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"content": "\u003cp>One of the fundamental ways scientists measure the well-being of a nation is tracking the rate at which its citizens die and how long they can be expected to live.\u003c/p>\n\u003cp>So the news out of the federal goverment Thursday is disturbing: The overall U.S. death rate has increased for the first time in a decade, according to an \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db267.htm\">analysis\u003c/a> of the latest data. And that led to a drop in overall life expectancy for the first time since 1993, particularly among people younger than 65.\u003c/p>\n\u003cp>\"This is a big deal,\" says \u003ca href=\"http://www.cpc.unc.edu/people/fellows/bio?person=morganp\">Philip Morgan\u003c/a>, a demographer at the University of North Carolina, Chapel Hill who was not involved in the new analysis.\u003c/p>\n\u003cp>\"There's not a better indicator of well-being than life expectancy,\" he says. \"The fact that it's leveling off in the U.S. is a striking finding.\"\u003c/p>\n\u003cp>Now, there's a chance that the latest data, from 2015, could be just a one-time blip. In fact, a preliminary analysis from the first two quarters of 2016 suggests that may be the case, says Robert Anderson, chief of the mortality statistics branch at the \u003ca href=\"https://www.cdc.gov/nchs/\">National Center for Health Statistics\u003c/a>, which released the new report.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Anderson says government analysts are awaiting more data before reaching any definitive conclusions.\u003c/p>\n\u003cp>\"We'll have to see what happens in the second half of 2016,\" he says.\u003c/p>\n\u003cp>Still, he believes the data from 2015 are worth paying attention to. Over that year, the overall death rate increased from 724.6 per 100,000 people to 733.1 per 100,000.\u003c/p>\n\u003cp>While that's not a lot, it was enough to cause the overall life expectancy to fall slightly. That's only happened a few times in the past 50 years. The dip in 1993, for example, was due to high death rates from AIDS, flu, homicide and accidental deaths that year.\u003c/p>\n\u003cp>On average, the overall life expectancy, for someone born in 2015, fell from 78.9 years to 78.8 years. The life expectancy for the average American man fell two-tenths of a year — from 76.5 to 76.3. For women, it dropped one-tenth — from 81.3 to 81.2 years.\u003c/p>\n\u003cp>\"It's remarkable,\" Morgan says. \"There are lots of things about this that are unexpected.\"\u003c/p>\n\u003cp>Most notably, the overall death rate for Americans increased because mortality from heart disease and stroke increased after declining for years. Deaths were also up from Alzheimer's disease, respiratory disease, kidney disease and diabetes. More Americans also died from unintentional injuries and suicide. In all, the decline was driven by increases in deaths from eight of the top 10 leading causes of death in the U.S.\u003c/p>\n\u003cp>\"When you see increases in so many of the leading causes of death, it's difficult to pinpoint one particular cause as the culprit,\" Anderson says.\u003c/p>\n\u003cp>The obesity epidemic could be playing a role in the increase in deaths from heart disease, strokes, diabetes and possibly Alzheimer's. It could also be that doctors have reached the limit of what they can do to fight heart disease with current treatments.\u003c/p>\n\u003cp>The epidemic of prescription opioid painkillers and heroin abuse is probably fueling the increase in unintentional injuries, \u003ca href=\"https://www.pop.upenn.edu/bio/arun-hendi\">Arun Hendi\u003c/a>, a demographer at Duke University, wrote in an email. The rise in drug abuse and suicide could be due to economic factors causing despair.\u003c/p>\n\u003cp>\"Clearly, that could be related to the economic circumstances that many Americans have experienced in the last eight years, or so, since the recession,\" says \u003ca href=\"https://sociology.sas.upenn.edu/irma_elo\">Irma Elo\u003c/a>, a sociologist at the University of Pennsylvania.\u003c/p>\n\u003cp>Whatever the cause, the trend is concerning, especially when the death rate is continuing to drop and life expectancy is still on the rise in most other industrialized countries.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's pretty grim,\" says \u003ca href=\"https://www.princeton.edu/%7Eaccase/\">Anne Case\u003c/a>, an economist at Princeton University studying the relationship between economics and health.\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=Life+Expectancy+In+U.S.+Drops+For+First+Time+In+Decades%2C+Report+Finds&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>One of the fundamental ways scientists measure the well-being of a nation is tracking the rate at which its citizens die and how long they can be expected to live.\u003c/p>\n\u003cp>So the news out of the federal goverment Thursday is disturbing: The overall U.S. death rate has increased for the first time in a decade, according to an \u003ca href=\"http://www.cdc.gov/nchs/products/databriefs/db267.htm\">analysis\u003c/a> of the latest data. And that led to a drop in overall life expectancy for the first time since 1993, particularly among people younger than 65.\u003c/p>\n\u003cp>\"This is a big deal,\" says \u003ca href=\"http://www.cpc.unc.edu/people/fellows/bio?person=morganp\">Philip Morgan\u003c/a>, a demographer at the University of North Carolina, Chapel Hill who was not involved in the new analysis.\u003c/p>\n\u003cp>\"There's not a better indicator of well-being than life expectancy,\" he says. \"The fact that it's leveling off in the U.S. is a striking finding.