and the bad. And the site keeps a \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:List_of_hoaxes_on_Wikipedia\" target=\"_blank\">list of hoaxes\u003c/a> that have appeared on its pages, a number of which stayed visible for many years.\u003c/p>\n\u003cp>In the months and maybe years ahead, Wikipedians -- and anyone involved in the gathering and dissemination of fact-based information, actually -- could have their work cut out for them. If the president-elect's own proclivity for \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2016/nov/28/donald-trump/donald-trumps-pants-fire-claim-millions-illegal-vo/\" target=\"_blank\">creating news out of whole cloth\u003c/a> is any indication, this problem is not going away.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>In response to a series of superbug outbreaks around the country, some doctors and hospitals are trying out disposable scopes to combat the spread of antibiotic-resistant bacteria.\u003c/p>\n\u003cp>U.S. regulators recently approved two new colonoscopes designed to be used just once and thrown away. They will sell for $250 or less apiece — compared to roughly $40,000 or more for a conventional scope that lasts several years but must be disinfected after each use. Other companies are promoting such devices — flexible, lighted tubes used to peer deep inside the body — for use in the lungs and kidneys.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s almost too good to be true with it being so cheap.'\u003c/aside>\n\u003cp>The new scopes are coming primarily from smaller companies looking to challenge a handful of dominant device makers. The upstarts are seizing on growing evidence that many reusable instruments cannot be cleaned reliably, even when manufacturer’s instructions are followed.\u003c/p>\n\u003cp>“If you can tell patients we have a disposable device so there’s really no chance of infection, that has to be very appealing,” said Chris Lavanchy, engineering director at the ECRI Institute, a nonprofit organization that tests medical devices. “This could allay public fears.”\u003c/p>\n\u003cp>Scopes include a wide array of devices used on millions of patients annually. As they snake through a patient’s throat, intestines and other cavities, they pick up mucus, blood and thousands of microbes. But the delicate devices can’t be sterilized like a scalpel because intense heat would destroy crucial components.\u003c/p>\n\u003cfigure id=\"attachment_305327\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\">\u003cimg class=\"size-full wp-image-305327\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\" alt=\"A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \" width=\"270\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270.jpg 270w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-240x360.jpg 240w\" sizes=\"(max-width: 270px) 100vw, 270px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \u003ccite>(Courtesy of Invendo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Instead, the scopes are brushed and washed with disinfectants in preparation for the next patient. Despite those efforts, contamination can persist and drug-resistant bacteria can result in patient infections that are difficult or even impossible to treat.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The threat has led to safety alerts from the Food and Drug Administration and a recent U.S. Senate investigation into repeated failures by manufacturers and hospitals to report outbreaks.\u003c/p>\n\u003cp>Overall, as many as 350 patients at 41 medical facilities worldwide were exposed to or infected by contaminated gastrointestinal scopes from 2010 to 2015, according to the FDA. And at least 35 patients at U.S. hospitals have died since 2013 after developing infections tied to tainted scopes, according to hospitals and public health officials.\u003c/p>\n\u003cp>For now, just a handful of medical centers are experimenting with the disposable colonoscopes. Some doctors remain skeptical about whether a cheaper scope will provide the high-quality images and versatility they need to diagnose and treat patients effectively. Many doctors count on the sophisticated cameras on existing scopes as well as multiple channels inside the device to accommodate surgical instruments.\u003c/p>\n\u003cp>Dr. Simon Lo, a nationally known gastroenterologist at Cedars-Sinai Medical Center in Los Angeles, said he shares those concerns. Nonetheless, he said he’s eager to try the disposable colonoscope from German device maker Invendo Medical in the coming months. The scope secured clearance from the U.S. Food and Drug Administration in August.\u003c/p>\n\u003cp>“I’m not totally sold this will be comparable to the [conventional] scopes other companies have spent decades perfecting. It’s almost too good to be true with it being so cheap,” Lo said. “But this is a fantastic possibility and at least gives us an alternative to the current scopes.”\u003c/p>\n\u003cp>Physician groups such as the American Society for Gastrointestinal Endoscopy maintain that the overall risk of infection is very low from these reusable devices. They say the benefits of screenings and many other procedures far outweigh any potential danger.\u003c/p>\n\u003cp>But some doctors say a simpler, single-use scope could be sufficient for many routine examinations. It could also be preferred for immunosuppressed patients who are more susceptible to infection and for patients who have already tested positive for antibiotic-resistant bacteria and would be likely to spread it.\u003c/p>\n\u003cp>“For those patients, it would be great to use this and throw it away,” Lo said.\u003c/p>\n\u003cp>His hospital, Cedars-Sinai, reported four infections last year from contaminated duodenoscopes, which are inserted down a patient’s throat and used to treat problems in the digestive tract such as cancers and blockages in the bile duct.\u003c/p>\n\u003cp>Colonoscopes, which look at the inner lining of the large intestine, haven’t been linked to the recent outbreaks, but concerns about cleaning and the spread of bacteria apply to all types of reusable scopes. Last year, the FDA warned about the risk to patients posed by bronchoscopes, used to examine problems in the airway and lungs.\u003c/p>\n\u003cp>In one study, researchers found that more than 75 percent of colonoscopes and gastroscopes were still contaminated after cleaning and disinfection in accordance with manufacturer guidelines.\u003c/p>\n\u003cp>Hospitals have experimented with a wide variety of new safety measures over the past two years. Some facilities started testing scopes for contamination after cleaning and holding them in quarantine for 48 hours to check them again for bacterial growth.\u003c/p>\n\u003cp>Those steps added layers to what was already a labor-intensive process. It costs about $75 or more to clean a scope each time.\u003c/p>\n\u003cp>“There is a lot of time and money tied up in that,” said John Cifarelli, chief commercial officer for Invendo. “The best solution is a device that doesn’t have to be cleaned.”\u003c/p>\n\u003cp>The leading scope makers haven’t shown much interest thus far in single-use devices, which could affect their longstanding dominance in the business.\u003c/p>\n\u003cp>Olympus Corp., which controls 85 percent of the U.S. market for gastrointestinal scopes, didn’t respond to a request for comment. The Tokyo-based company, linked to numerous infections in the U.S. and Europe, conducted a voluntary recall of its duodenoscopes this year and made repairs designed to reduce the contamination risk.\u003c/p>\n\u003cp>In a statement, another big manufacturer, Fujifilm, said it “has no plans at this time to market single-use disposable scopes, and cannot speak to the benefits or risks associated with such products.”\u003c/p>\n\u003cp>Israeli company GI-View received FDA clearance in August for its single-use colonoscope, called Aer-O-Scope, priced at about $200. The company’s chief executive, Tal Simchony, acknowledges that his smaller company faces an uphill battle against the industry giants. But he said he’s optimistic it can address the “ick” factor some patients feel with a reusable scope.\u003c/p>\n\u003cp>Other companies see opportunity, too. Boston Scientific, a bigger device maker, promotes a disposable ureteroscope to aid in treatment of kidney stones and other procedures. Ambu A/S, based in Denmark, has sold a single-use bronchoscope for about $300 in the U.S. for the past few years.\u003c/p>\n\u003cp>In Europe, two biomedical engineers are raising money to build a prototype and manufacture what could become a full line of disposable endoscopes. Francisco Soriano, one of the engineers in Barcelona, said he learned the business from repairing scopes with his father, who was a longtime Olympus technician.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We must reinvent the endoscope as we know it,” Soriano said. “Our vision is to eliminate cross-infection completely.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In response to a series of superbug outbreaks around the country, some doctors and hospitals are trying out disposable scopes to combat the spread of antibiotic-resistant bacteria.\u003c/p>\n\u003cp>U.S. regulators recently approved two new colonoscopes designed to be used just once and thrown away. They will sell for $250 or less apiece — compared to roughly $40,000 or more for a conventional scope that lasts several years but must be disinfected after each use. Other companies are promoting such devices — flexible, lighted tubes used to peer deep inside the body — for use in the lungs and kidneys.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s almost too good to be true with it being so cheap.'\u003c/aside>\n\u003cp>The new scopes are coming primarily from smaller companies looking to challenge a handful of dominant device makers. The upstarts are seizing on growing evidence that many reusable instruments cannot be cleaned reliably, even when manufacturer’s instructions are followed.\u003c/p>\n\u003cp>“If you can tell patients we have a disposable device so there’s really no chance of infection, that has to be very appealing,” said Chris Lavanchy, engineering director at the ECRI Institute, a nonprofit organization that tests medical devices. “This could allay public fears.”\u003c/p>\n\u003cp>Scopes include a wide array of devices used on millions of patients annually. As they snake through a patient’s throat, intestines and other cavities, they pick up mucus, blood and thousands of microbes. But the delicate devices can’t be sterilized like a scalpel because intense heat would destroy crucial components.\u003c/p>\n\u003cfigure id=\"attachment_305327\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\">\u003cimg class=\"size-full wp-image-305327\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\" alt=\"A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \" width=\"270\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270.jpg 270w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-240x360.jpg 240w\" sizes=\"(max-width: 270px) 100vw, 270px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \u003ccite>(Courtesy of Invendo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Instead, the scopes are brushed and washed with disinfectants in preparation for the next patient. Despite those efforts, contamination can persist and drug-resistant bacteria can result in patient infections that are difficult or even impossible to treat.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The threat has led to safety alerts from the Food and Drug Administration and a recent U.S. Senate investigation into repeated failures by manufacturers and hospitals to report outbreaks.\u003c/p>\n\u003cp>Overall, as many as 350 patients at 41 medical facilities worldwide were exposed to or infected by contaminated gastrointestinal scopes from 2010 to 2015, according to the FDA. And at least 35 patients at U.S. hospitals have died since 2013 after developing infections tied to tainted scopes, according to hospitals and public health officials.\u003c/p>\n\u003cp>For now, just a handful of medical centers are experimenting with the disposable colonoscopes. Some doctors remain skeptical about whether a cheaper scope will provide the high-quality images and versatility they need to diagnose and treat patients effectively. Many doctors count on the sophisticated cameras on existing scopes as well as multiple channels inside the device to accommodate surgical instruments.\u003c/p>\n\u003cp>Dr. Simon Lo, a nationally known gastroenterologist at Cedars-Sinai Medical Center in Los Angeles, said he shares those concerns. Nonetheless, he said he’s eager to try the disposable colonoscope from German device maker Invendo Medical in the coming months. The scope secured clearance from the U.S. Food and Drug Administration in August.\u003c/p>\n\u003cp>“I’m not totally sold this will be comparable to the [conventional] scopes other companies have spent decades perfecting. It’s almost too good to be true with it being so cheap,” Lo said. “But this is a fantastic possibility and at least gives us an alternative to the current scopes.”\u003c/p>\n\u003cp>Physician groups such as the American Society for Gastrointestinal Endoscopy maintain that the overall risk of infection is very low from these reusable devices. 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Last year, the FDA warned about the risk to patients posed by bronchoscopes, used to examine problems in the airway and lungs.\u003c/p>\n\u003cp>In one study, researchers found that more than 75 percent of colonoscopes and gastroscopes were still contaminated after cleaning and disinfection in accordance with manufacturer guidelines.\u003c/p>\n\u003cp>Hospitals have experimented with a wide variety of new safety measures over the past two years. Some facilities started testing scopes for contamination after cleaning and holding them in quarantine for 48 hours to check them again for bacterial growth.\u003c/p>\n\u003cp>Those steps added layers to what was already a labor-intensive process. 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The Tokyo-based company, linked to numerous infections in the U.S. and Europe, conducted a voluntary recall of its duodenoscopes this year and made repairs designed to reduce the contamination risk.\u003c/p>\n\u003cp>In a statement, another big manufacturer, Fujifilm, said it “has no plans at this time to market single-use disposable scopes, and cannot speak to the benefits or risks associated with such products.”\u003c/p>\n\u003cp>Israeli company GI-View received FDA clearance in August for its single-use colonoscope, called Aer-O-Scope, priced at about $200. The company’s chief executive, Tal Simchony, acknowledges that his smaller company faces an uphill battle against the industry giants. But he said he’s optimistic it can address the “ick” factor some patients feel with a reusable scope.\u003c/p>\n\u003cp>Other companies see opportunity, too. Boston Scientific, a bigger device maker, promotes a disposable ureteroscope to aid in treatment of kidney stones and other procedures. 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"content": "\u003cp>Britain's fertility regulator has approved controversial techniques allowing doctors to create babies using DNA from three people — what it called a \"historic\" decision to help prevent a small number of children from inheriting potentially fatal diseases from their mothers.\u003c/p>\n\u003cp>The regulator's chair, Sally Chesire, on Dec. 15 described it as a \"life-changing\" moment for families who might benefit from the treatment.\u003c/p>\n\u003cp>\"Parents at very high risk of having a child with a life-threatening mitochondrial disease may soon have the chance of a healthy, genetically related child,\" she said in a statement.\u003c/p>\n\u003cp>The new procedures are intended to fix problems linked to mitochondria, the energy-producing structures outside a cell's nucleus. Faulty mitochondria can result in conditions including muscular dystrophy, major organ failure and severe muscle weakness.\u003c/p>\n\u003cp>Last year, Britain changed its law to permit scientists to modify eggs or embryos before they are transferred into women, becoming the first country to legally approve the techniques. In September, U.S.-based doctors announced they had created the world's first baby using such techniques, after traveling to Mexico to perform the methods, which have not been approved in the United States.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>To help women with mitochondria problems from passing them down to their children, scientists remove the nucleus DNA from the egg of a prospective mother and insert it into a donor egg from which the donor DNA has been removed. That can happen before or after fertilization.\u003c/p>\n\u003cp>The resulting embryo ends up with nucleus DNA from its parents but mitochondrial DNA from a donor. The DNA from the donor amounts to less than 1 percent of the resulting embryo's genes.\u003c/p>\n\u003cp>But Britain's decision to approve using the new methods will not open the floodgates to genetically modified babies. Clinics will need to apply to Britain's fertility regulator for permission to use the techniques on a case-by-case basis. The decision was made after five years of reviewing the development, safety and efficacy of the procedures.\u003c/p>\n\u003cp>Newcastle University said it was planning to apply for a license to use the new fertility techniques and was aiming to treat up to 25 patients a year.\u003c/p>\n\u003cp>\"It is enormously gratifying that our many years of research in this area can finally be applied to help families affected by these devastating diseases,\" said Mary Herbert, a professor of reproductive biology at Newcastle University.\u003c/p>\n\u003cp>But critics charged the decision will put people at unnecessary risk of an untested procedure and said women with faulty mitochondria should opt simply to use egg donors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This decision opens the door to the world of (genetically modified) designer babies,\" said David King, director of the Human Genetics Alert group. \"Allowing mitochondrial replacement means that there is no logical basis for resisting GM babies.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Britain's fertility regulator has approved controversial techniques allowing doctors to create babies using DNA from three people — what it called a \"historic\" decision to help prevent a small number of children from inheriting potentially fatal diseases from their mothers.\u003c/p>\n\u003cp>The regulator's chair, Sally Chesire, on Dec. 15 described it as a \"life-changing\" moment for families who might benefit from the treatment.\u003c/p>\n\u003cp>\"Parents at very high risk of having a child with a life-threatening mitochondrial disease may soon have the chance of a healthy, genetically related child,\" she said in a statement.\u003c/p>\n\u003cp>The new procedures are intended to fix problems linked to mitochondria, the energy-producing structures outside a cell's nucleus. Faulty mitochondria can result in conditions including muscular dystrophy, major organ failure and severe muscle weakness.\u003c/p>\n\u003cp>Last year, Britain changed its law to permit scientists to modify eggs or embryos before they are transferred into women, becoming the first country to legally approve the techniques. In September, U.S.-based doctors announced they had created the world's first baby using such techniques, after traveling to Mexico to perform the methods, which have not been approved in the United States.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To help women with mitochondria problems from passing them down to their children, scientists remove the nucleus DNA from the egg of a prospective mother and insert it into a donor egg from which the donor DNA has been removed. That can happen before or after fertilization.\u003c/p>\n\u003cp>The resulting embryo ends up with nucleus DNA from its parents but mitochondrial DNA from a donor. The DNA from the donor amounts to less than 1 percent of the resulting embryo's genes.\u003c/p>\n\u003cp>But Britain's decision to approve using the new methods will not open the floodgates to genetically modified babies. Clinics will need to apply to Britain's fertility regulator for permission to use the techniques on a case-by-case basis. The decision was made after five years of reviewing the development, safety and efficacy of the procedures.\u003c/p>\n\u003cp>Newcastle University said it was planning to apply for a license to use the new fertility techniques and was aiming to treat up to 25 patients a year.\u003c/p>\n\u003cp>\"It is enormously gratifying that our many years of research in this area can finally be applied to help families affected by these devastating diseases,\" said Mary Herbert, a professor of reproductive biology at Newcastle University.\u003c/p>\n\u003cp>But critics charged the decision will put people at unnecessary risk of an untested procedure and said women with faulty mitochondria should opt simply to use egg donors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This decision opens the door to the world of (genetically modified) designer babies,\" said David King, director of the Human Genetics Alert group. \"Allowing mitochondrial replacement means that there is no logical basis for resisting GM babies.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Drugmakers Push Unproven Solution to Opioid Epidemic They Helped Create",
"title": "Drugmakers Push Unproven Solution to Opioid Epidemic They Helped Create",