\"\u003c/p>\n\u003cp>Now, there's a chance that the latest data, from 2015, could be just a one-time blip. In fact, a preliminary analysis from the first two quarters of 2016 suggests that may be the case, says Robert Anderson, chief of the mortality statistics branch at the \u003ca href=\"https://www.cdc.gov/nchs/\">National Center for Health Statistics\u003c/a>, which released the new report.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Anderson says government analysts are awaiting more data before reaching any definitive conclusions.\u003c/p>\n\u003cp>\"We'll have to see what happens in the second half of 2016,\" he says.\u003c/p>\n\u003cp>Still, he believes the data from 2015 are worth paying attention to. Over that year, the overall death rate increased from 724.6 per 100,000 people to 733.1 per 100,000.\u003c/p>\n\u003cp>While that's not a lot, it was enough to cause the overall life expectancy to fall slightly. That's only happened a few times in the past 50 years. The dip in 1993, for example, was due to high death rates from AIDS, flu, homicide and accidental deaths that year.\u003c/p>\n\u003cp>On average, the overall life expectancy, for someone born in 2015, fell from 78.9 years to 78.8 years. The life expectancy for the average American man fell two-tenths of a year — from 76.5 to 76.3. For women, it dropped one-tenth — from 81.3 to 81.2 years.\u003c/p>\n\u003cp>\"It's remarkable,\" Morgan says. \"There are lots of things about this that are unexpected.\"\u003c/p>\n\u003cp>Most notably, the overall death rate for Americans increased because mortality from heart disease and stroke increased after declining for years. Deaths were also up from Alzheimer's disease, respiratory disease, kidney disease and diabetes. More Americans also died from unintentional injuries and suicide. In all, the decline was driven by increases in deaths from eight of the top 10 leading causes of death in the U.S.\u003c/p>\n\u003cp>\"When you see increases in so many of the leading causes of death, it's difficult to pinpoint one particular cause as the culprit,\" Anderson says.\u003c/p>\n\u003cp>The obesity epidemic could be playing a role in the increase in deaths from heart disease, strokes, diabetes and possibly Alzheimer's. It could also be that doctors have reached the limit of what they can do to fight heart disease with current treatments.\u003c/p>\n\u003cp>The epidemic of prescription opioid painkillers and heroin abuse is probably fueling the increase in unintentional injuries, \u003ca href=\"https://www.pop.upenn.edu/bio/arun-hendi\">Arun Hendi\u003c/a>, a demographer at Duke University, wrote in an email. The rise in drug abuse and suicide could be due to economic factors causing despair.\u003c/p>\n\u003cp>\"Clearly, that could be related to the economic circumstances that many Americans have experienced in the last eight years, or so, since the recession,\" says \u003ca href=\"https://sociology.sas.upenn.edu/irma_elo\">Irma Elo\u003c/a>, a sociologist at the University of Pennsylvania.\u003c/p>\n\u003cp>Whatever the cause, the trend is concerning, especially when the death rate is continuing to drop and life expectancy is still on the rise in most other industrialized countries.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's pretty grim,\" says \u003ca href=\"https://www.princeton.edu/%7Eaccase/\">Anne Case\u003c/a>, an economist at Princeton University studying the relationship between economics and health.\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=Life+Expectancy+In+U.S.+Drops+For+First+Time+In+Decades%2C+Report+Finds&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A sprawling health bill that \u003ca href=\"http://californiahealthline.org/news/senate-approves-landmark-mental-health-bill-as-part-of-21st-century-cures-act/\" target=\"_blank\">passed the Senate Wednesday\u003c/a> and is expected to become law before the end of the year is a grab bag for industries that spent plenty of money lobbying to make sure it happened that way.\u003c/p>\n\u003cp>Here are some of the winners and losers in the 21st Century Cures Act:\u003c/p>\n\u003cp>\u003cstrong>Winners\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Pharmaceutical and Medical Device Companies\u003c/em>. The bill will likely save drug and device companies billions of dollars bringing products to market by giving the Food and Drug Administration new authority and tools to demand fewer studies from those companies and speed up approvals.\u003c/p>\n\u003cp>The changes represent a massive lobbying effort by 58 pharmaceutical companies, 24 device companies and 26 “biotech products and research” companies, according to a Kaiser Health News analysis of lobbying data compiled by the Center for Responsive Politics. The groups reported more than $192 million in lobbying expenses on the Cures Act and other legislative priorities, the analysis shows.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cem>Medical schools, hospitals and physicians\u003c/em>. The bill provides $4.8 billion over 10 years in additional funding to National Institutes of Health, the federal government’s main biomedical research organization. (The funds are not guaranteed, however, and will be subject to annual appropriations.)\u003c/p>\n\u003cp>The money could help researchers at universities and medical centers get hundreds of millions more dollars in research grants, most of it toward research on cancer, neurobiology and genetic medicine.