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"content": "\u003cp>Pilloried for their role in the epidemic of prescription painkiller abuse, drugmakers are aggressively pushing their remedy to the problem: a new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there's little proof they reduce rates of overdoses or deaths.\u003c/p>\n\u003caside class=\"pullquote alignright\">Harder-to-manipulate opioids have racked up billions in sales, despite a lack of proof that they reduce overdoses.\u003c/aside>\n\u003cp>More than prescriptions are at stake. Critics worry the drugmakers' nationwide lobbying campaign is distracting from more productive solutions and delaying crucial efforts to steer physicians away from prescription opioids — addictive pain medications involved in the deaths of more than 165,000 Americans since 2000.\u003c/p>\n\u003cp>\"If we've learned one lesson from the last 20 years on opioids it's that these products have very, very high inherent risks,\" said Dr. Caleb Alexander, co-director of Johns Hopkins University's Center for Drug Safety and Effectiveness. \"My concern is that they'll contribute to a perception that there is a safe opioid, and there's no such thing as a fully safe opioid.\"\u003c/p>\n\u003cp>The latest drugs — known as abuse-deterrent formulations, or ADFs — are generally harder to crush or dissolve, which the drugmakers tout as making them difficult to snort or inject. But they still are vulnerable to manipulation and potentially addictive when simply swallowed. National data from an industry-sponsored tracking system also show drug abusers quickly drop the reformulated drugs in favor of older painkillers or heroin.\u003c/p>\n\u003cp>In the last two years, pharmaceutical companies have made a concerted under-the-radar push for bills benefiting the anti-abuse opioids in statehouses and in Congress, where proposed legislation would require the Food and Drug Administration to replace older opioids with the new drugs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The lobbying push features industry-funded advocacy groups and physicians, along with grieving family members, who rarely disclosed the drugmakers' ties during their testimony in support of the drugs.\u003c/p>\n\u003cp>Besides the tamper-resistant pills, ADF opioids are being rolled out in other forms, including injectable drugs and pills that irritate users when they're snorted or contain substances that counteract highs.\u003c/p>\n\u003cp>\u003cstrong>Sales Opportunity\u003c/strong>\u003c/p>\n\u003cp>Making painkillers harder to abuse is a common-sense step. But it's also a multibillion-dollar sales opportunity, offering drugmakers the potential to wipe out lower-cost generic competitors and lock in sales of their higher-priced versions, which cost many times more than conventional pills. The big companies hold multiple patents on the reformulated drugs, shielding them from competition for years — in some cases decades.\u003c/p>\n\u003cp>Though abuse-deterrent painkillers represented less than 5 percent of all opioids prescribed last year, they generated more than $2.4 billion in sales, or roughly a quarter of the nearly $10 billion U.S. market for the drugs, according to IMS Health. The field is dominated by Purdue Pharma's OxyContin, patent-protected until 2030.\u003c/p>\n\u003cp>\"We at Purdue make certain that prescribers and other stakeholders understand that opioids with abuse-deterrent properties won't stop all prescription drug abuse, but they are an important part of the comprehensive approach needed to address this public health issue,\" Purdue spokesman Robert Josephson said in a statement.\u003c/p>\n\u003cp>Like a spokeswoman for Pfizer Inc., Josephson also noted that some public health officials, including the Food and Drug Administration, have endorsed using ADFs.\u003c/p>\n\u003cp>\"We need every tool that we can have in our toolbox,\" said Kentucky state Rep. Addia Wuchner, a Republican who has worked on several bills to benefit reformulated opioids. \"The extra steps are worth the effort in order to prevent this escalation of more addiction.\"\u003c/p>\n\u003cp>\u003cstrong>Massive Lobbying Effort\u003c/strong>\u003c/p>\n\u003cp>The current industry campaign draws on the same 50-state strategy that painkiller manufacturers successfully deployed to help kill or weaken measures aimed at stemming the tide of prescription opioids, a playbook The Associated Press and Center for Public Integrity exposed in September.\u003c/p>\n\u003cp>The \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/09/19/how-drugmakers-used-money-and-influence-to-shape-the-national-response-to-opioid-abuse/\" target=\"_blank\">reporting \u003c/a>detailed how opioid drugmakers and the nonprofits they help fund spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade, eight times what the gun lobby reported for the same period. The money represents the drugmakers' spending on all their legislative interests, including opioids.\u003c/p>\n\u003cp>The FDA has approved a handful of the reformulated drugs but has not yet concluded that any reduce rates of addiction, abuse or death, and the evidence gap has led to diverging views among health authorities.\u003c/p>\n\u003cp>\u003cstrong>'No less addictive'\u003c/strong>\u003c/p>\n\u003cp>Whereas FDA regulators emphasize the potential promise of reformulated painkillers, other government officials stress that they contain the same heroin-like ingredients as traditional opioids. An estimated 78 Americans die from heroin and prescription opioid overdoses every day.\u003c/p>\n\u003cp>\"'Abuse-deterrent' sounds to people sometimes like 'Oh, maybe it's not addictive.' But it's no less addictive,\" said Dr. Tom Frieden, head of the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Survey results published this year in the Clinical Journal of Pain showed nearly half of U.S. physicians incorrectly believed that reformulated opioids are less addictive than their predecessors.\u003c/p>\n\u003cp>Many experts see a key role for ADFs in reducing the number of people who first begin abusing opioids, and some say the abuse-deterrent formulations should be the default painkiller for patients with histories of drug use, anxiety or depression. But even they worry that some drugmakers are overselling the technology. They stress that separate measures are needed for the majority of opioid abusers who ingest the pills orally.\u003c/p>\n\u003cp>\"The way they're handling the ADF is that this is the answer. And it's not the answer — it's part of the bigger puzzle,\" said Theodore Cicero, a psychiatry professor at Washington University in St. Louis, who has authored several studies on the drugs.\u003c/p>\n\u003cp>\u003cstrong>'You can't put a price tag on anybody's life'\u003c/strong>\u003c/p>\n\u003cp>Two years after the overdose that killed her 21-year-old son, Terri Bartlett traveled to Illinois' state capital to champion an unlikely cause: revamped painkillers.\u003c/p>\n\u003cp>Bartlett's son Michael became hooked on Vicodin and later graduated to heroin. In emotional testimony last year, she urged lawmakers to support a bill that would prioritize the new harder-to-crush pills, saying she believed her son would still be alive if abuse-deterrent formulations had been on the market then.\u003c/p>\n\u003cp>\"You can't put a price tag on anybody's life,\" she said.\u003c/p>\n\u003cp>Bartlett didn't know then that she had been recruited into a wide-ranging lobbying campaign. A public relations firm hired by OxyContin-maker Purdue had helped recruit her to support the bill, along with local sheriffs and fire chiefs.\u003c/p>\n\u003cp>Her words, and similar testimony from parents of drug abusers elsewhere, reflect a tactic used by the drugmakers across the country. For instance, Purdue paid nearly $95,000 for similar lobbying efforts in New York, state records show.\u003c/p>\n\u003cp>And the industry's fingerprints are easy to spot in other areas. Of more than 100 bills dealing with the drugs introduced in 35 states in 2015 and 2016, at least 49 featured nearly identical language requiring insurers to cover abuse-deterrent drugs, according to an analysis of data from Quorum, a legislative tracking service. Several of the bill sponsors said they received the wording from pharmaceutical lobbyists.\u003c/p>\n\u003cp>Since 2012, at least 21 bills related to the drugs have become law, including five that require insurers to pay for the more expensive drugs in Maine, Maryland, Massachusetts, Florida and West Virginia.\u003c/p>\n\u003cp>Wins in such states will give drugmakers momentum to successfully push for copycat laws elsewhere, noted Paul Kelly, a federal lobbyist who has worked on multistate lobbying campaigns for drugstores and major retailers.\u003c/p>\n\u003cp>\"It's like a foot in the door,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Fierce Opposition\u003c/strong>\u003c/p>\n\u003cp>Drugmakers have found fierce opposition to their ADF legislation from insurers and employers who would be on the hook for the far pricier opioid variations.\u003c/p>\n\u003cp>The Illinois bill — and the 48 strikingly similar measures in other states — would require insurers to cover the drugs in the same way as other opioids, which the insurance companies argue would allow drugmakers to charge whatever they want for them.\u003c/p>\n\u003cp>\"That is not the best use of our medical care resources,\" Vernon Rowen, vice president of state government affairs for the insurance company Aetna, told Illinois lawmakers after Bartlett testified. \"It totally eliminates our ability to negotiate discounts with manufacturers.\"\u003c/p>\n\u003cp>New York Gov. Andrew Cuomo and New Jersey Gov. Chris Christie both vetoed such insurance mandates in the past year, citing the high costs and lack of evidence that the drugs help.\u003c/p>\n\u003cp>Federal health officials also have pushed back against requirements to cover the drugs, citing the \"staggering\" costs. For example, a 30-day supply of Pfizer's abuse-deterrent Embeda, a combination drug containing morphine, costs $268, while a 30-day supply of a generic morphine costs roughly $38, according to data compiled by Truven Health Analytics, a company that tracks drug prices set by manufacturers.\u003c/p>\n\u003cp>The Department of Veterans Affairs' Dr. Bernie Good estimated that converting the 8.8 million patient system exclusively to the new reformulations would increase opioid spending more than tenfold, to over $1.6 billion annually. Good, who co-directs the VA's program for medication safety, said the vast majority of veterans are not at risk for snorting or injecting their medications.\u003c/p>\n\u003cp>\"Would the excess money to pay for abuse-deterrent products — mostly to pay for it in cases where it wouldn't be necessary — be better spent for drug treatment centers?\" he asked at a recent federal meeting on the drugs.\u003c/p>\n\u003cp>Federal estimates say at least 2.2 million Americans are addicted to prescription opioids or heroin, yet only one in five actually receives treatment, according to a Surgeon General's report published last month. That's despite some $35 billion already spent annually on substance abuse programs by private and public health providers.\u003c/p>\n\u003cp>State lawmakers who support the abuse-deterrent bills often defend them as an important piece of solving the opioid puzzle, preventing more costly overdoses and hospitalizations.\u003c/p>\n\u003cp>And Fred Brason, executive director of Project Lazarus, a North Carolina-based group that promotes anti-addiction policies in several states, called the focus on the drugs' cost too narrow.\u003c/p>\n\u003cp>\"You're already spending that money at the back end,\" he said. \"You're spending it at the emergency department.\" He also noted the costs of addiction treatment.\u003c/p>\n\u003cp>\u003cstrong>Industry-Supported Groups and Physicians\u003c/strong>\u003c/p>\n\u003cp>When critics raise alarms about higher costs and limited evidence, drugmakers can rely on groups they support financially to argue their side, including the National Association of Drug Diversion Investigators, the Academy of Integrative Pain Management and the Partnership for Drug-Free Kids. Representatives from those groups have testified in favor of abuse-deterrent legislation in at least seven states.\u003c/p>\n\u003cp>NADDI president Charlie Cichon acknowledged his group receives funds from several ADF-makers, but said it views the drugs as a proven part of the solution to the opioid crisis. \"We're not testifying for Purdue Pharma's product or Endo's product,\" he said.\u003c/p>\n\u003cp>And Bob Twillman, executive director of the Academy, said, \"Increased use of abuse-deterrent opioids makes it more likely that those patients who need opiates to treat their pain will be able to get them.\"\u003c/p>\n\u003cp>The Partnership for Drug-Free Kids did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Physicians with financial ties to drugmakers play similar roles. Dr. Gareth Shemesh, a pain specialist, testified in support of a Colorado bill last year brought to the sponsoring legislator by Pfizer. Shemesh had received more than $13,500 from Pfizer that year in speaking fees, travel and meals, and more than $5,000 from Purdue the year before. He did not respond to repeated calls for comment, but Pfizer said he was not paid to testify and did not speak on behalf of any specific product.\u003c/p>\n\u003cp>\u003cstrong>Political Contributions Ramped Up\u003c/strong>\u003c/p>\n\u003cp>Purdue and Pfizer also have ramped up contributions to the Republican and Democratic attorneys general associations, which raise unlimited funds to help elect AGs across the country. In 2015 and 2016, they gave a total of $950,000 — more than in the previous four years combined.\u003c/p>\n\u003cp>To date, 51 attorneys general from U.S. states and territories have signed at least one of two National Association of Attorneys General letters to the FDA, urging the agency to favor abuse-deterrent drugs.\u003c/p>\n\u003cp>The pro-ADF playbook even includes a bit of political theater. In at least seven states, lawmakers or advocates have pounded the reformulated pills with hammers to demonstrate how difficult they are to smash.\u003c/p>\n\u003cp>In Illinois, it was Democratic Rep. Sara Feigenholtz wielding the hammer on the same committee that heard Terri Bartlett's testimony. The main sponsor of the bill prioritizing ADFs, Feigenholtz ranked second-highest among legislative recipients of money from Pfizer since the start of 2010, according to an analysis of data from the National Institute on Money in State Politics. The $6,200 she received during that period was more than she had received in the 14 previous years combined. Her bill passed the committee but later stalled in the Legislature and remains pending.\u003c/p>\n\u003cp>She did not return multiple requests for comment. Pfizer said its contributions to Feigenholtz go back 20 years and it would be \"inaccurate and misleading\" to suggest a tie to any one piece of legislation.\u003c/p>\n\u003cp>Bartlett said she doesn't mind that Purdue was ultimately responsible for her invitation to testify, even though she didn't know that at the time. She still supports the bill.\u003c/p>\n\u003cp>\"I want to believe that in every pharmaceutical company there still remains some sort of humanity,\" she said. \"Saving life is expensive.\"\u003c/p>\n\u003cp>\u003cstrong>'An addict can find a way'\u003c/strong>\u003c/p>\n\u003cp>The FDA has walked a careful line on the new drugs, promoting them as a promising approach to discouraging abuse while acknowledging their real-world benefits remain largely theoretical.\u003c/p>\n\u003cp>Earlier this year, the agency highlighted the drugs in its \"opioids action plan,\" issued after scathing criticism from some members of Congress that the FDA wasn't doing enough to combat the epidemic.\u003c/p>\n\u003cp>Thus far, the agency has approved seven drugs with labeling suggesting they are \"expected to\" discourage abuse, based on studies conducted by pharmaceutical companies.\u003c/p>\n\u003cp>But the FDA has not yet concluded that any of the products have a \"real-world impact\" on measures like overdose or death, according to Dr. Douglas Throckmorton, an agency deputy director. He and other regulators predict, however, that the reformulations will eventually translate into public health results.\u003c/p>\n\u003cp>\"We stand by those predictions,\" Throckmorton said at a recent public meeting on the drugs. \"We're confident in the science, we're confident in the assessments we conducted.\"\u003c/p>\n\u003cp>Even some former FDA advisers who support expanded use of the drugs say they are only part of the solution. Dr. Lewis Nelson, who previously chaired an FDA panel on drug safety, notes that the drugs don't deter the most common form of abuse: swallowing pills whole.\u003c/p>\n\u003cp>\"Certainly, you might not eat one and get high,\" he said. \"You eat three and get high.\"\u003c/p>\n\u003cp>At least one study found that while OxyContin's reformulation coincided with many abusers switching to other drugs, other users still were able to defeat the pills' technology and snort or inject the contents.\u003c/p>\n\u003cp>David Rook, a 40-year-old Henrico, Virginia, resident who now operates a recovery facility, was among them. Before entering treatment, he said, he would break down abuse-deterrent OxyContins and crush-resistant Opanas using water, lemon juice and a microwave.\u003c/p>\n\u003cp>\"The truth is an addict can find a way to abuse a medication one way or the other,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Unpredictable Effects\u003c/strong>\u003c/p>\n\u003cp>A recent HIV outbreak in rural Indiana illustrates the sometimes unpredictable effect of ADFs on abusers' behavior.\u003c/p>\n\u003cp>Approximately 210 people have tested positive for the virus in Scott County since 2014, a public health crisis linked to needle-sharing among abusers of Opana. Endo Pharmaceuticals received approval for a reformulated version of the drug in 2011, making it harder to crush. As a result, many abusers switched from snorting the drug to injecting it with syringes, leading to the spread of the blood-borne HIV virus, according to the state health commissioner and other officials.\u003c/p>\n\u003cp>Endo spokeswoman Heather Zoumas Lubeski declined to comment on the outbreak, but issued a statement saying, \"Patient safety has always been a top priority for Endo and we are committed to providing patients with approved products that are safe and effective when used as prescribed.\"\u003c/p>\n\u003cp>The FDA declined to approve labeling claims for Opana's anti-abuse features, noting that the drug still can easily be cooked and injected.\u003c/p>\n\u003cp>Pfizer, Purdue, Endo and Teva Pharmaceuticals Industries Ltd. spent more than $20 million between 2012 and 2015 on federal lobbying efforts that included support of a bill that would require the FDA to gradually replace current opioids with harder-to-abuse versions that become available. Teva declined comment.\u003c/p>\n\u003cp>Rep. William Keating, D-Mass., first introduced the bill in 2012 and tried again in 2013 and 2015. Like his colleagues at the state level, he employed the hammer-smashing routine to illustrate the medications' crush-resistant properties.\u003c/p>\n\u003cp>Keating said the industry played no part in spurring the bill, even though the head of a nonprofit association funded by abuse-deterrent drugmakers spoke at the press conference introducing his legislation. He also received $2,500 in political contributions from makers of reformulated opioids in 2011 and 2012, a small fraction of his overall fundraising haul.\u003c/p>\n\u003cp>\"My interest in this stems from when I was a district attorney and I got to see the lives that were lost,\" Keating said in an interview.\u003c/p>\n\u003cp>While Keating's bill has not received a vote in Congress, the FDA already has begun moving in the direction suggested by companies, mapping out a process for removing older opioids from the market when newer versions are shown to be more effective at thwarting abuse.\u003c/p>\n\u003cp>\"You don't have to pass a bill, necessarily, to change policy,\" said Dan Cohen of the Abuse Deterrent Coalition, which represents smaller abuse-deterrent manufacturers.\u003c/p>\n\u003cp>The lack of real-world data on reformulated opioids is the main reason some federal officials haven't embraced them.\u003c/p>\n\u003cp>The CDC did not recommend ADFs in its landmark opioid guidelines this year, the first-ever federal recommendations for doctors prescribing the drugs. Why? Frieden, the agency's director, said his staff could not find any evidence showing the updated opioids actually reduce rates of addiction, overdoses or deaths.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Center for Public Integrity data reporter Ben Wieder contributed to this article.\u003c/em>\u003c/p>\n\n",
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"headline": "Drugmakers Push Unproven Solution to Opioid Epidemic They Helped Create",
"datePublished": "2016-12-20T10:25:59-08:00",
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"nprByline": "Matthew Perrone\u003cbr />Geoff Mulvihill\u003cbr />Liz Essley Whyte\u003cbr />Associated Press and Center for Public Integrity",
"source": "KQED Future of You",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Pilloried for their role in the epidemic of prescription painkiller abuse, drugmakers are aggressively pushing their remedy to the problem: a new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there's little proof they reduce rates of overdoses or deaths.\u003c/p>\n\u003caside class=\"pullquote alignright\">Harder-to-manipulate opioids have racked up billions in sales, despite a lack of proof that they reduce overdoses.\u003c/aside>\n\u003cp>More than prescriptions are at stake. Critics worry the drugmakers' nationwide lobbying campaign is distracting from more productive solutions and delaying crucial efforts to steer physicians away from prescription opioids — addictive pain medications involved in the deaths of more than 165,000 Americans since 2000.\u003c/p>\n\u003cp>\"If we've learned one lesson from the last 20 years on opioids it's that these products have very, very high inherent risks,\" said Dr. Caleb Alexander, co-director of Johns Hopkins University's Center for Drug Safety and Effectiveness. \"My concern is that they'll contribute to a perception that there is a safe opioid, and there's no such thing as a fully safe opioid.\"\u003c/p>\n\u003cp>The latest drugs — known as abuse-deterrent formulations, or ADFs — are generally harder to crush or dissolve, which the drugmakers tout as making them difficult to snort or inject. But they still are vulnerable to manipulation and potentially addictive when simply swallowed. National data from an industry-sponsored tracking system also show drug abusers quickly drop the reformulated drugs in favor of older painkillers or heroin.\u003c/p>\n\u003cp>In the last two years, pharmaceutical companies have made a concerted under-the-radar push for bills benefiting the anti-abuse opioids in statehouses and in Congress, where proposed legislation would require the Food and Drug Administration to replace older opioids with the new drugs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The lobbying push features industry-funded advocacy groups and physicians, along with grieving family members, who rarely disclosed the drugmakers' ties during their testimony in support of the drugs.\u003c/p>\n\u003cp>Besides the tamper-resistant pills, ADF opioids are being rolled out in other forms, including injectable drugs and pills that irritate users when they're snorted or contain substances that counteract highs.\u003c/p>\n\u003cp>\u003cstrong>Sales Opportunity\u003c/strong>\u003c/p>\n\u003cp>Making painkillers harder to abuse is a common-sense step. But it's also a multibillion-dollar sales opportunity, offering drugmakers the potential to wipe out lower-cost generic competitors and lock in sales of their higher-priced versions, which cost many times more than conventional pills. The big companies hold multiple patents on the reformulated drugs, shielding them from competition for years — in some cases decades.\u003c/p>\n\u003cp>Though abuse-deterrent painkillers represented less than 5 percent of all opioids prescribed last year, they generated more than $2.4 billion in sales, or roughly a quarter of the nearly $10 billion U.S. market for the drugs, according to IMS Health. The field is dominated by Purdue Pharma's OxyContin, patent-protected until 2030.\u003c/p>\n\u003cp>\"We at Purdue make certain that prescribers and other stakeholders understand that opioids with abuse-deterrent properties won't stop all prescription drug abuse, but they are an important part of the comprehensive approach needed to address this public health issue,\" Purdue spokesman Robert Josephson said in a statement.\u003c/p>\n\u003cp>Like a spokeswoman for Pfizer Inc., Josephson also noted that some public health officials, including the Food and Drug Administration, have endorsed using ADFs.\u003c/p>\n\u003cp>\"We need every tool that we can have in our toolbox,\" said Kentucky state Rep. Addia Wuchner, a Republican who has worked on several bills to benefit reformulated opioids. \"The extra steps are worth the effort in order to prevent this escalation of more addiction.\"\u003c/p>\n\u003cp>\u003cstrong>Massive Lobbying Effort\u003c/strong>\u003c/p>\n\u003cp>The current industry campaign draws on the same 50-state strategy that painkiller manufacturers successfully deployed to help kill or weaken measures aimed at stemming the tide of prescription opioids, a playbook The Associated Press and Center for Public Integrity exposed in September.\u003c/p>\n\u003cp>The \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/09/19/how-drugmakers-used-money-and-influence-to-shape-the-national-response-to-opioid-abuse/\" target=\"_blank\">reporting \u003c/a>detailed how opioid drugmakers and the nonprofits they help fund spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade, eight times what the gun lobby reported for the same period. The money represents the drugmakers' spending on all their legislative interests, including opioids.\u003c/p>\n\u003cp>The FDA has approved a handful of the reformulated drugs but has not yet concluded that any reduce rates of addiction, abuse or death, and the evidence gap has led to diverging views among health authorities.\u003c/p>\n\u003cp>\u003cstrong>'No less addictive'\u003c/strong>\u003c/p>\n\u003cp>Whereas FDA regulators emphasize the potential promise of reformulated painkillers, other government officials stress that they contain the same heroin-like ingredients as traditional opioids. An estimated 78 Americans die from heroin and prescription opioid overdoses every day.\u003c/p>\n\u003cp>\"'Abuse-deterrent' sounds to people sometimes like 'Oh, maybe it's not addictive.' But it's no less addictive,\" said Dr. Tom Frieden, head of the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Survey results published this year in the Clinical Journal of Pain showed nearly half of U.S. physicians incorrectly believed that reformulated opioids are less addictive than their predecessors.\u003c/p>\n\u003cp>Many experts see a key role for ADFs in reducing the number of people who first begin abusing opioids, and some say the abuse-deterrent formulations should be the default painkiller for patients with histories of drug use, anxiety or depression. But even they worry that some drugmakers are overselling the technology. They stress that separate measures are needed for the majority of opioid abusers who ingest the pills orally.\u003c/p>\n\u003cp>\"The way they're handling the ADF is that this is the answer. And it's not the answer — it's part of the bigger puzzle,\" said Theodore Cicero, a psychiatry professor at Washington University in St. Louis, who has authored several studies on the drugs.\u003c/p>\n\u003cp>\u003cstrong>'You can't put a price tag on anybody's life'\u003c/strong>\u003c/p>\n\u003cp>Two years after the overdose that killed her 21-year-old son, Terri Bartlett traveled to Illinois' state capital to champion an unlikely cause: revamped painkillers.\u003c/p>\n\u003cp>Bartlett's son Michael became hooked on Vicodin and later graduated to heroin. In emotional testimony last year, she urged lawmakers to support a bill that would prioritize the new harder-to-crush pills, saying she believed her son would still be alive if abuse-deterrent formulations had been on the market then.\u003c/p>\n\u003cp>\"You can't put a price tag on anybody's life,\" she said.\u003c/p>\n\u003cp>Bartlett didn't know then that she had been recruited into a wide-ranging lobbying campaign. A public relations firm hired by OxyContin-maker Purdue had helped recruit her to support the bill, along with local sheriffs and fire chiefs.\u003c/p>\n\u003cp>Her words, and similar testimony from parents of drug abusers elsewhere, reflect a tactic used by the drugmakers across the country. For instance, Purdue paid nearly $95,000 for similar lobbying efforts in New York, state records show.\u003c/p>\n\u003cp>And the industry's fingerprints are easy to spot in other areas. Of more than 100 bills dealing with the drugs introduced in 35 states in 2015 and 2016, at least 49 featured nearly identical language requiring insurers to cover abuse-deterrent drugs, according to an analysis of data from Quorum, a legislative tracking service. Several of the bill sponsors said they received the wording from pharmaceutical lobbyists.\u003c/p>\n\u003cp>Since 2012, at least 21 bills related to the drugs have become law, including five that require insurers to pay for the more expensive drugs in Maine, Maryland, Massachusetts, Florida and West Virginia.\u003c/p>\n\u003cp>Wins in such states will give drugmakers momentum to successfully push for copycat laws elsewhere, noted Paul Kelly, a federal lobbyist who has worked on multistate lobbying campaigns for drugstores and major retailers.\u003c/p>\n\u003cp>\"It's like a foot in the door,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Fierce Opposition\u003c/strong>\u003c/p>\n\u003cp>Drugmakers have found fierce opposition to their ADF legislation from insurers and employers who would be on the hook for the far pricier opioid variations.\u003c/p>\n\u003cp>The Illinois bill — and the 48 strikingly similar measures in other states — would require insurers to cover the drugs in the same way as other opioids, which the insurance companies argue would allow drugmakers to charge whatever they want for them.\u003c/p>\n\u003cp>\"That is not the best use of our medical care resources,\" Vernon Rowen, vice president of state government affairs for the insurance company Aetna, told Illinois lawmakers after Bartlett testified. \"It totally eliminates our ability to negotiate discounts with manufacturers.\"\u003c/p>\n\u003cp>New York Gov. Andrew Cuomo and New Jersey Gov. Chris Christie both vetoed such insurance mandates in the past year, citing the high costs and lack of evidence that the drugs help.\u003c/p>\n\u003cp>Federal health officials also have pushed back against requirements to cover the drugs, citing the \"staggering\" costs. For example, a 30-day supply of Pfizer's abuse-deterrent Embeda, a combination drug containing morphine, costs $268, while a 30-day supply of a generic morphine costs roughly $38, according to data compiled by Truven Health Analytics, a company that tracks drug prices set by manufacturers.\u003c/p>\n\u003cp>The Department of Veterans Affairs' Dr. Bernie Good estimated that converting the 8.8 million patient system exclusively to the new reformulations would increase opioid spending more than tenfold, to over $1.6 billion annually. Good, who co-directs the VA's program for medication safety, said the vast majority of veterans are not at risk for snorting or injecting their medications.\u003c/p>\n\u003cp>\"Would the excess money to pay for abuse-deterrent products — mostly to pay for it in cases where it wouldn't be necessary — be better spent for drug treatment centers?\" he asked at a recent federal meeting on the drugs.\u003c/p>\n\u003cp>Federal estimates say at least 2.2 million Americans are addicted to prescription opioids or heroin, yet only one in five actually receives treatment, according to a Surgeon General's report published last month. That's despite some $35 billion already spent annually on substance abuse programs by private and public health providers.\u003c/p>\n\u003cp>State lawmakers who support the abuse-deterrent bills often defend them as an important piece of solving the opioid puzzle, preventing more costly overdoses and hospitalizations.\u003c/p>\n\u003cp>And Fred Brason, executive director of Project Lazarus, a North Carolina-based group that promotes anti-addiction policies in several states, called the focus on the drugs' cost too narrow.\u003c/p>\n\u003cp>\"You're already spending that money at the back end,\" he said. \"You're spending it at the emergency department.\" He also noted the costs of addiction treatment.\u003c/p>\n\u003cp>\u003cstrong>Industry-Supported Groups and Physicians\u003c/strong>\u003c/p>\n\u003cp>When critics raise alarms about higher costs and limited evidence, drugmakers can rely on groups they support financially to argue their side, including the National Association of Drug Diversion Investigators, the Academy of Integrative Pain Management and the Partnership for Drug-Free Kids. Representatives from those groups have testified in favor of abuse-deterrent legislation in at least seven states.\u003c/p>\n\u003cp>NADDI president Charlie Cichon acknowledged his group receives funds from several ADF-makers, but said it views the drugs as a proven part of the solution to the opioid crisis. \"We're not testifying for Purdue Pharma's product or Endo's product,\" he said.\u003c/p>\n\u003cp>And Bob Twillman, executive director of the Academy, said, \"Increased use of abuse-deterrent opioids makes it more likely that those patients who need opiates to treat their pain will be able to get them.\"\u003c/p>\n\u003cp>The Partnership for Drug-Free Kids did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Physicians with financial ties to drugmakers play similar roles. Dr. Gareth Shemesh, a pain specialist, testified in support of a Colorado bill last year brought to the sponsoring legislator by Pfizer. Shemesh had received more than $13,500 from Pfizer that year in speaking fees, travel and meals, and more than $5,000 from Purdue the year before. He did not respond to repeated calls for comment, but Pfizer said he was not paid to testify and did not speak on behalf of any specific product.\u003c/p>\n\u003cp>\u003cstrong>Political Contributions Ramped Up\u003c/strong>\u003c/p>\n\u003cp>Purdue and Pfizer also have ramped up contributions to the Republican and Democratic attorneys general associations, which raise unlimited funds to help elect AGs across the country. In 2015 and 2016, they gave a total of $950,000 — more than in the previous four years combined.\u003c/p>\n\u003cp>To date, 51 attorneys general from U.S. states and territories have signed at least one of two National Association of Attorneys General letters to the FDA, urging the agency to favor abuse-deterrent drugs.\u003c/p>\n\u003cp>The pro-ADF playbook even includes a bit of political theater. In at least seven states, lawmakers or advocates have pounded the reformulated pills with hammers to demonstrate how difficult they are to smash.\u003c/p>\n\u003cp>In Illinois, it was Democratic Rep. Sara Feigenholtz wielding the hammer on the same committee that heard Terri Bartlett's testimony. The main sponsor of the bill prioritizing ADFs, Feigenholtz ranked second-highest among legislative recipients of money from Pfizer since the start of 2010, according to an analysis of data from the National Institute on Money in State Politics. The $6,200 she received during that period was more than she had received in the 14 previous years combined. Her bill passed the committee but later stalled in the Legislature and remains pending.\u003c/p>\n\u003cp>She did not return multiple requests for comment. Pfizer said its contributions to Feigenholtz go back 20 years and it would be \"inaccurate and misleading\" to suggest a tie to any one piece of legislation.\u003c/p>\n\u003cp>Bartlett said she doesn't mind that Purdue was ultimately responsible for her invitation to testify, even though she didn't know that at the time. She still supports the bill.\u003c/p>\n\u003cp>\"I want to believe that in every pharmaceutical company there still remains some sort of humanity,\" she said. \"Saving life is expensive.\"\u003c/p>\n\u003cp>\u003cstrong>'An addict can find a way'\u003c/strong>\u003c/p>\n\u003cp>The FDA has walked a careful line on the new drugs, promoting them as a promising approach to discouraging abuse while acknowledging their real-world benefits remain largely theoretical.\u003c/p>\n\u003cp>Earlier this year, the agency highlighted the drugs in its \"opioids action plan,\" issued after scathing criticism from some members of Congress that the FDA wasn't doing enough to combat the epidemic.\u003c/p>\n\u003cp>Thus far, the agency has approved seven drugs with labeling suggesting they are \"expected to\" discourage abuse, based on studies conducted by pharmaceutical companies.\u003c/p>\n\u003cp>But the FDA has not yet concluded that any of the products have a \"real-world impact\" on measures like overdose or death, according to Dr. Douglas Throckmorton, an agency deputy director. He and other regulators predict, however, that the reformulations will eventually translate into public health results.\u003c/p>\n\u003cp>\"We stand by those predictions,\" Throckmorton said at a recent public meeting on the drugs. \"We're confident in the science, we're confident in the assessments we conducted.\"\u003c/p>\n\u003cp>Even some former FDA advisers who support expanded use of the drugs say they are only part of the solution. Dr. Lewis Nelson, who previously chaired an FDA panel on drug safety, notes that the drugs don't deter the most common form of abuse: swallowing pills whole.\u003c/p>\n\u003cp>\"Certainly, you might not eat one and get high,\" he said. \"You eat three and get high.\"\u003c/p>\n\u003cp>At least one study found that while OxyContin's reformulation coincided with many abusers switching to other drugs, other users still were able to defeat the pills' technology and snort or inject the contents.\u003c/p>\n\u003cp>David Rook, a 40-year-old Henrico, Virginia, resident who now operates a recovery facility, was among them. Before entering treatment, he said, he would break down abuse-deterrent OxyContins and crush-resistant Opanas using water, lemon juice and a microwave.\u003c/p>\n\u003cp>\"The truth is an addict can find a way to abuse a medication one way or the other,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Unpredictable Effects\u003c/strong>\u003c/p>\n\u003cp>A recent HIV outbreak in rural Indiana illustrates the sometimes unpredictable effect of ADFs on abusers' behavior.\u003c/p>\n\u003cp>Approximately 210 people have tested positive for the virus in Scott County since 2014, a public health crisis linked to needle-sharing among abusers of Opana. Endo Pharmaceuticals received approval for a reformulated version of the drug in 2011, making it harder to crush. As a result, many abusers switched from snorting the drug to injecting it with syringes, leading to the spread of the blood-borne HIV virus, according to the state health commissioner and other officials.\u003c/p>\n\u003cp>Endo spokeswoman Heather Zoumas Lubeski declined to comment on the outbreak, but issued a statement saying, \"Patient safety has always been a top priority for Endo and we are committed to providing patients with approved products that are safe and effective when used as prescribed.\"\u003c/p>\n\u003cp>The FDA declined to approve labeling claims for Opana's anti-abuse features, noting that the drug still can easily be cooked and injected.\u003c/p>\n\u003cp>Pfizer, Purdue, Endo and Teva Pharmaceuticals Industries Ltd. spent more than $20 million between 2012 and 2015 on federal lobbying efforts that included support of a bill that would require the FDA to gradually replace current opioids with harder-to-abuse versions that become available. Teva declined comment.\u003c/p>\n\u003cp>Rep. William Keating, D-Mass., first introduced the bill in 2012 and tried again in 2013 and 2015. Like his colleagues at the state level, he employed the hammer-smashing routine to illustrate the medications' crush-resistant properties.\u003c/p>\n\u003cp>Keating said the industry played no part in spurring the bill, even though the head of a nonprofit association funded by abuse-deterrent drugmakers spoke at the press conference introducing his legislation. He also received $2,500 in political contributions from makers of reformulated opioids in 2011 and 2012, a small fraction of his overall fundraising haul.\u003c/p>\n\u003cp>\"My interest in this stems from when I was a district attorney and I got to see the lives that were lost,\" Keating said in an interview.\u003c/p>\n\u003cp>While Keating's bill has not received a vote in Congress, the FDA already has begun moving in the direction suggested by companies, mapping out a process for removing older opioids from the market when newer versions are shown to be more effective at thwarting abuse.\u003c/p>\n\u003cp>\"You don't have to pass a bill, necessarily, to change policy,\" said Dan Cohen of the Abuse Deterrent Coalition, which represents smaller abuse-deterrent manufacturers.\u003c/p>\n\u003cp>The lack of real-world data on reformulated opioids is the main reason some federal officials haven't embraced them.\u003c/p>\n\u003cp>The CDC did not recommend ADFs in its landmark opioid guidelines this year, the first-ever federal recommendations for doctors prescribing the drugs. Why? Frieden, the agency's director, said his staff could not find any evidence showing the updated opioids actually reduce rates of addiction, overdoses or deaths.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Center for Public Integrity data reporter Ben Wieder contributed to this article.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hospitalized Elderly Have Lower Death Rate When Cared for by Female Doc: Study",
"title": "Hospitalized Elderly Have Lower Death Rate When Cared for by Female Doc: Study",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>In a study that is sure to rile male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Patients cared for by women were less likely to die or return to the hospital after discharge.\u003c/p>\n\u003cp>Previous research has shown that female doctors are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/8769910\">more likely to follow\u003c/a> recommendations about prevention counseling and to order \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJM199308123290707#t=article\">preventive tests\u003c/a> like Pap smears and mammograms.\u003c/p>\n\u003cp>But the \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593255\">latest work\u003c/a>, published Monday in \u003cem>JAMA Internal Medicine\u003c/em>, is the first to show a big difference in the result that matters most to patients: life or death.\u003c/p>\n\u003cp>The study's authors estimate \"that approximately 32,000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year.\"\u003c/p>\n\u003cp>\"Of course! What did you expect?\" replied the wife of Dr. Ashish Jha, the study's senior author, when he shared his team's findings with her. Jha said he expects a backlash on the study results. But his team's methodology, successfully put through multiple analyses, makes this work noteworthy, he added.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But tens of thousands of fewer deaths per year if we just went with female doctors?\u003c/p>\n\u003cp>Whoa! To us, a man and woman who met as we were getting our start in medicine, them's fightin' words.\u003c/p>\n\u003cp>An \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593252\">editorial\u003c/a> about the study urges doctors to remedy the gender disparities in care and the pay gap that favors male physicians over women.\u003c/p>\n\u003cp>Since half the patients we treat are women and girls, it makes sense that at least half the physician corps should reflect the population. We've achieved that in \u003ca href=\"https://www.aamc.org/members/gwims/statistics/\">medical school\u003c/a> rolls, but overall only a third of practicing doctors are female. And many specialties, including orthopedics, cardiology and neurosurgery, are still dominated by men.\u003c/p>\n\u003cp>So why is there a gender-based difference in physicians' care? The authors admit that they are \"unable to identify exactly why female physicians have better outcomes than male physicians.\"\u003c/p>\n\u003cp>We don't pretend to know for sure, but as married doctors, we have our hunches. We talked it over and here are our thoughts about the research.\u003c/p>\n\u003cp>\u003cstrong>Dr. Sarah-Anne Henning Schumann:\u003c/strong> The actual effect reported in the study is small, but multiplied over a huge population it does add up to something significant.\u003c/p>\n\u003cp>\u003cstrong>Dr. John Henning Schumann:\u003c/strong> I like the Big Data aspect of it. The authors said, \"Let's look at more than a million Medicare patients over several years and see how they fared based on the gender of their doctor.\" While many people may want to tear this study apart, I think the findings make intuitive sense.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm assuming the difference is because of the way that women, in general, communicate. It's about being better listeners, more nurturing and having emotional intelligence.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> There are plenty of men who are good communicators.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Yes, just as there are plenty of women who don't really have those qualities. For female doctors, having worked their way through pre-med, med school, and residency, they can have some of that nurturing communication skill beaten out of them.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That happens to men, too!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> That's true. But this study shows us — just possibly — that if female doctors, on average, communicate better, their style might be more effective in treating disease and preventing death.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> It's interesting to me because I think about some of my older patients, who much prefer that I tell them what to do rather than to discuss options and share decision-making.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I think that traditionally men were the doctors. People often assume men are more intelligent and so would be more likely to take their advice.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That has to change, as we get closer to parity with women in the profession.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> My mother has had many experiences with male doctors, where she feels they haven't listened to her. They aren't warm or kind, but she feels reassured anyway. She thinks they're smart, and what's most important to her is their knowledge and technical skill, not their bedside manner.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Mom always knows best, if that's what she values.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Even in our family, we're both doctors. I'm a family doctor, trained to see adults and kids. You're an internist, trained to only see adults. And in both of our families, most of the time, our family members will reach out to you with their questions — even about kids. And my family, who attended my Harvard Medical School graduation, I'll remind you, seems to value your opinion more. They seem to be looking for opinions more from men. That's kind of an interesting thing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> I never really thought about that. I can see how that's totally male privilege. It has to be frustrating to be taken less seriously.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm in a Facebook group of physicians who are moms. While it's not every doctor-mom in the country, there are over 60,000 of us in it. So many tell stories of being mistaken for nurses—and taking great offense at that. We have worked so hard to get where we are and want to be treated as equals to our male colleagues.\u003c/p>\n\u003cp>But I see the mix-up as a compliment rather than an insult. To be compared with a nurse says that patients are seeing me as someone who is caring for them and nurturing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That's a smart way to reframe it. Our colleague Jill used to get angry when people assumed she was a nurse. Instead, she decided to embrace it and use it as a call to service. Now she asks patients if they need an extra blanket or something to drink. And she believes that she provides better, more empathic care.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Everyone is going to want to know what is it about women that leads to these better outcomes. I think it's going to be hard to figure out exactly.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Do you think people that read or hear about this study will take home the message that they need to choose female doctors?\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Some will no doubt oversimplify it to that. What I take away is that if communication is the key, as I suspect, then we need to better select and train medical students and residents to exhibit these qualities.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Amen to that. What about equal pay for equal (or better!) outcomes? Paging, \u003ca href=\"https://www.eeoc.gov/eeoc/publications/brochure-equal_pay_and_ledbetter_act.cfm\">Lilly Ledbetter\u003c/a>!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> You're not really asking me that, are you?\u003c/p>\n\u003cp>\u003cem>Sarah-Anne Henning Schumann is a family doctor and serves as medical director of \u003c/em>\u003ca href=\"http://communityhealthconnection.org/\">Community Health Connection\u003c/a>,\u003cem> a federally qualified community health center in Tulsa, Okla.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>John Henning Schumann is an internal medicine doctor and serves as President of the University of Oklahoma's Tulsa campus. He also hosts \u003c/em>\u003ca href=\"http://publicradiotulsa.org/term/john-henning-schumann\">Studio Tulsa: Medical Monday\u003c/a>\u003cem> on KWGS Public Radio Tulsa. He's on Twitter: @\u003c/em>\u003ca href=\"https://twitter.com/glasshospital?lang=en\">\u003cem>GlassHospital\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 KWGS-FM. To see more, visit \u003ca href=\"http://publicradiotulsa.org/\">KWGS-FM\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Patients+Cared+For+By+Female+Doctors+Fare+Better+Than+Those+Treated+By+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "If male doctors were as good as their female counterparts at caring for older people in the hospital, about 32,000 fewer patients a year would die. What do women doctors do better than men?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a study that is sure to rile male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Patients cared for by women were less likely to die or return to the hospital after discharge.\u003c/p>\n\u003cp>Previous research has shown that female doctors are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/8769910\">more likely to follow\u003c/a> recommendations about prevention counseling and to order \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJM199308123290707#t=article\">preventive tests\u003c/a> like Pap smears and mammograms.\u003c/p>\n\u003cp>But the \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593255\">latest work\u003c/a>, published Monday in \u003cem>JAMA Internal Medicine\u003c/em>, is the first to show a big difference in the result that matters most to patients: life or death.\u003c/p>\n\u003cp>The study's authors estimate \"that approximately 32,000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year.\"\u003c/p>\n\u003cp>\"Of course! What did you expect?\" replied the wife of Dr. Ashish Jha, the study's senior author, when he shared his team's findings with her. Jha said he expects a backlash on the study results. But his team's methodology, successfully put through multiple analyses, makes this work noteworthy, he added.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But tens of thousands of fewer deaths per year if we just went with female doctors?\u003c/p>\n\u003cp>Whoa! To us, a man and woman who met as we were getting our start in medicine, them's fightin' words.\u003c/p>\n\u003cp>An \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593252\">editorial\u003c/a> about the study urges doctors to remedy the gender disparities in care and the pay gap that favors male physicians over women.\u003c/p>\n\u003cp>Since half the patients we treat are women and girls, it makes sense that at least half the physician corps should reflect the population. We've achieved that in \u003ca href=\"https://www.aamc.org/members/gwims/statistics/\">medical school\u003c/a> rolls, but overall only a third of practicing doctors are female. And many specialties, including orthopedics, cardiology and neurosurgery, are still dominated by men.\u003c/p>\n\u003cp>So why is there a gender-based difference in physicians' care? The authors admit that they are \"unable to identify exactly why female physicians have better outcomes than male physicians.\"\u003c/p>\n\u003cp>We don't pretend to know for sure, but as married doctors, we have our hunches. We talked it over and here are our thoughts about the research.\u003c/p>\n\u003cp>\u003cstrong>Dr. Sarah-Anne Henning Schumann:\u003c/strong> The actual effect reported in the study is small, but multiplied over a huge population it does add up to something significant.\u003c/p>\n\u003cp>\u003cstrong>Dr. John Henning Schumann:\u003c/strong> I like the Big Data aspect of it. The authors said, \"Let's look at more than a million Medicare patients over several years and see how they fared based on the gender of their doctor.\" While many people may want to tear this study apart, I think the findings make intuitive sense.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm assuming the difference is because of the way that women, in general, communicate. It's about being better listeners, more nurturing and having emotional intelligence.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> There are plenty of men who are good communicators.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Yes, just as there are plenty of women who don't really have those qualities. For female doctors, having worked their way through pre-med, med school, and residency, they can have some of that nurturing communication skill beaten out of them.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That happens to men, too!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> That's true. But this study shows us — just possibly — that if female doctors, on average, communicate better, their style might be more effective in treating disease and preventing death.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> It's interesting to me because I think about some of my older patients, who much prefer that I tell them what to do rather than to discuss options and share decision-making.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I think that traditionally men were the doctors. People often assume men are more intelligent and so would be more likely to take their advice.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That has to change, as we get closer to parity with women in the profession.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> My mother has had many experiences with male doctors, where she feels they haven't listened to her. They aren't warm or kind, but she feels reassured anyway. She thinks they're smart, and what's most important to her is their knowledge and technical skill, not their bedside manner.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Mom always knows best, if that's what she values.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Even in our family, we're both doctors. I'm a family doctor, trained to see adults and kids. You're an internist, trained to only see adults. And in both of our families, most of the time, our family members will reach out to you with their questions — even about kids. And my family, who attended my Harvard Medical School graduation, I'll remind you, seems to value your opinion more. They seem to be looking for opinions more from men. That's kind of an interesting thing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> I never really thought about that. I can see how that's totally male privilege. It has to be frustrating to be taken less seriously.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm in a Facebook group of physicians who are moms. While it's not every doctor-mom in the country, there are over 60,000 of us in it. So many tell stories of being mistaken for nurses—and taking great offense at that. We have worked so hard to get where we are and want to be treated as equals to our male colleagues.\u003c/p>\n\u003cp>But I see the mix-up as a compliment rather than an insult. To be compared with a nurse says that patients are seeing me as someone who is caring for them and nurturing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That's a smart way to reframe it. Our colleague Jill used to get angry when people assumed she was a nurse. Instead, she decided to embrace it and use it as a call to service. Now she asks patients if they need an extra blanket or something to drink. And she believes that she provides better, more empathic care.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Everyone is going to want to know what is it about women that leads to these better outcomes. I think it's going to be hard to figure out exactly.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Do you think people that read or hear about this study will take home the message that they need to choose female doctors?\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Some will no doubt oversimplify it to that. What I take away is that if communication is the key, as I suspect, then we need to better select and train medical students and residents to exhibit these qualities.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Amen to that. What about equal pay for equal (or better!) outcomes? Paging, \u003ca href=\"https://www.eeoc.gov/eeoc/publications/brochure-equal_pay_and_ledbetter_act.cfm\">Lilly Ledbetter\u003c/a>!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> You're not really asking me that, are you?\u003c/p>\n\u003cp>\u003cem>Sarah-Anne Henning Schumann is a family doctor and serves as medical director of \u003c/em>\u003ca href=\"http://communityhealthconnection.org/\">Community Health Connection\u003c/a>,\u003cem> a federally qualified community health center in Tulsa, Okla.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>John Henning Schumann is an internal medicine doctor and serves as President of the University of Oklahoma's Tulsa campus. He also hosts \u003c/em>\u003ca href=\"http://publicradiotulsa.org/term/john-henning-schumann\">Studio Tulsa: Medical Monday\u003c/a>\u003cem> on KWGS Public Radio Tulsa. He's on Twitter: @\u003c/em>\u003ca href=\"https://twitter.com/glasshospital?lang=en\">\u003cem>GlassHospital\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 KWGS-FM. To see more, visit \u003ca href=\"http://publicradiotulsa.org/\">KWGS-FM\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Patients+Cared+For+By+Female+Doctors+Fare+Better+Than+Those+Treated+By+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New HIV Studies Offer Fresh Hope for a Cure",
"title": "New HIV Studies Offer Fresh Hope for a Cure",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>The HIV research community is increasingly optimistic about the promising \"shock and kill\" approach to eradicating HIV from infected patients. Such removal of all traces of the virus from an individual's body would represent an actual cure for AIDS.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We know from the science that a cure can happen.'\u003c/aside>\n\u003cp>A new small-scale human trial of the treatment is starting this week in New York and two sister sites, in Germany and Denmark. The trial will combine an anticancer drug, romidepsin, with antiretroviral drugs, also known as ARVs.\u003c/p>\n\u003cp>Another small human study will start in January, followed by a larger human shock and kill trial in June.\u003c/p>\n\u003cp>Shock and kill combines standard ARVs with an immune booster, a combo that’s been effective in test tube, animal and now human trials. The treatment flushes out and eradicates pockets of HIV, which lie inactive inside dormant immune cells even as antiretroviral drugs reduce the actively reproducing virus to undetectable levels in the blood.\u003c/p>\n\u003cp>The new trials follow validating shock and kill data from University of California, San Francisco researchers, shared at the HIV Cure Summit, held on Dec. 1 at UCSF.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">[contextly_sidebar id=\"mMgRCnE0h9dNvCoKR8ZADxCU0RnaFUGQ\"]\"I feel a very real sense of optimism based on the evidence that we know a cure can be achieved,” said Dr. Rowena Johnston, vice-president for amfAR, in a post-summit interview with KQED. “There is a fundamental understanding we have now of the barriers between us and a cure, and how we go about to solving the problems.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">In a related upcoming trial, a \u003cspan class=\"s1\">UCSF team will study whether an oral pill or IV drip is more effective in delivering drugs to tissue reservoirs where HIV hides. A separate observational study designed to serve as a reference for all HIV cure trials will monitor people who stop taking ARVs.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Building on a Breakthrough\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The mood at the HIV Cure Summit was one of cautious optimism, in part fueled by reports from the first human shock and kill trial in Britain. In October, UK scientists conducting a 50-person study announced that the first patient to complete the treatment, a 44-year-old man given Vorinostat, ARVs and vaccines to prod the immune system, \u003c/span>showed no detectable signs of the virus in his blood.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In short, he appeared cured. But \u003c/span>\u003cspan class=\"s1\">HIV scientists worldwide quickly deemed any declaration of victory premature, cautioning that more time, as well as tissue samples, are needed to judge the treatment's efficacy. The UK trial will wrap up in 2018, and no results are expected until then.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Animal Studies Offer Hope – And a Warning \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The early human findings mirror promising results from numerous lab and \u003cspan class=\"s2\">\u003ca href=\"http://www.iflscience.com/health-and-medicine/shock-and-kill-approach-cures-mice-hiv-world-first/\">animal studies\u003c/a> \u003c/span>employing shock and kill and related therapies. In October, researchers reported that several of eight monkeys given an immune therapy plus ARVs to flush out SIV, the simian cousin to HIV, now remain\u003ca href=\"http://www.reuters.com/article/us-aids-day-cure-analysis-idUSKBN13Q3BM\">\u003cspan class=\"s2\"> free\u003c/span>\u003c/a> of the virus after two years. The animals continue to be monitored. \u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cspan class=\"s1\">But another group has just issued a cautionary note. It may be that not all approaches to boosting the immune system will prove safe, even if effective. On Dec. 12, scientists reported \u003ca href=\"http://www.pharmpro.com/news/2016/12/hiv-shock-and-kill-strategy-may-harm-patient-brains\" target=\"_blank\">brain inflammation\u003c/a> in a study of three SIV-infected macaques given a year’s course of Vorinostat; Ingenol-B, another latency-reversing agent; and ARVs. While Vorinostat has passed human safety studies, Ingenol-B has not, said Johnston.\u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">\"Our study sounds a major cautionary note about the potential for unintended consequences of the shock-and-kill treatment strategy,\" stated Janice Clements, a veteran AIDS researchers at the Johns Hopkins University School of Medicine.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>The Berlin Patient\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the UCSF summit, researchers stressed the difference between a full or sterilizing cure, which would constitute eradication of every last particle of HIV, and a functional cure, meaning remission. In the latter, the immune system prevents HIV from ever emerging out of dormancy.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A total cure has only been achieved in one person to date: Timothy Ray Brown, also known as \u003ca href=\"http://www.sciencemag.org/news/2014/09/how-did-berlin-patient-rid-himself-hiv\" target=\"_blank\">The Berlin Patient\u003c/a>. Brown was initially infected with HIV in 1995. After years of antiretroviral drugs, Brown, who also suffers from acute myeloid leukemia, underwent chemotherapy followed by two stem cell transplants from a donor whose immune cells were genetically resistant to HIV. Today, nine years later, Brown remains free of any trace of the virus in not only his bloodstream but in myriad tissue samples. He recently relocated to participate in studies in San Francisco. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The Berlin Patient gave us the proof of concept” for an HIV cure, said Kevin Frost, amfAR CEO and the summit spokesperson. Referring to the number of people with HIV globally, he said, “Now we have to go from N-1 to N-37 million.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Berlin Patient's case was unique and his treatment prohibitively expensive, out of reach to millions with HIV. In the short term, a more realistic remedy than eradication of the virus is remission without antiretroviral drugs. A small minority of long-term HIV survivors, called \"\u003ca href=\"http://www.sfchronicle.com/health/article/Protected-from-HIV-elite-controllers-still-10420068.php\">\u003cspan class=\"s2\">elite controllers\u003c/span>\u003c/a>,\" already can manage without the drugs due to their own immune systems.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">If shock and kill therapies prove effective and durable, they will also prove a boon for HIV prevention. Two major \u003ca href=\"https://hptn.org/research/studies/33\">\u003cspan class=\"s2\">studies\u003c/span>\u003c/a> over the last five years in thousands of couples showed that individuals on ARVs with undetectable levels of HIV were \u003cspan class=\"s2\">\u003ca href=\"http://i-base.info/htb/30108\">not infectious. \u003c/a>\u003c/span>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A number of preventive shock and kill vaccines are now being evaluated in new laboratory studies.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Needed: R&D for New Tools\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Some of the buzz at the HIV Cure Summit focused on progress made with new tools to find, measure, and map latent HIV. UCSF's Peter Hunt introduced results of a new RNA-DNA probe that can simultaneously measure dormant and replicating HIV in tissue cells, as well as pinpoint the cell type. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">That allows for mapping of not only the regions where reservoirs of HIV are lurking but the individual cells, explained Johnston. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“It’s an incredible advance,\" Johnston said. \"There’s not a single group in the world who has done that.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Another UCSF researcher, Satish Pillai, presented a novel digital-drop technology and multifluid chip test that can analyze many cells at once. Such tools are critical to assess if patients off medicines will remain HIV-free.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Looking ahead, Frost of amfAR thought a barrier to more rapid progress is a lack of pharma investment in research and diagnostics. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“In the development of antiretrovirals, the pace of research accelerated at a speed commensurate with the revenue generated,\" he said. \"With only a few exceptions, pharma hasn’t even come to the table on cure research yet.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">HIV cure proponents also worry about possible cuts in research dollars under incoming President Donald Trump.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But such hurdles haven’t dampened their growing faith in a cure. \u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“We know from the science that a cure can happen,” said Pillai. “That’s definitely a reason to be hopeful. We just need more resources and more people involved to move us along faster.”\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The HIV research community is increasingly optimistic about the promising \"shock and kill\" approach to eradicating HIV from infected patients. Such removal of all traces of the virus from an individual's body would represent an actual cure for AIDS.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We know from the science that a cure can happen.'\u003c/aside>\n\u003cp>A new small-scale human trial of the treatment is starting this week in New York and two sister sites, in Germany and Denmark. The trial will combine an anticancer drug, romidepsin, with antiretroviral drugs, also known as ARVs.\u003c/p>\n\u003cp>Another small human study will start in January, followed by a larger human shock and kill trial in June.\u003c/p>\n\u003cp>Shock and kill combines standard ARVs with an immune booster, a combo that’s been effective in test tube, animal and now human trials. The treatment flushes out and eradicates pockets of HIV, which lie inactive inside dormant immune cells even as antiretroviral drugs reduce the actively reproducing virus to undetectable levels in the blood.\u003c/p>\n\u003cp>The new trials follow validating shock and kill data from University of California, San Francisco researchers, shared at the HIV Cure Summit, held on Dec. 1 at UCSF.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003c/p>\u003cp>\u003c/p>\u003cp>\"I feel a very real sense of optimism based on the evidence that we know a cure can be achieved,” said Dr. Rowena Johnston, vice-president for amfAR, in a post-summit interview with KQED. “There is a fundamental understanding we have now of the barriers between us and a cure, and how we go about to solving the problems.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">In a related upcoming trial, a \u003cspan class=\"s1\">UCSF team will study whether an oral pill or IV drip is more effective in delivering drugs to tissue reservoirs where HIV hides. A separate observational study designed to serve as a reference for all HIV cure trials will monitor people who stop taking ARVs.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Building on a Breakthrough\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The mood at the HIV Cure Summit was one of cautious optimism, in part fueled by reports from the first human shock and kill trial in Britain. In October, UK scientists conducting a 50-person study announced that the first patient to complete the treatment, a 44-year-old man given Vorinostat, ARVs and vaccines to prod the immune system, \u003c/span>showed no detectable signs of the virus in his blood.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In short, he appeared cured. But \u003c/span>\u003cspan class=\"s1\">HIV scientists worldwide quickly deemed any declaration of victory premature, cautioning that more time, as well as tissue samples, are needed to judge the treatment's efficacy. The UK trial will wrap up in 2018, and no results are expected until then.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Animal Studies Offer Hope – And a Warning \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The early human findings mirror promising results from numerous lab and \u003cspan class=\"s2\">\u003ca href=\"http://www.iflscience.com/health-and-medicine/shock-and-kill-approach-cures-mice-hiv-world-first/\">animal studies\u003c/a> \u003c/span>employing shock and kill and related therapies. In October, researchers reported that several of eight monkeys given an immune therapy plus ARVs to flush out SIV, the simian cousin to HIV, now remain\u003ca href=\"http://www.reuters.com/article/us-aids-day-cure-analysis-idUSKBN13Q3BM\">\u003cspan class=\"s2\"> free\u003c/span>\u003c/a> of the virus after two years. The animals continue to be monitored. \u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cspan class=\"s1\">But another group has just issued a cautionary note. It may be that not all approaches to boosting the immune system will prove safe, even if effective. On Dec. 12, scientists reported \u003ca href=\"http://www.pharmpro.com/news/2016/12/hiv-shock-and-kill-strategy-may-harm-patient-brains\" target=\"_blank\">brain inflammation\u003c/a> in a study of three SIV-infected macaques given a year’s course of Vorinostat; Ingenol-B, another latency-reversing agent; and ARVs. While Vorinostat has passed human safety studies, Ingenol-B has not, said Johnston.\u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">\"Our study sounds a major cautionary note about the potential for unintended consequences of the shock-and-kill treatment strategy,\" stated Janice Clements, a veteran AIDS researchers at the Johns Hopkins University School of Medicine.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>The Berlin Patient\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the UCSF summit, researchers stressed the difference between a full or sterilizing cure, which would constitute eradication of every last particle of HIV, and a functional cure, meaning remission. In the latter, the immune system prevents HIV from ever emerging out of dormancy.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A total cure has only been achieved in one person to date: Timothy Ray Brown, also known as \u003ca href=\"http://www.sciencemag.org/news/2014/09/how-did-berlin-patient-rid-himself-hiv\" target=\"_blank\">The Berlin Patient\u003c/a>. Brown was initially infected with HIV in 1995. After years of antiretroviral drugs, Brown, who also suffers from acute myeloid leukemia, underwent chemotherapy followed by two stem cell transplants from a donor whose immune cells were genetically resistant to HIV. Today, nine years later, Brown remains free of any trace of the virus in not only his bloodstream but in myriad tissue samples. He recently relocated to participate in studies in San Francisco. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The Berlin Patient gave us the proof of concept” for an HIV cure, said Kevin Frost, amfAR CEO and the summit spokesperson. Referring to the number of people with HIV globally, he said, “Now we have to go from N-1 to N-37 million.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Berlin Patient's case was unique and his treatment prohibitively expensive, out of reach to millions with HIV. In the short term, a more realistic remedy than eradication of the virus is remission without antiretroviral drugs. A small minority of long-term HIV survivors, called \"\u003ca href=\"http://www.sfchronicle.com/health/article/Protected-from-HIV-elite-controllers-still-10420068.php\">\u003cspan class=\"s2\">elite controllers\u003c/span>\u003c/a>,\" already can manage without the drugs due to their own immune systems.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">If shock and kill therapies prove effective and durable, they will also prove a boon for HIV prevention. Two major \u003ca href=\"https://hptn.org/research/studies/33\">\u003cspan class=\"s2\">studies\u003c/span>\u003c/a> over the last five years in thousands of couples showed that individuals on ARVs with undetectable levels of HIV were \u003cspan class=\"s2\">\u003ca href=\"http://i-base.info/htb/30108\">not infectious. \u003c/a>\u003c/span>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A number of preventive shock and kill vaccines are now being evaluated in new laboratory studies.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Needed: R&D for New Tools\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Some of the buzz at the HIV Cure Summit focused on progress made with new tools to find, measure, and map latent HIV. UCSF's Peter Hunt introduced results of a new RNA-DNA probe that can simultaneously measure dormant and replicating HIV in tissue cells, as well as pinpoint the cell type. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">That allows for mapping of not only the regions where reservoirs of HIV are lurking but the individual cells, explained Johnston. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“It’s an incredible advance,\" Johnston said. \"There’s not a single group in the world who has done that.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Another UCSF researcher, Satish Pillai, presented a novel digital-drop technology and multifluid chip test that can analyze many cells at once. Such tools are critical to assess if patients off medicines will remain HIV-free.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Looking ahead, Frost of amfAR thought a barrier to more rapid progress is a lack of pharma investment in research and diagnostics. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“In the development of antiretrovirals, the pace of research accelerated at a speed commensurate with the revenue generated,\" he said. \"With only a few exceptions, pharma hasn’t even come to the table on cure research yet.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">HIV cure proponents also worry about possible cuts in research dollars under incoming President Donald Trump.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But such hurdles haven’t dampened their growing faith in a cure. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Scientists in Ireland are using a rather unexpected material to make an extremely sensitive pressure detector: Silly Putty.\u003c/p>\n\u003cp>The Irish researchers combined the kids' plaything with a special form of carbon, and came up with a remarkable new material — one they think could someday be useful in making medical devices.\u003c/p>\n\u003cp>Physicist \u003ca href=\"http://www.crann.tcd.ie/research/investigators/school-of-physics/prof-jonathon-coleman.aspx\">Jonathan Coleman\u003c/a>, at Trinity College, Dublin, says Silly Putty has some extraordinary properties. If you roll the stuff into a tight ball and throw it on the ground, it'll bounce. \"But if you pull it very, very slowly, it will flow as if it's a liquid, a viscous liquid,\" he says.\u003c/p>\n\u003cp>That's why you have to put Silly Putty back in its plastic egg when you're done playing with it. If you don't, it'll flow into the carpet and you'll never get it out, as many frustrated parents have discovered.\u003c/p>\n\u003cp>Industrial scientists came up with the \u003ca href=\"http://www.kidsdiscover.com/quick-reads/weird-science-the-accidental-invention-of-silly-putty/\">formula for Silly Putty\u003c/a> about 70 years ago. They were looking for synthetic substitutes for rubber. It's basically a mixture of boric acid and silicone oil. But apart from turning it into a \u003ca href=\"http://shop.crayola.com/shop-by-brand/silly-putty\">toy\u003c/a>, nobody could really figure out what to do with it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It's got these strange properties but it never really found an application. So we thought, if we could make it do something, that would be cool,\" says Coleman.\u003c/p>\n\u003cp>Coleman mainly works with another unusual material, a remarkable form of carbon called \u003ca href=\"http://www.graphene.manchester.ac.uk/explore/what-can-graphene-do/\">graphene\u003c/a>. Graphene comes in sheets barely an atom thick and is extremely good at conducting electricity.\u003c/p>\n\u003cp>One of his students had this funny idea: What if we mix graphene, with its electrical properties, with the Silly Putty and its strange bouncy, runny properties.\u003c/p>\n\u003cp>Turns out making a composite material using graphene and Silly Putty gives you a new material that is still runny and bouncy, but now conducts electricity and is extremely sensitive to pressure. Press on it just the tiniest amount, and you change its electrical resistance.\u003c/p>\n\u003cp>Coleman thinks there will be many applications for his new material. For example, he has shown that if you press a small blob of it against someone's carotid artery, you can measure not only the pulse but also blood pressure.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aag2879\">research findings were\u003c/a> published online last week by the journal \u003cem>Science\u003c/em>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Adding+A+Funny+Form+Of+Carbon+To+Silly+Putty+Creates+A+Heart+Monitor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Scientists in Ireland are using a rather unexpected material to make an extremely sensitive pressure detector: Silly Putty.\u003c/p>\n\u003cp>The Irish researchers combined the kids' plaything with a special form of carbon, and came up with a remarkable new material — one they think could someday be useful in making medical devices.\u003c/p>\n\u003cp>Physicist \u003ca href=\"http://www.crann.tcd.ie/research/investigators/school-of-physics/prof-jonathon-coleman.aspx\">Jonathan Coleman\u003c/a>, at Trinity College, Dublin, says Silly Putty has some extraordinary properties. If you roll the stuff into a tight ball and throw it on the ground, it'll bounce. \"But if you pull it very, very slowly, it will flow as if it's a liquid, a viscous liquid,\" he says.\u003c/p>\n\u003cp>That's why you have to put Silly Putty back in its plastic egg when you're done playing with it. If you don't, it'll flow into the carpet and you'll never get it out, as many frustrated parents have discovered.\u003c/p>\n\u003cp>Industrial scientists came up with the \u003ca href=\"http://www.kidsdiscover.com/quick-reads/weird-science-the-accidental-invention-of-silly-putty/\">formula for Silly Putty\u003c/a> about 70 years ago. They were looking for synthetic substitutes for rubber. It's basically a mixture of boric acid and silicone oil. But apart from turning it into a \u003ca href=\"http://shop.crayola.com/shop-by-brand/silly-putty\">toy\u003c/a>, nobody could really figure out what to do with it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It's got these strange properties but it never really found an application. So we thought, if we could make it do something, that would be cool,\" says Coleman.\u003c/p>\n\u003cp>Coleman mainly works with another unusual material, a remarkable form of carbon called \u003ca href=\"http://www.graphene.manchester.ac.uk/explore/what-can-graphene-do/\">graphene\u003c/a>. Graphene comes in sheets barely an atom thick and is extremely good at conducting electricity.\u003c/p>\n\u003cp>One of his students had this funny idea: What if we mix graphene, with its electrical properties, with the Silly Putty and its strange bouncy, runny properties.\u003c/p>\n\u003cp>Turns out making a composite material using graphene and Silly Putty gives you a new material that is still runny and bouncy, but now conducts electricity and is extremely sensitive to pressure. Press on it just the tiniest amount, and you change its electrical resistance.\u003c/p>\n\u003cp>Coleman thinks there will be many applications for his new material. For example, he has shown that if you press a small blob of it against someone's carotid artery, you can measure not only the pulse but also blood pressure.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aag2879\">research findings were\u003c/a> published online last week by the journal \u003cem>Science\u003c/em>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Adding+A+Funny+Form+Of+Carbon+To+Silly+Putty+Creates+A+Heart+Monitor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Is it any surprise that Oxford Dictionaries has named \u003ca href=\"https://en.oxforddictionaries.com/word-of-the-year/word-of-the-year-2016\">post-truth\u003c/a> the 2016 word of the year?\u003c/p>\n\u003cp>Oxford says the word gained momentum after the Brexit vote and the American presidential election. It defines the adjective as \"relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.”\u003c/p>\n\u003cp>A widely cited post-election Buzzfeed \u003ca href=\"https://www.buzzfeed.com/craigsilverman/viral-fake-election-news-outperformed-real-news-on-facebook?utm_term=.is5qzqZ2ny#.exbMLMeNA7\">analysis\u003c/a> would seem to buttress the validity of that idea, by showing the wild social media success of fake news stories as compared to real ones.\u003c/p>\n\u003cp>So how does a science reporter like myself successfully relay information if so many people don’t care, necessarily, about its accuracy? (Or even if it's \u003ca href=\"https://en.wikipedia.org/wiki/Pizzagate_(conspiracy_theory)\">made up out of whole cloth\u003c/a>.) How do we get readers to pay attention to news that confronts erroneous but entrenched \u003ca href=\"http://www.pewinternet.org/2016/10/04/the-politics-of-climate/ps_2016-10-04_politics-of-climate_0-01/\" target=\"_blank\">beliefs\u003c/a>, when the \u003ca href=\"http://www.nytimes.com/2016/12/07/us/politics/scott-pruitt-epa-trump.html\" target=\"_blank\">people\u003c/a> filling the country's\u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2016/jun/03/hillary-clinton/yes-donald-trump-did-call-climate-change-chinese-h/\" target=\"_blank\"> highest offices\u003c/a> ignore \u003ca href=\"http://climate.nasa.gov/scientific-consensus/\" target=\"_blank\">overwhelming evidence\u003c/a> to the contrary?\u003c/p>\n\u003cp>As you may imagine, these questions have fueled many conversations, not to mention entire meetings, in our newsroom of late.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cb>Stirring Hearts\u003cbr>\n\u003c/b>\u003c/p>\n\u003cp>And that's where TEDMED comes in. \u003ca href=\"http://tedmed.com/\">TEDMED's\u003c/a> approach to its annual conference reminded me that part of the answer is to continue to tell true stories based on good science, but with a focus on \u003ci>people\u003c/i>. (\u003ca href=\"https://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">See here\u003c/a> for a good example from KQED's State of Health.)\u003c/p>\n\u003cp>A three-day event, TEDMED attracts a who’s who in medical innovation. When videos of the presentations go online, they typically receive between 500,000 to 1 million views. Last year’s \u003ca href=\"https://www.ted.com/talks/judson_brewer_a_simple_way_to_break_a_bad_habit\">talk\u003c/a> by psychiatrist Judson Brewer about a simple way to break a bad habit has drawn 5.6 million views and counting.\u003c/p>\n\u003cp>This year, when I wandered into a massive, dimly lit Palm Springs ballroom, decked out in plush couches and brightly colored velvet arm chairs, I thought I was cozying in for three days of speeches about gadgets and medical breakthroughs.\u003c/p>\n\u003cp>But that wasn’t the case. The speakers rarely discussed data, instead focusing on what was inspiring, memorable, and most importantly, personal. All of which is key if what you're communicating confronts entrenched beliefs that are unlikely to shift without engaging the heart as well as the brain.\u003c/p>\n\u003cp>\u003cb>Memorable Talks\u003c/b>\u003c/p>\n\u003cfigure id=\"attachment_300967\" class=\"wp-caption alignleft\" style=\"max-width: 315px\">\u003cimg class=\"wp-image-300967 \" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/emi.jpb_-800x532.jpg\" alt=\"Spoken word poet Emtithal “Emi” Mahmoud on stage at TEDMED at the La Quinta Resort in Palm Springs. \" width=\"315\" height=\"209\">\u003cfigcaption class=\"wp-caption-text\">Spoken word poet Emtithal “Emi” Mahmoud on stage at TEDMED at the La Quinta Resort in Palm Springs. \u003ccite>(TEDMED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The theme of the opening session was \u003ci>Invisible Threats\u003c/i>. I assumed that meant speeches about airborne viruses like Ebola or Zika. But instead, Emitithal “Emi” Mahmoud, a spoken word poet from Sudan, took the stage. She performed an intimate piece about the emotional toll of violence in her country. Yes there were plenty of audience tears.\u003c/p>\n\u003cp>“The invisible threats that we grapple with on a personal level, such as the biases that we hold or the traumas that we have gone through, but have not processed completely, affect how we influence and interact with other human beings,” Mahmoud told me after her performance. “Because in the long run, if you’re standing across from someone who needs help, and invisible barriers make you see them through a lens that makes you think they are not like you or they are an ‘other,’ chances are you are not going to help them. That’s incredibly dangerous.”\u003c/p>\n\u003cp>Over the course of the next few days, the speakers continued to share human stories that took the audience on surprising journeys all over the world.\u003c/p>\n\u003cfigure id=\"attachment_300975\" class=\"wp-caption alignleft\" style=\"max-width: 314px\">\u003cimg class=\" wp-image-300975\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/DSC_8921-900x600-800x533.jpg\" alt=\"Documentary filmmaker Carolyn Jones shared the story of Sister Stephens, a Wisconsin nurse who helps dying patients in their final days. \" width=\"314\" height=\"209\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600.jpg 900w\" sizes=\"(max-width: 314px) 100vw, 314px\">\u003cfigcaption class=\"wp-caption-text\">Documentary filmmaker Carolyn Jones shared the story of Sister Stephens, a Wisconsin nurse who helps dying patients in their final days. \u003ccite>(TEDMED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Documentary filmmaker Carolyn Jones highlighted the undervalued role nurses play in the health care industry. She shared the story of Sister Stephens, a Wisconsin nurse who runs an unusual nursing home. \"She uses ducks, goats and lambs for animal therapy with the residents who might not be able to remember their own name, but can rejoice in holding a baby lamb,\" Jones reported.\u003c/p>\n\u003cfigure id=\"attachment_300973\" class=\"wp-caption alignleft\" style=\"max-width: 314px\">\u003cimg class=\"wp-image-300973\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/cheryl-800x533.jpg\" alt=\"Prison psychologist Cheryl Steed shares inmate Mr. Burdick's story to illustrate how helping others can rehabilitate hardened criminals. \" width=\"314\" height=\"210\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-520x347.jpg 520w\" sizes=\"(max-width: 314px) 100vw, 314px\">\u003cfigcaption class=\"wp-caption-text\">Prison psychologist Cheryl Steed shares inmate Mr. Burdick's story to illustrate how helping others can rehabilitate hardened criminals. \u003ccite>(TEDMED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Prison psychologist Cheryl Steed revealed a unique rehabilitation program called the Gold Coats. Physically able inmates, wearing gold jackets, take care of older convicts who are struggling with dementia. She told the story of Mr. Burdick, incarcerated for 40 years, who helps elderly inmates shower, dress and eat daily. \"Society at large tends to reduce people to labels – criminal, thief, killer...\" Steed said. \"How do you explain the fact that a man who once took a life is now a caregiver? Which version of that person is the truth? The beautiful complexity of human nature is that \u003ci>both\u003c/i> are true. And by shouldering responsibility for someone who needs them, these men have begun to discover another way of life and a healthier, happier version of themselves.\"\u003c/p>\n\u003cfigure id=\"attachment_300974\" class=\"wp-caption alignleft\" style=\"max-width: 314px\">\u003cimg class=\" wp-image-300974\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/lauren-800x533.jpg\" alt=\"New Yorker writer Larissa MacFarquhar explores the lives of extreme altruists. \" width=\"314\" height=\"209\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren.jpg 900w\" sizes=\"(max-width: 314px) 100vw, 314px\">\u003cfigcaption class=\"wp-caption-text\">New Yorker writer Larissa MacFarquhar explores the lives of extreme altruists. \u003ccite>(TEDMED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>New Yorker writer Larissa MacFarquhar shared her research on the motivations behind altruism. She told the heroic tale of the Badeau family, a couple who kept adopting foster care children until they were housing 20 special needs kids. \"The thing about people like Sue and Hector is that they have a deep and happy sense of purpose,\" said MacFarquhar. \"Yes, they sacrifice a lot of comforts. But in exchange they know that they’ve changed many lives for the better, and they believe that they are living their own lives as they ought to. And how many of us can say that?\"\u003c/p>\n\u003cp>Even more traditional talks like psychiatrist Kafui Dzirasa’s use of neuroelectrical stimulation to treat mental illness, or Israeli internist Nir Barzilai’s research on extending life revolved around personal narratives that tugged at the audience’s emotions.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Data and good research is a prerequisite for any science reporting. But TEDMED's speakers reminded me that communicating science, in an era where accurate information must compete with agenda- or profit-driven \"news,\" is not necessarily about driving home the numbers that scientists prize. Translating those numbers into stories of people who are actually affected by what they represent is what ultimately will move people to take science seriously.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Is it any surprise that Oxford Dictionaries has named \u003ca href=\"https://en.oxforddictionaries.com/word-of-the-year/word-of-the-year-2016\">post-truth\u003c/a> the 2016 word of the year?\u003c/p>\n\u003cp>Oxford says the word gained momentum after the Brexit vote and the American presidential election. It defines the adjective as \"relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.”\u003c/p>\n\u003cp>A widely cited post-election Buzzfeed \u003ca href=\"https://www.buzzfeed.com/craigsilverman/viral-fake-election-news-outperformed-real-news-on-facebook?utm_term=.is5qzqZ2ny#.exbMLMeNA7\">analysis\u003c/a> would seem to buttress the validity of that idea, by showing the wild social media success of fake news stories as compared to real ones.\u003c/p>\n\u003cp>So how does a science reporter like myself successfully relay information if so many people don’t care, necessarily, about its accuracy? (Or even if it's \u003ca href=\"https://en.wikipedia.org/wiki/Pizzagate_(conspiracy_theory)\">made up out of whole cloth\u003c/a>.) How do we get readers to pay attention to news that confronts erroneous but entrenched \u003ca href=\"http://www.pewinternet.org/2016/10/04/the-politics-of-climate/ps_2016-10-04_politics-of-climate_0-01/\" target=\"_blank\">beliefs\u003c/a>, when the \u003ca href=\"http://www.nytimes.com/2016/12/07/us/politics/scott-pruitt-epa-trump.html\" target=\"_blank\">people\u003c/a> filling the country's\u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2016/jun/03/hillary-clinton/yes-donald-trump-did-call-climate-change-chinese-h/\" target=\"_blank\"> highest offices\u003c/a> ignore \u003ca href=\"http://climate.nasa.gov/scientific-consensus/\" target=\"_blank\">overwhelming evidence\u003c/a> to the contrary?\u003c/p>\n\u003cp>As you may imagine, these questions have fueled many conversations, not to mention entire meetings, in our newsroom of late.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>Stirring Hearts\u003cbr>\n\u003c/b>\u003c/p>\n\u003cp>And that's where TEDMED comes in. \u003ca href=\"http://tedmed.com/\">TEDMED's\u003c/a> approach to its annual conference reminded me that part of the answer is to continue to tell true stories based on good science, but with a focus on \u003ci>people\u003c/i>. (\u003ca href=\"https://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">See here\u003c/a> for a good example from KQED's State of Health.)\u003c/p>\n\u003cp>A three-day event, TEDMED attracts a who’s who in medical innovation. When videos of the presentations go online, they typically receive between 500,000 to 1 million views. Last year’s \u003ca href=\"https://www.ted.com/talks/judson_brewer_a_simple_way_to_break_a_bad_habit\">talk\u003c/a> by psychiatrist Judson Brewer about a simple way to break a bad habit has drawn 5.6 million views and counting.\u003c/p>\n\u003cp>This year, when I wandered into a massive, dimly lit Palm Springs ballroom, decked out in plush couches and brightly colored velvet arm chairs, I thought I was cozying in for three days of speeches about gadgets and medical breakthroughs.\u003c/p>\n\u003cp>But that wasn’t the case. The speakers rarely discussed data, instead focusing on what was inspiring, memorable, and most importantly, personal. All of which is key if what you're communicating confronts entrenched beliefs that are unlikely to shift without engaging the heart as well as the brain.\u003c/p>\n\u003cp>\u003cb>Memorable Talks\u003c/b>\u003c/p>\n\u003cfigure id=\"attachment_300967\" class=\"wp-caption alignleft\" style=\"max-width: 315px\">\u003cimg class=\"wp-image-300967 \" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/emi.jpb_-800x532.jpg\" alt=\"Spoken word poet Emtithal “Emi” Mahmoud on stage at TEDMED at the La Quinta Resort in Palm Springs. \" width=\"315\" height=\"209\">\u003cfigcaption class=\"wp-caption-text\">Spoken word poet Emtithal “Emi” Mahmoud on stage at TEDMED at the La Quinta Resort in Palm Springs. \u003ccite>(TEDMED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The theme of the opening session was \u003ci>Invisible Threats\u003c/i>. I assumed that meant speeches about airborne viruses like Ebola or Zika. But instead, Emitithal “Emi” Mahmoud, a spoken word poet from Sudan, took the stage. She performed an intimate piece about the emotional toll of violence in her country. Yes there were plenty of audience tears.\u003c/p>\n\u003cp>“The invisible threats that we grapple with on a personal level, such as the biases that we hold or the traumas that we have gone through, but have not processed completely, affect how we influence and interact with other human beings,” Mahmoud told me after her performance. “Because in the long run, if you’re standing across from someone who needs help, and invisible barriers make you see them through a lens that makes you think they are not like you or they are an ‘other,’ chances are you are not going to help them. That’s incredibly dangerous.”\u003c/p>\n\u003cp>Over the course of the next few days, the speakers continued to share human stories that took the audience on surprising journeys all over the world.\u003c/p>\n\u003cfigure id=\"attachment_300975\" class=\"wp-caption alignleft\" style=\"max-width: 314px\">\u003cimg class=\" wp-image-300975\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/DSC_8921-900x600-800x533.jpg\" alt=\"Documentary filmmaker Carolyn Jones shared the story of Sister Stephens, a Wisconsin nurse who helps dying patients in their final days. \" width=\"314\" height=\"209\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/DSC_8921-900x600.jpg 900w\" sizes=\"(max-width: 314px) 100vw, 314px\">\u003cfigcaption class=\"wp-caption-text\">Documentary filmmaker Carolyn Jones shared the story of Sister Stephens, a Wisconsin nurse who helps dying patients in their final days. \u003ccite>(TEDMED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Documentary filmmaker Carolyn Jones highlighted the undervalued role nurses play in the health care industry. She shared the story of Sister Stephens, a Wisconsin nurse who runs an unusual nursing home. \"She uses ducks, goats and lambs for animal therapy with the residents who might not be able to remember their own name, but can rejoice in holding a baby lamb,\" Jones reported.\u003c/p>\n\u003cfigure id=\"attachment_300973\" class=\"wp-caption alignleft\" style=\"max-width: 314px\">\u003cimg class=\"wp-image-300973\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/cheryl-800x533.jpg\" alt=\"Prison psychologist Cheryl Steed shares inmate Mr. Burdick's story to illustrate how helping others can rehabilitate hardened criminals. \" width=\"314\" height=\"210\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/cheryl-520x347.jpg 520w\" sizes=\"(max-width: 314px) 100vw, 314px\">\u003cfigcaption class=\"wp-caption-text\">Prison psychologist Cheryl Steed shares inmate Mr. Burdick's story to illustrate how helping others can rehabilitate hardened criminals. \u003ccite>(TEDMED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Prison psychologist Cheryl Steed revealed a unique rehabilitation program called the Gold Coats. Physically able inmates, wearing gold jackets, take care of older convicts who are struggling with dementia. She told the story of Mr. Burdick, incarcerated for 40 years, who helps elderly inmates shower, dress and eat daily. \"Society at large tends to reduce people to labels – criminal, thief, killer...\" Steed said. \"How do you explain the fact that a man who once took a life is now a caregiver? Which version of that person is the truth? The beautiful complexity of human nature is that \u003ci>both\u003c/i> are true. And by shouldering responsibility for someone who needs them, these men have begun to discover another way of life and a healthier, happier version of themselves.\"\u003c/p>\n\u003cfigure id=\"attachment_300974\" class=\"wp-caption alignleft\" style=\"max-width: 314px\">\u003cimg class=\" wp-image-300974\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/lauren-800x533.jpg\" alt=\"New Yorker writer Larissa MacFarquhar explores the lives of extreme altruists. \" width=\"314\" height=\"209\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/lauren.jpg 900w\" sizes=\"(max-width: 314px) 100vw, 314px\">\u003cfigcaption class=\"wp-caption-text\">New Yorker writer Larissa MacFarquhar explores the lives of extreme altruists. \u003ccite>(TEDMED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>New Yorker writer Larissa MacFarquhar shared her research on the motivations behind altruism. She told the heroic tale of the Badeau family, a couple who kept adopting foster care children until they were housing 20 special needs kids. \"The thing about people like Sue and Hector is that they have a deep and happy sense of purpose,\" said MacFarquhar. \"Yes, they sacrifice a lot of comforts. But in exchange they know that they’ve changed many lives for the better, and they believe that they are living their own lives as they ought to. And how many of us can say that?\"\u003c/p>\n\u003cp>Even more traditional talks like psychiatrist Kafui Dzirasa’s use of neuroelectrical stimulation to treat mental illness, or Israeli internist Nir Barzilai’s research on extending life revolved around personal narratives that tugged at the audience’s emotions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Data and good research is a prerequisite for any science reporting. But TEDMED's speakers reminded me that communicating science, in an era where accurate information must compete with agenda- or profit-driven \"news,\" is not necessarily about driving home the numbers that scientists prize. Translating those numbers into stories of people who are actually affected by what they represent is what ultimately will move people to take science seriously.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Any pet owner will tell you that their animal companions comfort and sustain them when life gets rough. This may be especially true for people with serious mental illness, a study finds. When people with schizophrenia or bipolar disorder were asked who or what helped them manage the condition, many said it was pets that helped the most.\u003c/p>\n\u003cp>\"When I'm feeling really low they are wonderful because they won't leave my side for two days,\" one study participant with two dogs and two cats, \"They just stay with me until I am ready to come out of it.\"\u003c/p>\n\u003cp>Another person said of their pet birds: \"If I didn't have my pets I think I would be on my own. You know what I mean, so it's — it's nice to come home and, you know, listen to the birds singing and that, you know.\"\u003c/p>\n\u003cp>Many people with serious mental illness live at home and have limited contact with the health care system, says Helen Brooks, a mental health researcher at University of Manchester in the United Kingdom and the lead author on the study, which was \u003ca href=\"https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-1111-3\">published Friday\u003c/a> in the journal \u003cem>BMC Psychiatry\u003c/em>. So they're doing a lot of the work of managing their conditions.\u003c/p>\n\u003cp>Brooks says, \"Many felt deep emotional connections with their pet that weren't available from friends and family.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Brooks and her colleagues interviewed 54 people with serious long-term mental illnesses. Twenty-five of them considered their pets to be a part of their social network. The scientists asked who they went to when they needed help or advice, where they gained emotional support and encouragement and how they spent their days.\u003c/p>\n\u003cp>The participants were then given a diagram with three consecutive circles radiating out from a square representing the participant. They were asked to write the people, places and things that gave them support into the circles, with the circles closest to the center being the most important.\u003c/p>\n\u003cp>Sixty percent of the people who considered pets to be a part of their social networks placed them in the central, most important circle — the same place many people put close family and social workers. 20 percent placed pets in the second circle.\u003c/p>\n\u003cp>The interviews with participants are poignant, and reveal the struggle and isolation that can come with mental illness.\u003c/p>\n\u003cp>\"I think it's really hard when you haven't had a mental illness to know what the actual experience is [like],\" said one participant. \"There's like a chasm, deep chasm between us ... [Other people are] on one side of it, and we're on the other side of it. We're sending smoke signals to each other to try and understand each other but we don't always — we don't always understand.\"\u003c/p>\n\u003cp>People with mental illnesses often see their social groups shrink and find themselves alienated from their friends. For many of these people, says Brooks, animals can break through the isolation. They give affection without needing to understand the disorder.\u003c/p>\n\u003cp>\"[Pets] don't look at the scars on your arms,\" one participant said. \"They don't question where you've been.\"\u003c/p>\n\u003cp>The pets provided more than just emotional support and companionship, participants said. The animals also could distract them from their illness, even from severe psychosis.\u003c/p>\n\u003cp>One study participant placed birds in his closest social circle. When he was hearing voices, he said that they \"help me in the sense, you know, I'm not thinking about the voices, I'm just thinking of when I hear the birds singing.\"\u003c/p>\n\u003cp>Another participant said that merely seeing a hamster climbing the bars on the cage and acting cute helped with some difficult situations.\u003c/p>\n\u003cp>And having to take care of pets keeps people from withdrawing from the world. \"They force me, the cats force me to sort of still be involved,\" said one participant.\u003c/p>\n\u003cp>Another said that walking the dog helped them get out of the house and with people. \"That surprised me, you know, the amount of people that stop and talk to him, and that, yeah, it cheers me up with him. I haven't got much in my life, but he's quite good, yeah.\"\u003c/p>\n\u003cp>\"The routine these pets provide is really important for people,\" says Brooks. \"Getting up in the morning to feed them and groom them and walk them, giving them structure and a sense of purpose that they won't otherwise have.\"\u003c/p>\n\u003cp>Many of the study participants are unemployed because of their illness, she notes. Having a pet that was well taken care of was a source of pride for them.\u003c/p>\n\u003cp>Mark Longsjo, the program director of adult services at \u003ca href=\"http://www.mcleanhospital.org/programs/mclean-southeast-adult-psychiatric-inpatient-program\">McLean Southeast\u003c/a>, an inpatient mental facility in Middleborough, Mass., says that the interviews in the study reflect his professional experiences. \"We have so many patients come through, and we always ask them about their support system. Sometimes its family members, sometimes its friends, but it's very common to hear about pets.\"\u003c/p>\n\u003cp>When he does patient intake surveys, Longsjo says that he includes pets in their risk assessments. Patients with pets often say the animals help keep them from following through on suicidal thinking, because they know their pets depend on them.\u003c/p>\n\u003cp>The social workers at McLean also incorporate pets into their aftercare planning, encouraging patients to make walking and grooming their pets a part of their routine. \"I think there's significant value in considering the common everyday pet to be as important as the relationships one has with one's family in the course of their treatment,\" says Longsjo. He feels this study is important because, although there's a lot of work looking at the \u003ca href=\"http://www.npr.org/sections/health-shots/2012/03/09/146583986/pet-therapy-how-animals-and-humans-heal-each-other\">benefits of trained therapy animals\u003c/a>, they can be expensive and out of the reach of many patients.\u003c/p>\n\u003cp>Brooks hopes that more health workers will consider incorporating pets into care plans for people with mental illness. Many of her participants said that sometimes it felt like their pets could sense when they needed help the most, and were able to provide it — just like the owners took care of them.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>As one person in the study said, \"When he comes up and sits beside you on a night, it's different, you know. It's just, like, he needs me as much as I need him.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pets+Help+People+Manage+The+Pain+Of+Serious+Mental+Illness+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Any pet owner will tell you that their animal companions comfort and sustain them when life gets rough. This may be especially true for people with serious mental illness, a study finds. When people with schizophrenia or bipolar disorder were asked who or what helped them manage the condition, many said it was pets that helped the most.\u003c/p>\n\u003cp>\"When I'm feeling really low they are wonderful because they won't leave my side for two days,\" one study participant with two dogs and two cats, \"They just stay with me until I am ready to come out of it.\"\u003c/p>\n\u003cp>Another person said of their pet birds: \"If I didn't have my pets I think I would be on my own. You know what I mean, so it's — it's nice to come home and, you know, listen to the birds singing and that, you know.\"\u003c/p>\n\u003cp>Many people with serious mental illness live at home and have limited contact with the health care system, says Helen Brooks, a mental health researcher at University of Manchester in the United Kingdom and the lead author on the study, which was \u003ca href=\"https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-1111-3\">published Friday\u003c/a> in the journal \u003cem>BMC Psychiatry\u003c/em>. So they're doing a lot of the work of managing their conditions.\u003c/p>\n\u003cp>Brooks says, \"Many felt deep emotional connections with their pet that weren't available from friends and family.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Brooks and her colleagues interviewed 54 people with serious long-term mental illnesses. Twenty-five of them considered their pets to be a part of their social network. The scientists asked who they went to when they needed help or advice, where they gained emotional support and encouragement and how they spent their days.\u003c/p>\n\u003cp>The participants were then given a diagram with three consecutive circles radiating out from a square representing the participant. They were asked to write the people, places and things that gave them support into the circles, with the circles closest to the center being the most important.\u003c/p>\n\u003cp>Sixty percent of the people who considered pets to be a part of their social networks placed them in the central, most important circle — the same place many people put close family and social workers. 20 percent placed pets in the second circle.\u003c/p>\n\u003cp>The interviews with participants are poignant, and reveal the struggle and isolation that can come with mental illness.\u003c/p>\n\u003cp>\"I think it's really hard when you haven't had a mental illness to know what the actual experience is [like],\" said one participant. \"There's like a chasm, deep chasm between us ... [Other people are] on one side of it, and we're on the other side of it. We're sending smoke signals to each other to try and understand each other but we don't always — we don't always understand.\"\u003c/p>\n\u003cp>People with mental illnesses often see their social groups shrink and find themselves alienated from their friends. For many of these people, says Brooks, animals can break through the isolation. They give affection without needing to understand the disorder.\u003c/p>\n\u003cp>\"[Pets] don't look at the scars on your arms,\" one participant said. \"They don't question where you've been.\"\u003c/p>\n\u003cp>The pets provided more than just emotional support and companionship, participants said. The animals also could distract them from their illness, even from severe psychosis.\u003c/p>\n\u003cp>One study participant placed birds in his closest social circle. When he was hearing voices, he said that they \"help me in the sense, you know, I'm not thinking about the voices, I'm just thinking of when I hear the birds singing.\"\u003c/p>\n\u003cp>Another participant said that merely seeing a hamster climbing the bars on the cage and acting cute helped with some difficult situations.\u003c/p>\n\u003cp>And having to take care of pets keeps people from withdrawing from the world. \"They force me, the cats force me to sort of still be involved,\" said one participant.\u003c/p>\n\u003cp>Another said that walking the dog helped them get out of the house and with people. \"That surprised me, you know, the amount of people that stop and talk to him, and that, yeah, it cheers me up with him. I haven't got much in my life, but he's quite good, yeah.\"\u003c/p>\n\u003cp>\"The routine these pets provide is really important for people,\" says Brooks. \"Getting up in the morning to feed them and groom them and walk them, giving them structure and a sense of purpose that they won't otherwise have.\"\u003c/p>\n\u003cp>Many of the study participants are unemployed because of their illness, she notes. Having a pet that was well taken care of was a source of pride for them.\u003c/p>\n\u003cp>Mark Longsjo, the program director of adult services at \u003ca href=\"http://www.mcleanhospital.org/programs/mclean-southeast-adult-psychiatric-inpatient-program\">McLean Southeast\u003c/a>, an inpatient mental facility in Middleborough, Mass., says that the interviews in the study reflect his professional experiences. \"We have so many patients come through, and we always ask them about their support system. Sometimes its family members, sometimes its friends, but it's very common to hear about pets.\"\u003c/p>\n\u003cp>When he does patient intake surveys, Longsjo says that he includes pets in their risk assessments. Patients with pets often say the animals help keep them from following through on suicidal thinking, because they know their pets depend on them.\u003c/p>\n\u003cp>The social workers at McLean also incorporate pets into their aftercare planning, encouraging patients to make walking and grooming their pets a part of their routine. \"I think there's significant value in considering the common everyday pet to be as important as the relationships one has with one's family in the course of their treatment,\" says Longsjo. He feels this study is important because, although there's a lot of work looking at the \u003ca href=\"http://www.npr.org/sections/health-shots/2012/03/09/146583986/pet-therapy-how-animals-and-humans-heal-each-other\">benefits of trained therapy animals\u003c/a>, they can be expensive and out of the reach of many patients.\u003c/p>\n\u003cp>Brooks hopes that more health workers will consider incorporating pets into care plans for people with mental illness. Many of her participants said that sometimes it felt like their pets could sense when they needed help the most, and were able to provide it — just like the owners took care of them.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As one person in the study said, \"When he comes up and sits beside you on a night, it's different, you know. It's just, like, he needs me as much as I need him.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pets+Help+People+Manage+The+Pain+Of+Serious+Mental+Illness+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Baby boomers are getting high in increasing numbers, reflecting growing acceptance of the drug as treatment for various medical conditions, according to a study published in the journal \u003cem>Addiction\u003c/em>.\u003c/p>\n\u003cp>The findings reveal overall use among the 50-and-older study group increased “significantly” from 2006 to 2013. Marijuana users peaked between ages 50 to 64, then declined among the 65-and-over crowd.\u003c/p>\n\u003cp>Men used marijuana more frequently than women, the study showed, but marital status and educational levels were not major factors in determining users.\u003c/p>\n\u003cp>The study by researchers at New York University School of Medicine suggests more data is needed about the long-term health impact of marijuana use among seniors. Study participants said they did not perceive the drug as dangerous, a sign of changing attitudes.\u003c/p>\n\u003cp>The study was based on 47,140 responses collected from the National Survey on Drug Use and Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Joseph Palamar, a professor at the NYU medical school and a co-author of the study, said the findings reinforce the need for research and a call for providers to screen the elderly for drug use.\u003c/p>\n\u003cp>“They shouldn’t just assume that someone is not a drug user because they’re older,” Palamar said.\u003c/p>\n\u003cp>Growing use of the drug among the 50-and-older crowd reflects the national trend toward pushing cannabis into mainstream culture. Over 22 million people used the drug in 2015, according to the Substance Abuse and Mental Health Services Administration. Eight states have legalized the drug for recreational use as well as medicinal use, according to Marijuana Policy Project, a non-profit advocacy group dedicated to enacting non-punitive marijuana policies across the United States. The drug has also proved to be a financial boon for state economies, generating over $19 million in September in Colorado.\u003c/p>\n\u003cp>Researchers also uncovered an increasing diversity in marijuana users. Past-year use doubled among married couples and those earning less than $20,000 per year.\u003c/p>\n\u003cp>More people living with medical conditions also sought out marijuana. The study showed the number of individuals living with two or more chronic conditions who used the drug over the past year more than doubled. Among those living with depression, the rate also doubled to 11.4 percent.\u003c/p>\n\u003cp>Palamar says the increase among the sick could be attributed to more individuals seeking to self-medicate. Historically, the plant was difficult to research due to the government crackdown on the substance. The Drug Enforcement Administration classifies the plant as a Schedule I substance, “defined as drugs with no currently accepted medical use and a high potential for abuse.”\u003c/p>\n\u003cp>Benjamin Han, assistant professor at the New York University School of Medicine and the study’s lead author, fears that marijuana used with prescription drugs could make the elderly more vulnerable to adverse health outcomes, particularly to falls and cognitive impairment.\u003c/p>\n\u003cp>“While there may be benefits to using marijuana such as chronic pain,” he said, “there may be risks that we don’t know about.”\u003c/p>\n\u003cp>The push and pull between state and federal governments has resulted in varying degrees of legality across the United States. Palamar says this variation places populations at risk of unknowingly breaking the law and getting arrested for drug possession. The issue poses one of the biggest public health concerns associated with marijuana, Palamar says.\u003c/p>\n\u003cp>But unlike the marijuana of their youth, seniors living in states that legalized marijuana for medicinal use now can access a drug that has been tested for quality and purity, said Paul Armentano deputy director of NORML, a non-profit group advocating for marijuana legalization. Additionally, the plant is prescribed to manage diseases that usually strike in older age, pointing to an increasing desire to take a medication that has less side effects than traditional prescription drugs.\u003c/p>\n\u003cp>The study found over half of the users picked up the habit before turning 18, and over 90 percent of them before age 36.\u003c/p>\n\u003cp>“We are coming to a point where state lawmakers are responding to the rapidly emerging consensus-both public consensus and a scientific consensus — that marijuana is not an agent that possesses risks that qualifies it as a legally prohibited substance,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>KHN’s coverage of end-of-life and serious illness issues is supported by The Gordon and Betty Moore Foundation.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Baby boomers are getting high in increasing numbers, reflecting growing acceptance of the drug as treatment for various medical conditions, according to a study published in the journal \u003cem>Addiction\u003c/em>.\u003c/p>\n\u003cp>The findings reveal overall use among the 50-and-older study group increased “significantly” from 2006 to 2013. Marijuana users peaked between ages 50 to 64, then declined among the 65-and-over crowd.\u003c/p>\n\u003cp>Men used marijuana more frequently than women, the study showed, but marital status and educational levels were not major factors in determining users.\u003c/p>\n\u003cp>The study by researchers at New York University School of Medicine suggests more data is needed about the long-term health impact of marijuana use among seniors. Study participants said they did not perceive the drug as dangerous, a sign of changing attitudes.\u003c/p>\n\u003cp>The study was based on 47,140 responses collected from the National Survey on Drug Use and Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Joseph Palamar, a professor at the NYU medical school and a co-author of the study, said the findings reinforce the need for research and a call for providers to screen the elderly for drug use.\u003c/p>\n\u003cp>“They shouldn’t just assume that someone is not a drug user because they’re older,” Palamar said.\u003c/p>\n\u003cp>Growing use of the drug among the 50-and-older crowd reflects the national trend toward pushing cannabis into mainstream culture. Over 22 million people used the drug in 2015, according to the Substance Abuse and Mental Health Services Administration. Eight states have legalized the drug for recreational use as well as medicinal use, according to Marijuana Policy Project, a non-profit advocacy group dedicated to enacting non-punitive marijuana policies across the United States. The drug has also proved to be a financial boon for state economies, generating over $19 million in September in Colorado.\u003c/p>\n\u003cp>Researchers also uncovered an increasing diversity in marijuana users. Past-year use doubled among married couples and those earning less than $20,000 per year.\u003c/p>\n\u003cp>More people living with medical conditions also sought out marijuana. The study showed the number of individuals living with two or more chronic conditions who used the drug over the past year more than doubled. Among those living with depression, the rate also doubled to 11.4 percent.\u003c/p>\n\u003cp>Palamar says the increase among the sick could be attributed to more individuals seeking to self-medicate. Historically, the plant was difficult to research due to the government crackdown on the substance. The Drug Enforcement Administration classifies the plant as a Schedule I substance, “defined as drugs with no currently accepted medical use and a high potential for abuse.”\u003c/p>\n\u003cp>Benjamin Han, assistant professor at the New York University School of Medicine and the study’s lead author, fears that marijuana used with prescription drugs could make the elderly more vulnerable to adverse health outcomes, particularly to falls and cognitive impairment.\u003c/p>\n\u003cp>“While there may be benefits to using marijuana such as chronic pain,” he said, “there may be risks that we don’t know about.”\u003c/p>\n\u003cp>The push and pull between state and federal governments has resulted in varying degrees of legality across the United States. Palamar says this variation places populations at risk of unknowingly breaking the law and getting arrested for drug possession. The issue poses one of the biggest public health concerns associated with marijuana, Palamar says.\u003c/p>\n\u003cp>But unlike the marijuana of their youth, seniors living in states that legalized marijuana for medicinal use now can access a drug that has been tested for quality and purity, said Paul Armentano deputy director of NORML, a non-profit group advocating for marijuana legalization. Additionally, the plant is prescribed to manage diseases that usually strike in older age, pointing to an increasing desire to take a medication that has less side effects than traditional prescription drugs.\u003c/p>\n\u003cp>The study found over half of the users picked up the habit before turning 18, and over 90 percent of them before age 36.\u003c/p>\n\u003cp>“We are coming to a point where state lawmakers are responding to the rapidly emerging consensus-both public consensus and a scientific consensus — that marijuana is not an agent that possesses risks that qualifies it as a legally prohibited substance,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>KHN’s coverage of end-of-life and serious illness issues is supported by The Gordon and Betty Moore Foundation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Anti-Smoking Researchers Target Hipsters. And Yes, They Know Who You Are",
"title": "Anti-Smoking Researchers Target Hipsters. And Yes, They Know Who You Are",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">While no self-respecting hipsters would identify themselves as such, lots of people in the business of defining things -- from \u003ca href=\"https://en.wikipedia.org/wiki/Hipster_(contemporary_subculture)\" target=\"_blank\">Wikipedia\u003c/a> to \u003ca href=\"http://www.merriam-webster.com/dictionary/hipster\" target=\"_blank\">Merriam-Webster\u003c/a> -- are happy to do it for them.\u003c/span>\u003c/p>\n\u003cp>While hipster haters may delight in the \u003ca href=\"https://www.google.com/search?q=hipsters+irritating\" target=\"_blank\">pejorative pigeonholing\u003c/a> of beard-festooned, flannel-loving millennials, some anti-tobacco researchers have analyzed, categorized and targeted this population not to condemn them, but to get them to quit smoking.\u003c/p>\n\u003caside class=\"pullquote alignright\">Researchers have created an actual 'brand' to communicate that Big Tobacco is antithetical to everything hipsters hold dear.\u003c/aside>\n\u003cp>In San Francisco, as part of a new \u003ca href=\"http://www.sfcancer.org/\" target=\"_blank\">initiative\u003c/a> aiming to reduce the incidence and mortality rate of residents with common cancers, researchers have begun creating \u003ca href=\"https://www.facebook.com/communesmokefree?hc_ref=SEARCH&fref=nf\">\u003cspan style=\"font-weight: 400\">Facebook smoking cessation groups\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> under the banner of a “brand” created specifically for the hipster community.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The groups are an extension of\u003c/span>\u003cb> r\u003c/b>esearch funded by the National Cancer Institute on how to boost the impact\u003cb> \u003c/b>of public anti-smoking campaigns in the face of the overpowering marketing know-how of big tobacco companies.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Young adults are the focus because the tobacco industry has long set its sights on turning them into customers. Somewhat successfully, it turns out. In California, for instance, \u003c/span>\u003cspan style=\"font-weight: 400\">21-29-year-olds smoke at a \u003ca href=\"https://www.cdph.ca.gov/programs/tobacco/Documents/CDPH%20CTCP%20Refresh/Research%20and%20Evaluation/Facts%20and%20Figures/FactsFigures2016PrePrintEditionV2.pdf\" target=\"_blank\">higher rate\u003c/a> than any other age group\u003c/span>\u003cspan style=\"font-weight: 400\">, and while there has been a drop in smoking overall\u003cstrong>, \u003c/strong>the reduction among 20-somethings has lagged. \u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In an attempt\u003cstrong> \u003c/strong>to get the drop in the young adult smoking rate moving again, Dr. Pamela Ling of t\u003c/span>\u003cspan style=\"font-weight: 400\">he University of California, San Francisco's Center for Tobacco Control Research and Education \u003c/span>\u003cspan style=\"font-weight: 400\">has been working with the Rescue marketing agency of San Diego to establish an anti-smoking brand called “Commune,” specifically targeting the nation's ample supply of hipsters. \u003c/span>\u003c/p>\n\u003cp>What the brand is \"selling\" is the desire not to smoke.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“One of the challenges around doing public health campaigns is that it’s really hard to sell the idea of not doing something,” says Ling. “If you’re selling cigarettes you can promote Marlboro, but if you’re selling not smoking Marlboro, you’re not really promoting anything. So the idea is creating a brand that competes with the tobacco brand.”\u003c/span>\u003c/p>\n\u003cp>\u003cb>Peer Crowds \u003cem> \u003c/em>\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">To that end, the Rescue campaign has held \u003ca href=\"https://www.facebook.com/pg/jointhecommune/events/?ref=page_internal\" target=\"_blank\">events\u003c/a> under the banner of the Commune brand in hipster drinking establishments in a handful of cities around the country. The lineups feature local bands and artists and the campaigns are currently active in Minneapolis and Duluth. The project ended an eight-year run in San Diego in February and a 3-year stint in San Francisco in June. \u003c/span>\u003c/p>\n\u003cp>The campaigns use a marketing strategy called \u003ca href=\"http://rescueagency.com/files/pdf/Young_Adult_Social_Branding.pdf\" target=\"_blank\">social branding\u003c/a>, which attempts to associate healthy behaviors with the values of individual subcultures, called \"peer crowds.\" In this model, a traditional demographic, such as young adults, is divided into cultural segments with shared interests, styles of dress, values, and media consumption habits\u003cb>. \u003c/b>Hipsters were the first target.\u003c/p>\n\u003cp>“Our goal was to develop something that spoke to them authentically,” says Jeff Jordan, the founder and president of Rescue. “That’s really the value of segmentation. Not only can you concentrate your resources on a higher risk group, minimizing waste, but you can actually make something a lot more appealing and tailored to the group, so they actually listen to you.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The potential messaging power of using peer crowds like hipsters is illustrated in a recent \u003ca href=\"http://tobaccocontrol.bmj.com/content/25/Suppl_1/i83.full\">paper\u003c/a> by Jordan, Ling and UCSF statistician Nadra Lisha, looking at data from surveys of 3,366 18-26 year-olds, conducted in the watering holes of San Diego, San Francisco, and L.A. The researchers focused on bars because studies have found an association between tobacco marketing there and smoking. From the data, t\u003c/span>he researchers mapped use of cigarettes, e-cigarettes, hookahs, cigars and smokeless tobacco to six different peer crowds. (A seventh group, LGBT, was added after subsequent studies.)\u003c/p>\n\u003cp>\u003ca href=\"http://tobaccocontrol.bmj.com/content/25/Suppl_1/i83/F1.large.jpg\">\u003cimg src=\"http://tobaccocontrol.bmj.com/content/25/Suppl_1/i83/F1.large.jpg\">\u003c/a>\u003c/p>\n\u003cp>The researchers found membership in these groups to be a significant predictor of tobacco use on its own, independent of traditional demographics like ethnicity. For instance, while nearly 50 percent of Hispanics in the sample used at least one of the products, the hipster Hispanic rate was 55 percent while the Young Professional Hispanic rate just 39 percent.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Similarly, Jordan, Ling and colleagues found, in a 2013 \u003c/span>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3795790/\">study\u003c/a> of\u003c/span>\u003cspan style=\"font-weight: 400\"> 13 to 20-year-old black youth in Richmond, Virginia, that \u003c/span>\u003cspan style=\"font-weight: 400\">a Hip Hop peer group smoked at a much higher rate than two other African-American cohorts, called Mainstream and Preppy.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Worth a Thousand Words\u003c/b>\u003c/p>\n\u003cp>Okay--but how do researchers know which peer group to assign each person to?\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">What makes a hipster a hipster? \u003c/span>\u003c/p>\n\u003cp>The researchers started by showing focus groups images of people with different clothing and hair styles. Individual photos elicited similar descriptions, which the researchers grouped together under different labels, like Hipster, Partier, or \"Homebody.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When looking at the photos,\u003cstrong> \"\u003c/strong>the kind of narrative that people talk about is quite different,\" says Ling. “So you can say, OK … picture No. 27 is always put in the Partier group; people are talking about how they like to go out and have a good time and they drink beer and like sports.”\u003c/span>\u003c/p>\n\u003cp>Having pegged certain photos to particular groups, the researchers then asked study participants to pick photos of people who “best fit into your main group of friends.” Those rankings were then combined with data from a list of bars the subjects patronized, and voilà -- you have been labeled.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Researchers named one of the peer crowds \"Hipsters\" because it was a common term of description for certain photos. They don't, of course, use the word with their subjects.\u003c/span>\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=_ykbVR-iZU8\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> “We don’t usually overtly say hipsters because it will turn off all the hipster\u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">s,”\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> Ling says.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Building a Brand\u003c/strong>\u003c/p>\n\u003cp>The first intervention started in San Diego in 2008. The researchers picked hipsters as a target because that was the group with the highest smoking rate.\u003c/p>\n\u003cp>The next step was to create a brand around an anti-smoking message. The name “Commune” tested best.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The thing that tested well about Commune is the idea that this peer crowd supports each other, whether you’re an artist, a band, a DJ or you have your own little clothing store,” says Jordan. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The project then instituted monthly bar nights and other Commune-branded events, promoting them as a way to support the local community. Local is big with hipsters, according to the research. While taking in the music and art, attendees also got a good dose of anti-tobacco messaging. This was meant to counter tobacco advertising aimed at young barflies by ‘\u003c/span>\u003ca href=\"http://online.liebertpub.com/doi/pdf/10.1089/ped.2010.0031\">\u003cspan style=\"font-weight: 400\">denormalizing’ \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> the companies that sell cigarettes -- tying them to a host of perceived ills anathema to the hipster population. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"We have rejected big corporations for a long time, like Big Music that hinders creative freedom and Big Fashion that runs sweatshops,\" the \u003ca href=\"http://jointhecommune.com/\" target=\"_blank\">Commune website\u003c/a> says. \"Our stand against Big Tobacco is even more important, since the industry contributes to things like world hunger, deforestation, and neo-conservative policies.\" \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The idea that Commune is trying to convey, says Ling, is that it's \"more authentically hipster than, say, Camel, that’s trying to come in here and sponsor tattoo artists and kind of pretending to be hipster, but they’re really not.\"\u003c/span>\u003c/p>\n\u003cp>\"It's kind of a war of ideals,\" she said.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=9dzS1c2HBA8&ab_channel=Rescue%3ATheBehaviorChangeAgency\u003c/p>\n\u003cp>\u003cstrong>Come for the Music, Stay to Quit Smoking\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Megan Younce, 32, attended \u003ca href=\"https://www.facebook.com/jointhecommune/\" target=\"_blank\">Commune Wednesday\u003c/a> events in San Diego when she was in her mid-20s.\u003c/span>“I had probably heard of it because of the bands and the local art,\" she says. \"One month it would be a girl who made jewelry, one month a painter, one month these girls who buy vintage clothing and alter them. Always a local person.”\u003c/p>\n\u003cp>While Younce came for the cultural events of \u003ca href=\"https://www.facebook.com/jointhecommune/\" target=\"_blank\">Commune Wednesdays\u003c/a>, she stayed for a smoking cessation program that was eventually introduced. She's now been off cigarettes almost five years.\u003c/p>\n\u003cp>Was she aware that the campaign had specifically designated her a hipster?\u003c/p>\n\u003cp>\"I definitely heard it from other people,\" she said. \"That doesn’t surprise me, considering where the events were held.\"\u003c/p>\n\u003cp>\u003cstrong> Measuring Results \u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As it turns out, it’s “really hard in this population to find the same hipster year after year,” Ling says. So in order to measure their campaign's efficacy, the researchers had to use \u003c/span>\u003ca href=\"http://link.springer.com/referenceworkentry/10.1007%2F978-94-007-0753-5_4201\">\u003cspan style=\"font-weight: 400\">time-location sampling\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, often employed with hard-to-reach populations. While they weren't able to track the exact people who initially signed up for the study, they went to the same bars where the Commune events had been held, to survey whoever was present in the right age range.In San Diego, using this method, the researchers \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025707/\" target=\"_blank\">found a decrease in the hipster smoking rate \u003c/a>over three years, from 57 to 48 percent, and a daily smoking decrease from 22 to 15 percent. There was no decrease in the rate for non-hipster peer groups who were not part of the Commune project.\u003c/span>\u003c/p>\n\u003cp>Two other studies, in Albuquerque and Las Vegas, also found a smoking decrease in the Partier and LGBT groups after similar campaigns were run. A third study, in Oklahoma City, did not find a smoking decrease in the overall Partier population, but did find that the rate of daily smoking decreased for those who were aware of the brand called HAVOC. The rate actually increased for those who were not aware of it.\u003c/p>\n\u003cp>The researchers acknowledge the limitations of these small studies, but feel that the evidence for the effectiveness of this approach is mounting.\u003c/p>\n\u003cp>\"We are cautious not to be overly confident about changes in tobacco use being attributable to our intervention,\" says Jordan. \"What gives us more confidence is the repetition of these findings.\"\u003c/p>\n\u003cp>Laura Gibson, research director for the Tobacco Center of Regulatory Science at the University of Pennsylvania's Annenberg School for Communication, has studied anti-smoking communications for youth and young adults. She says other research corroborates that tailoring a message for distinct groups makes the target audience more likely to pay attention.\u003c/p>\n\u003cp>\"Further, segmentation can help campaign planners put their message in places where those groups are more likely to come across them,\" she wrote in an email.\u003c/p>\n\u003cp>However, she said, creating separate anti-tobacco communications strategies for different groups could actually cost more money than creating a one-size-fits-all message, given that individual sub-cultures like hipsters aren't the only young adult groups with a smoking problem.\u003c/p>\n\u003cp>\"If only hipsters are smoking, then perhaps there's no need for universal appeal, but that's not the situation,\" she said.\u003c/p>\n\u003cp>The data from San Francisco Commune intervention is being analyzed now, and Ling says she hopes to present it at the National Conference on Tobacco or Health in March.\u003c/p>\n\u003cp>Meanwhile, hipsters shouldn't feel singled out in having been stamped \u003cspan style=\"line-height: 1.5\">with empirically proven traits. For instance, among the characteristics of Partiers, says Jordan, are prioritizing fashion and a tendency to be \"more concerned about their appearance.\" \u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Science marches on.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">While no self-respecting hipsters would identify themselves as such, lots of people in the business of defining things -- from \u003ca href=\"https://en.wikipedia.org/wiki/Hipster_(contemporary_subculture)\" target=\"_blank\">Wikipedia\u003c/a> to \u003ca href=\"http://www.merriam-webster.com/dictionary/hipster\" target=\"_blank\">Merriam-Webster\u003c/a> -- are happy to do it for them.\u003c/span>\u003c/p>\n\u003cp>While hipster haters may delight in the \u003ca href=\"https://www.google.com/search?q=hipsters+irritating\" target=\"_blank\">pejorative pigeonholing\u003c/a> of beard-festooned, flannel-loving millennials, some anti-tobacco researchers have analyzed, categorized and targeted this population not to condemn them, but to get them to quit smoking.\u003c/p>\n\u003caside class=\"pullquote alignright\">Researchers have created an actual 'brand' to communicate that Big Tobacco is antithetical to everything hipsters hold dear.\u003c/aside>\n\u003cp>In San Francisco, as part of a new \u003ca href=\"http://www.sfcancer.org/\" target=\"_blank\">initiative\u003c/a> aiming to reduce the incidence and mortality rate of residents with common cancers, researchers have begun creating \u003ca href=\"https://www.facebook.com/communesmokefree?hc_ref=SEARCH&fref=nf\">\u003cspan style=\"font-weight: 400\">Facebook smoking cessation groups\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> under the banner of a “brand” created specifically for the hipster community.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The groups are an extension of\u003c/span>\u003cb> r\u003c/b>esearch funded by the National Cancer Institute on how to boost the impact\u003cb> \u003c/b>of public anti-smoking campaigns in the face of the overpowering marketing know-how of big tobacco companies.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Young adults are the focus because the tobacco industry has long set its sights on turning them into customers. Somewhat successfully, it turns out. In California, for instance, \u003c/span>\u003cspan style=\"font-weight: 400\">21-29-year-olds smoke at a \u003ca href=\"https://www.cdph.ca.gov/programs/tobacco/Documents/CDPH%20CTCP%20Refresh/Research%20and%20Evaluation/Facts%20and%20Figures/FactsFigures2016PrePrintEditionV2.pdf\" target=\"_blank\">higher rate\u003c/a> than any other age group\u003c/span>\u003cspan style=\"font-weight: 400\">, and while there has been a drop in smoking overall\u003cstrong>, \u003c/strong>the reduction among 20-somethings has lagged. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In an attempt\u003cstrong> \u003c/strong>to get the drop in the young adult smoking rate moving again, Dr. Pamela Ling of t\u003c/span>\u003cspan style=\"font-weight: 400\">he University of California, San Francisco's Center for Tobacco Control Research and Education \u003c/span>\u003cspan style=\"font-weight: 400\">has been working with the Rescue marketing agency of San Diego to establish an anti-smoking brand called “Commune,” specifically targeting the nation's ample supply of hipsters. \u003c/span>\u003c/p>\n\u003cp>What the brand is \"selling\" is the desire not to smoke.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“One of the challenges around doing public health campaigns is that it’s really hard to sell the idea of not doing something,” says Ling. “If you’re selling cigarettes you can promote Marlboro, but if you’re selling not smoking Marlboro, you’re not really promoting anything. So the idea is creating a brand that competes with the tobacco brand.”\u003c/span>\u003c/p>\n\u003cp>\u003cb>Peer Crowds \u003cem> \u003c/em>\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">To that end, the Rescue campaign has held \u003ca href=\"https://www.facebook.com/pg/jointhecommune/events/?ref=page_internal\" target=\"_blank\">events\u003c/a> under the banner of the Commune brand in hipster drinking establishments in a handful of cities around the country. The lineups feature local bands and artists and the campaigns are currently active in Minneapolis and Duluth. The project ended an eight-year run in San Diego in February and a 3-year stint in San Francisco in June. \u003c/span>\u003c/p>\n\u003cp>The campaigns use a marketing strategy called \u003ca href=\"http://rescueagency.com/files/pdf/Young_Adult_Social_Branding.pdf\" target=\"_blank\">social branding\u003c/a>, which attempts to associate healthy behaviors with the values of individual subcultures, called \"peer crowds.\" In this model, a traditional demographic, such as young adults, is divided into cultural segments with shared interests, styles of dress, values, and media consumption habits\u003cb>. \u003c/b>Hipsters were the first target.\u003c/p>\n\u003cp>“Our goal was to develop something that spoke to them authentically,” says Jeff Jordan, the founder and president of Rescue. “That’s really the value of segmentation. Not only can you concentrate your resources on a higher risk group, minimizing waste, but you can actually make something a lot more appealing and tailored to the group, so they actually listen to you.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The potential messaging power of using peer crowds like hipsters is illustrated in a recent \u003ca href=\"http://tobaccocontrol.bmj.com/content/25/Suppl_1/i83.full\">paper\u003c/a> by Jordan, Ling and UCSF statistician Nadra Lisha, looking at data from surveys of 3,366 18-26 year-olds, conducted in the watering holes of San Diego, San Francisco, and L.A. The researchers focused on bars because studies have found an association between tobacco marketing there and smoking. From the data, t\u003c/span>he researchers mapped use of cigarettes, e-cigarettes, hookahs, cigars and smokeless tobacco to six different peer crowds. (A seventh group, LGBT, was added after subsequent studies.)\u003c/p>\n\u003cp>\u003ca href=\"http://tobaccocontrol.bmj.com/content/25/Suppl_1/i83/F1.large.jpg\">\u003cimg src=\"http://tobaccocontrol.bmj.com/content/25/Suppl_1/i83/F1.large.jpg\">\u003c/a>\u003c/p>\n\u003cp>The researchers found membership in these groups to be a significant predictor of tobacco use on its own, independent of traditional demographics like ethnicity. For instance, while nearly 50 percent of Hispanics in the sample used at least one of the products, the hipster Hispanic rate was 55 percent while the Young Professional Hispanic rate just 39 percent.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Similarly, Jordan, Ling and colleagues found, in a 2013 \u003c/span>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3795790/\">study\u003c/a> of\u003c/span>\u003cspan style=\"font-weight: 400\"> 13 to 20-year-old black youth in Richmond, Virginia, that \u003c/span>\u003cspan style=\"font-weight: 400\">a Hip Hop peer group smoked at a much higher rate than two other African-American cohorts, called Mainstream and Preppy.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Worth a Thousand Words\u003c/b>\u003c/p>\n\u003cp>Okay--but how do researchers know which peer group to assign each person to?\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">What makes a hipster a hipster? \u003c/span>\u003c/p>\n\u003cp>The researchers started by showing focus groups images of people with different clothing and hair styles. Individual photos elicited similar descriptions, which the researchers grouped together under different labels, like Hipster, Partier, or \"Homebody.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When looking at the photos,\u003cstrong> \"\u003c/strong>the kind of narrative that people talk about is quite different,\" says Ling. “So you can say, OK … picture No. 27 is always put in the Partier group; people are talking about how they like to go out and have a good time and they drink beer and like sports.”\u003c/span>\u003c/p>\n\u003cp>Having pegged certain photos to particular groups, the researchers then asked study participants to pick photos of people who “best fit into your main group of friends.” Those rankings were then combined with data from a list of bars the subjects patronized, and voilà -- you have been labeled.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Researchers named one of the peer crowds \"Hipsters\" because it was a common term of description for certain photos. They don't, of course, use the word with their subjects.\u003c/span>\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/_ykbVR-iZU8'\n title='//www.youtube.com/embed/_ykbVR-iZU8'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\"> “We don’t usually overtly say hipsters because it will turn off all the hipster\u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">s,”\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> Ling says.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Building a Brand\u003c/strong>\u003c/p>\n\u003cp>The first intervention started in San Diego in 2008. The researchers picked hipsters as a target because that was the group with the highest smoking rate.\u003c/p>\n\u003cp>The next step was to create a brand around an anti-smoking message. The name “Commune” tested best.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“The thing that tested well about Commune is the idea that this peer crowd supports each other, whether you’re an artist, a band, a DJ or you have your own little clothing store,” says Jordan. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The project then instituted monthly bar nights and other Commune-branded events, promoting them as a way to support the local community. Local is big with hipsters, according to the research. While taking in the music and art, attendees also got a good dose of anti-tobacco messaging. This was meant to counter tobacco advertising aimed at young barflies by ‘\u003c/span>\u003ca href=\"http://online.liebertpub.com/doi/pdf/10.1089/ped.2010.0031\">\u003cspan style=\"font-weight: 400\">denormalizing’ \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> the companies that sell cigarettes -- tying them to a host of perceived ills anathema to the hipster population. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"We have rejected big corporations for a long time, like Big Music that hinders creative freedom and Big Fashion that runs sweatshops,\" the \u003ca href=\"http://jointhecommune.com/\" target=\"_blank\">Commune website\u003c/a> says. \"Our stand against Big Tobacco is even more important, since the industry contributes to things like world hunger, deforestation, and neo-conservative policies.\" \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The idea that Commune is trying to convey, says Ling, is that it's \"more authentically hipster than, say, Camel, that’s trying to come in here and sponsor tattoo artists and kind of pretending to be hipster, but they’re really not.\"\u003c/span>\u003c/p>\n\u003cp>\"It's kind of a war of ideals,\" she said.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=9dzS1c2HBA8&ab_channel=Rescue%3ATheBehaviorChangeAgency\u003c/p>\n\u003cp>\u003cstrong>Come for the Music, Stay to Quit Smoking\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Megan Younce, 32, attended \u003ca href=\"https://www.facebook.com/jointhecommune/\" target=\"_blank\">Commune Wednesday\u003c/a> events in San Diego when she was in her mid-20s.\u003c/span>“I had probably heard of it because of the bands and the local art,\" she says. \"One month it would be a girl who made jewelry, one month a painter, one month these girls who buy vintage clothing and alter them. Always a local person.”\u003c/p>\n\u003cp>While Younce came for the cultural events of \u003ca href=\"https://www.facebook.com/jointhecommune/\" target=\"_blank\">Commune Wednesdays\u003c/a>, she stayed for a smoking cessation program that was eventually introduced. She's now been off cigarettes almost five years.\u003c/p>\n\u003cp>Was she aware that the campaign had specifically designated her a hipster?\u003c/p>\n\u003cp>\"I definitely heard it from other people,\" she said. \"That doesn’t surprise me, considering where the events were held.\"\u003c/p>\n\u003cp>\u003cstrong> Measuring Results \u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As it turns out, it’s “really hard in this population to find the same hipster year after year,” Ling says. So in order to measure their campaign's efficacy, the researchers had to use \u003c/span>\u003ca href=\"http://link.springer.com/referenceworkentry/10.1007%2F978-94-007-0753-5_4201\">\u003cspan style=\"font-weight: 400\">time-location sampling\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, often employed with hard-to-reach populations. While they weren't able to track the exact people who initially signed up for the study, they went to the same bars where the Commune events had been held, to survey whoever was present in the right age range.In San Diego, using this method, the researchers \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025707/\" target=\"_blank\">found a decrease in the hipster smoking rate \u003c/a>over three years, from 57 to 48 percent, and a daily smoking decrease from 22 to 15 percent. There was no decrease in the rate for non-hipster peer groups who were not part of the Commune project.\u003c/span>\u003c/p>\n\u003cp>Two other studies, in Albuquerque and Las Vegas, also found a smoking decrease in the Partier and LGBT groups after similar campaigns were run. A third study, in Oklahoma City, did not find a smoking decrease in the overall Partier population, but did find that the rate of daily smoking decreased for those who were aware of the brand called HAVOC. The rate actually increased for those who were not aware of it.\u003c/p>\n\u003cp>The researchers acknowledge the limitations of these small studies, but feel that the evidence for the effectiveness of this approach is mounting.\u003c/p>\n\u003cp>\"We are cautious not to be overly confident about changes in tobacco use being attributable to our intervention,\" says Jordan. \"What gives us more confidence is the repetition of these findings.\"\u003c/p>\n\u003cp>Laura Gibson, research director for the Tobacco Center of Regulatory Science at the University of Pennsylvania's Annenberg School for Communication, has studied anti-smoking communications for youth and young adults. She says other research corroborates that tailoring a message for distinct groups makes the target audience more likely to pay attention.\u003c/p>\n\u003cp>\"Further, segmentation can help campaign planners put their message in places where those groups are more likely to come across them,\" she wrote in an email.\u003c/p>\n\u003cp>However, she said, creating separate anti-tobacco communications strategies for different groups could actually cost more money than creating a one-size-fits-all message, given that individual sub-cultures like hipsters aren't the only young adult groups with a smoking problem.\u003c/p>\n\u003cp>\"If only hipsters are smoking, then perhaps there's no need for universal appeal, but that's not the situation,\" she said.\u003c/p>\n\u003cp>The data from San Francisco Commune intervention is being analyzed now, and Ling says she hopes to present it at the National Conference on Tobacco or Health in March.\u003c/p>\n\u003cp>Meanwhile, hipsters shouldn't feel singled out in having been stamped \u003cspan style=\"line-height: 1.5\">with empirically proven traits. For instance, among the characteristics of Partiers, says Jordan, are prioritizing fashion and a tendency to be \"more concerned about their appearance.\" \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "California Tests Electronic Database For End-Of-Life Wishes",
"title": "California Tests Electronic Database For End-Of-Life Wishes",
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"content": "\u003cp>Mary De Freze, who has heart problems, chronic lung disease and a history of falling, knows she may not have too many years left. And she’s clear about what she wants — and doesn’t want — at the end of her life.\u003c/p>\n\u003cp>“I don’t want to be in a lot of pain and I don’t want to be kept alive by machines,” said De Freze, 81.\u003c/p>\n\u003cp>After a recent fall landed De Freze in Stonebrook Healthcare Center with cracked ribs and a bruised spleen, the staff there helped her put those wishes on paper.\u003c/p>\n\u003cp>The document they used, Physician Orders for Life-Sustaining Treatment, or POLST, gives patients a choice of how much medical care they want in an emergency.\u003c/p>\n\u003cp>Prompted by a state law that took effect this year, a coalition of emergency and social service providers is working to create an electronic registry for POLST forms so they will be available to first responders and medical providers when they are neededC. The group is starting with a three-year pilot project in San Diego and Contra Costa counties that could serve as a model for a single, statewide registry. Paper-based POLST forms are used across the nation, but electronic registries exist only in a few states, including Oregon, New York and West Virginia.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many adults have advance directives, which are legal documents that designate a surrogate decision-maker and list patients’ health care preferences. POLST forms go further, creating a set of medical orders that are signed by the provider and the patient or a legally recognized decision-maker. Unlike advance directives, they are specifically designed for people who are already seriously ill or near the end of life.\u003c/p>\n\u003cp>Research shows that POLST forms help ensure patients’ end-of-life wishes are followed. But that only happens if doctors and other emergency providers can get them quickly. In California, the POLST form is a paper document and might not be at hand when patients need it. In many situations — a heart attack, a stroke or severe dementia — patients may not be able to communicate. And doctors may not be able to reach their families right away.\u003c/p>\n\u003cp>Without information on what patients want, there is an increased chance their wishes won’t be followed.\u003c/p>\n\u003cp>“If you take the time to fill out a POLST form, you want your health care wishes to be known and respected,” said Kate O’Malley, a senior program officer at the California Health Care Foundation, which is funding the pilot project in California. (California Healthline is an editorially independent service of the California Health Care Foundation.)\u003c/p>\n\u003cp>A POLST registry “would be a big plus for being able to give people the care they want and not give them the care they don’t want,” said Jeffrey Klingman, a neurologist at Kaiser Permanente in the East Bay.\u003c/p>\n\u003cp>“I don’t want to do things to people they don’t want done,” he said. “On the other hand, I don’t want to delay treatment while I wait to figure out what they want done.”\u003c/p>\n\u003cfigure id=\"attachment_292639\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/senior2.jpg\">\u003cimg class=\"size-full wp-image-292639\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/senior2.jpg\" alt=\"Audrey de Jesus, 83, filled out a Physician Orders for Life-Sustaining Treatment form at Chaparral House in Berkeley. De Jesus has seven children and said the form tells them exactly what she wants – comfort-focused treatment -- so there aren’t any questions in an emergency.\" width=\"370\" height=\"247\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/senior2.jpg 370w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/senior2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/senior2-240x160.jpg 240w\" sizes=\"(max-width: 370px) 100vw, 370px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Audrey de Jesus, 83, filled out a Physician Orders for Life-Sustaining Treatment form at Chaparral House in Berkeley. De Jesus has seven children and said the form tells them exactly what she wants – comfort-focused treatment -- so there aren’t any questions in an emergency. \u003ccite>(Anna Gorman/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Oregon was the first state to use POLST forms in 1991. California has been using them for nearly 20 years. Filling out the forms is voluntary, but once they are completed and signed, they must be followed, and providers have immunity from criminal prosecution or civil liability when they do so in good faith. The forms are printed on bright pink paper and include decisions such as whether a patient should be resuscitated, admitted to the intensive care unit or have a feeding tube inserted.\u003c/p>\n\u003cp>Tony Chicotel, a staff attorney at California Advocates for Nursing Home Reform in San Francisco, said patients should document their wishes in advance but that there are some downsides to doing so only with POLST forms. They are not nearly as thorough as advance directives and don’t allow you to designate a decision-maker, he noted. “The most comprehensive health care planning you can do is to name an agent.”\u003c/p>\n\u003cp>In addition, Chicotel said many nursing home residents are being urged to complete POLST forms even if they aren’t seriously ill or at the end of life. He said if an electronic registry is created, it should also include advance health care directives.\u003c/p>\n\u003cp>California’s electronic registry would be a secure, cloud-based portal for medical providers to submit and view POLST forms, regardless of whether the patient was at home, in the hospital or at a nursing home.\u003c/p>\n\u003cp>An electronic registry is a “no-brainer,” said Judy Thomas, CEO of the Coalition for Compassionate Care of California, which coordinates the state’s POLST program. But implementation will be much harder because it will require the cooperation of state agencies, doctors, emergency personnel, and private and public health systems. Success will also depend in part on hospitals’ willingness to share records.\u003c/p>\n\u003cp>“We are not asking all health systems to share all information,” said Allen Namath, co-founder of Vynca, the technology vendor for the project. “But the value in these forms is being able to share them.”\u003c/p>\n\u003cp>Patients who go through the trouble of documenting their medical preferences shouldn’t have to worry about getting the wrong care, he said. “It is not a cardiology problem. It is not a cancer problem. Helping improve our end-of-life care … applies to everybody.”\u003c/p>\n\u003cp>San Diego County already has a health information exchange that allows hospitals and health systems to share some data. But Contra Costa County is further behind.\u003c/p>\n\u003cp>“It’s going to be challenging,” said Donald Waters, executive director of the Alameda-Contra Costa Medical Association, which is helping lead the pilot project.\u003c/p>\n\u003cp>But Waters said it’s worth the effort to overcome the hurdles because having documents uploaded means paramedics and others will know in an instant if patients want to be resuscitated or just kept comfortable.\u003c/p>\n\u003cp>Situations arise every day in which being able to access POLST forms electronically could improve end-of-life care, said Tom Sugarman, an emergency physician at Sutter Delta Medical Center in Antioch, Calif.\u003c/p>\n\u003cp>“If you come [to the hospital] in full cardiac arrest … we only have one or two minutes to make a decision,” said Sugarman, who educates doctors about POLST. “All physicians are going to err on the side of preserving life.”\u003c/p>\n\u003cp>Sometimes, however, a patient may prefer comfort care, Sugarman said. A POLST form — if it is available — means families don’t have to make decisions during an emergency, he said. “The worst time to have that conversation is during a crisis.”\u003c/p>\n\u003cp>At Chaparral House, a nursing home in Berkeley, the POLST forms are in the residents’ folders at the nursing station. The forms go with patients to the hospital, but sometimes there is still a disconnect. Administrator KJ Page recalls one resident getting a feeding tube when he didn’t want one and another who almost underwent bypass surgery against his wishes.\u003c/p>\n\u003cp>Audrey de Jesus, 83, arrived at Chaparral House just a few months ago. She uses a wheelchair and an oxygen tank. Beside her bed sits a Bible and a book of Psalms.\u003c/p>\n\u003cp>De Jesus has seven children and said the form tells them exactly what she wants — comfort-focused treatment — so there aren’t any questions in an emergency. “I want pain control and the least suffering for my family,” she said.\u003c/p>\n\u003cp>Stonebrook Healthcare Center Social Services Director Shirley Jackson said filling out POLST forms is part of the admission process. “It’s almost like a driver’s license for the end of your life,” she said. “It’s important.”\u003c/p>\n\u003cp>Having the form available electronically would make it much easier for everyone. “If, God forbid, you have to send somebody out in an emergency, especially if they are unresponsive, it’s right there in the chart,” she said.\u003c/p>\n\u003cp>De Freze, a former certified nursing assistant, said she plans to put her pink form on her refrigerator when she leaves Stonebrook. She knows she could have an emergency and may not be able to tell doctors or paramedics what she wants.\u003c/p>\n\u003cp>“You can’t communicate if you are in excruciating pain,” she said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Mary De Freze, who has heart problems, chronic lung disease and a history of falling, knows she may not have too many years left. And she’s clear about what she wants — and doesn’t want — at the end of her life.\u003c/p>\n\u003cp>“I don’t want to be in a lot of pain and I don’t want to be kept alive by machines,” said De Freze, 81.\u003c/p>\n\u003cp>After a recent fall landed De Freze in Stonebrook Healthcare Center with cracked ribs and a bruised spleen, the staff there helped her put those wishes on paper.\u003c/p>\n\u003cp>The document they used, Physician Orders for Life-Sustaining Treatment, or POLST, gives patients a choice of how much medical care they want in an emergency.\u003c/p>\n\u003cp>Prompted by a state law that took effect this year, a coalition of emergency and social service providers is working to create an electronic registry for POLST forms so they will be available to first responders and medical providers when they are neededC. The group is starting with a three-year pilot project in San Diego and Contra Costa counties that could serve as a model for a single, statewide registry. Paper-based POLST forms are used across the nation, but electronic registries exist only in a few states, including Oregon, New York and West Virginia.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many adults have advance directives, which are legal documents that designate a surrogate decision-maker and list patients’ health care preferences. POLST forms go further, creating a set of medical orders that are signed by the provider and the patient or a legally recognized decision-maker. Unlike advance directives, they are specifically designed for people who are already seriously ill or near the end of life.\u003c/p>\n\u003cp>Research shows that POLST forms help ensure patients’ end-of-life wishes are followed. But that only happens if doctors and other emergency providers can get them quickly. In California, the POLST form is a paper document and might not be at hand when patients need it. In many situations — a heart attack, a stroke or severe dementia — patients may not be able to communicate. And doctors may not be able to reach their families right away.\u003c/p>\n\u003cp>Without information on what patients want, there is an increased chance their wishes won’t be followed.\u003c/p>\n\u003cp>“If you take the time to fill out a POLST form, you want your health care wishes to be known and respected,” said Kate O’Malley, a senior program officer at the California Health Care Foundation, which is funding the pilot project in California. (California Healthline is an editorially independent service of the California Health Care Foundation.)\u003c/p>\n\u003cp>A POLST registry “would be a big plus for being able to give people the care they want and not give them the care they don’t want,” said Jeffrey Klingman, a neurologist at Kaiser Permanente in the East Bay.\u003c/p>\n\u003cp>“I don’t want to do things to people they don’t want done,” he said. “On the other hand, I don’t want to delay treatment while I wait to figure out what they want done.”\u003c/p>\n\u003cfigure id=\"attachment_292639\" class=\"wp-caption alignright\" style=\"max-width: 370px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/senior2.jpg\">\u003cimg class=\"size-full wp-image-292639\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/senior2.jpg\" alt=\"Audrey de Jesus, 83, filled out a Physician Orders for Life-Sustaining Treatment form at Chaparral House in Berkeley. De Jesus has seven children and said the form tells them exactly what she wants – comfort-focused treatment -- so there aren’t any questions in an emergency.\" width=\"370\" height=\"247\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/senior2.jpg 370w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/senior2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/senior2-240x160.jpg 240w\" sizes=\"(max-width: 370px) 100vw, 370px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Audrey de Jesus, 83, filled out a Physician Orders for Life-Sustaining Treatment form at Chaparral House in Berkeley. De Jesus has seven children and said the form tells them exactly what she wants – comfort-focused treatment -- so there aren’t any questions in an emergency. \u003ccite>(Anna Gorman/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Oregon was the first state to use POLST forms in 1991. California has been using them for nearly 20 years. Filling out the forms is voluntary, but once they are completed and signed, they must be followed, and providers have immunity from criminal prosecution or civil liability when they do so in good faith. The forms are printed on bright pink paper and include decisions such as whether a patient should be resuscitated, admitted to the intensive care unit or have a feeding tube inserted.\u003c/p>\n\u003cp>Tony Chicotel, a staff attorney at California Advocates for Nursing Home Reform in San Francisco, said patients should document their wishes in advance but that there are some downsides to doing so only with POLST forms. They are not nearly as thorough as advance directives and don’t allow you to designate a decision-maker, he noted. “The most comprehensive health care planning you can do is to name an agent.”\u003c/p>\n\u003cp>In addition, Chicotel said many nursing home residents are being urged to complete POLST forms even if they aren’t seriously ill or at the end of life. He said if an electronic registry is created, it should also include advance health care directives.\u003c/p>\n\u003cp>California’s electronic registry would be a secure, cloud-based portal for medical providers to submit and view POLST forms, regardless of whether the patient was at home, in the hospital or at a nursing home.\u003c/p>\n\u003cp>An electronic registry is a “no-brainer,” said Judy Thomas, CEO of the Coalition for Compassionate Care of California, which coordinates the state’s POLST program. But implementation will be much harder because it will require the cooperation of state agencies, doctors, emergency personnel, and private and public health systems. Success will also depend in part on hospitals’ willingness to share records.\u003c/p>\n\u003cp>“We are not asking all health systems to share all information,” said Allen Namath, co-founder of Vynca, the technology vendor for the project. “But the value in these forms is being able to share them.”\u003c/p>\n\u003cp>Patients who go through the trouble of documenting their medical preferences shouldn’t have to worry about getting the wrong care, he said. “It is not a cardiology problem. It is not a cancer problem. Helping improve our end-of-life care … applies to everybody.”\u003c/p>\n\u003cp>San Diego County already has a health information exchange that allows hospitals and health systems to share some data. But Contra Costa County is further behind.\u003c/p>\n\u003cp>“It’s going to be challenging,” said Donald Waters, executive director of the Alameda-Contra Costa Medical Association, which is helping lead the pilot project.\u003c/p>\n\u003cp>But Waters said it’s worth the effort to overcome the hurdles because having documents uploaded means paramedics and others will know in an instant if patients want to be resuscitated or just kept comfortable.\u003c/p>\n\u003cp>Situations arise every day in which being able to access POLST forms electronically could improve end-of-life care, said Tom Sugarman, an emergency physician at Sutter Delta Medical Center in Antioch, Calif.\u003c/p>\n\u003cp>“If you come [to the hospital] in full cardiac arrest … we only have one or two minutes to make a decision,” said Sugarman, who educates doctors about POLST. “All physicians are going to err on the side of preserving life.”\u003c/p>\n\u003cp>Sometimes, however, a patient may prefer comfort care, Sugarman said. A POLST form — if it is available — means families don’t have to make decisions during an emergency, he said. “The worst time to have that conversation is during a crisis.”\u003c/p>\n\u003cp>At Chaparral House, a nursing home in Berkeley, the POLST forms are in the residents’ folders at the nursing station. The forms go with patients to the hospital, but sometimes there is still a disconnect. Administrator KJ Page recalls one resident getting a feeding tube when he didn’t want one and another who almost underwent bypass surgery against his wishes.\u003c/p>\n\u003cp>Audrey de Jesus, 83, arrived at Chaparral House just a few months ago. She uses a wheelchair and an oxygen tank. Beside her bed sits a Bible and a book of Psalms.\u003c/p>\n\u003cp>De Jesus has seven children and said the form tells them exactly what she wants — comfort-focused treatment — so there aren’t any questions in an emergency. “I want pain control and the least suffering for my family,” she said.\u003c/p>\n\u003cp>Stonebrook Healthcare Center Social Services Director Shirley Jackson said filling out POLST forms is part of the admission process. “It’s almost like a driver’s license for the end of your life,” she said. “It’s important.”\u003c/p>\n\u003cp>Having the form available electronically would make it much easier for everyone. “If, God forbid, you have to send somebody out in an emergency, especially if they are unresponsive, it’s right there in the chart,” she said.\u003c/p>\n\u003cp>De Freze, a former certified nursing assistant, said she plans to put her pink form on her refrigerator when she leaves Stonebrook. She knows she could have an emergency and may not be able to tell doctors or paramedics what she wants.\u003c/p>\n\u003cp>“You can’t communicate if you are in excruciating pain,” she said.\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": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"masters-of-scale": {
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},
"mindshift": {
"id": "mindshift",
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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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"order": 12
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"morning-edition": {
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"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
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"onourwatch": {
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"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"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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"order": 11
},
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"on-the-media": {
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"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"link": "/radio/program/on-the-media",
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},
"pbs-newshour": {
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"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
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},
"perspectives": {
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"order": 14
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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"link": "/radio/program/planet-money",
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"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
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},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"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.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
},
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
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"possible": {
"id": "possible",
"title": "Possible",
"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.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
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