\u003c/p>\n\u003cp>The bill attracted lobbying activity from more than 60 schools, 36 hospitals and several dozen groups representing physician organizations. They reported spending more than $120 million in disclosures that included Cures Act lobbying.\u003c/p>\n\u003cp>\u003cem>Mental health and substance abuse advocates\u003c/em>. The bill provides $1 billion in state grants over two years to address opioid abuse and addiction. While most of that money goes to treatment facilities, some will fund research.\u003c/p>\n\u003cp>The bill also boosts funding for mental health research and treatment, with hundreds of millions of dollars authorized for dozens of existing and new programs.\u003c/p>\n\u003cp>Mental health, psychology and psychiatry groups spent $1.8 million on lobbying disclosures that included the Cures bill as an issue.\u003c/p>\n\u003cp>\u003cem>Patient groups\u003c/em>. Specialty disease and patient advocacy groups supported the legislation and lobbied vigorously. Many of these groups get a portion of their funding from drug and device companies. The bill includes more patient input in the drug development and approval process, and the bill is a boost to the clout of such groups.\u003c/p>\n\u003cp>More than two dozen patient groups lobbied the bill, and reported spending $6.4 million in disclosures that named the bill as one of their issues.\u003c/p>\n\u003cp>\u003cem>Health information technology and software companies\u003c/em>. The bill pushes federal agencies and health providers nationwide to use electronic health records systems and to collect data to enhance research and treatment. Although it doesn’t specifically fund the effort, IT and data management companies could gain millions of dollars in new business.\u003c/p>\n\u003cp>More than a dozen computer, software and telecom companies reported Cures Act lobbying. The groups’ total lobbying spending was $35 million on Cures as well as other legislation.\u003c/p>\n\u003cp>\u003cstrong>Losers\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Preventive medicine\u003c/em>. The bill cuts $3.5 billion — about 30 percent — from the Prevention and Public Health Fund established under Obamacare to promote prevention of Alzheimer’s disease, hospital acquired infections, chronic illnesses and other ailments.\u003c/p>\n\u003cp>\u003cem>Consumer and patient safety groups\u003c/em>. Groups like Public Citizen and the National Center for Health Research either fought the law outright or sought substantial changes. Although they won on some points, these groups still say Cures opens the door for unsafe drug and device approvals and doesn’t address rising drug costs.\u003c/p>\n\u003cp>\u003cem>Hair growth patients.\u003c/em> The bill says federal Medicaid will no longer help pay for drugs that help patients restore hair. The National Alopecia Areata Foundation spent $40,000 on lobbying disclosures this cycle that included Cures.\u003c/p>\n\u003cp>\u003cem>The FDA.\u003c/em> The bill gives the FDA an additional $500 million through 2026 and more hiring power, but critics say it isn’t enough to cover the additional workload under the bill. The agency also got something it opposed: renewal of a controversial voucher program that awards companies that approve drugs for rare pediatric diseases.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A sprawling health bill that \u003ca href=\"http://californiahealthline.org/news/senate-approves-landmark-mental-health-bill-as-part-of-21st-century-cures-act/\" target=\"_blank\">passed the Senate Wednesday\u003c/a> and is expected to become law before the end of the year is a grab bag for industries that spent plenty of money lobbying to make sure it happened that way.\u003c/p>\n\u003cp>Here are some of the winners and losers in the 21st Century Cures Act:\u003c/p>\n\u003cp>\u003cstrong>Winners\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Pharmaceutical and Medical Device Companies\u003c/em>. The bill will likely save drug and device companies billions of dollars bringing products to market by giving the Food and Drug Administration new authority and tools to demand fewer studies from those companies and speed up approvals.\u003c/p>\n\u003cp>The changes represent a massive lobbying effort by 58 pharmaceutical companies, 24 device companies and 26 “biotech products and research” companies, according to a Kaiser Health News analysis of lobbying data compiled by the Center for Responsive Politics. The groups reported more than $192 million in lobbying expenses on the Cures Act and other legislative priorities, the analysis shows.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Medical schools, hospitals and physicians\u003c/em>. The bill provides $4.8 billion over 10 years in additional funding to National Institutes of Health, the federal government’s main biomedical research organization. (The funds are not guaranteed, however, and will be subject to annual appropriations.)\u003c/p>\n\u003cp>The money could help researchers at universities and medical centers get hundreds of millions more dollars in research grants, most of it toward research on cancer, neurobiology and genetic medicine.\u003c/p>\n\u003cp>The bill attracted lobbying activity from more than 60 schools, 36 hospitals and several dozen groups representing physician organizations. They reported spending more than $120 million in disclosures that included Cures Act lobbying.\u003c/p>\n\u003cp>\u003cem>Mental health and substance abuse advocates\u003c/em>. The bill provides $1 billion in state grants over two years to address opioid abuse and addiction. While most of that money goes to treatment facilities, some will fund research.\u003c/p>\n\u003cp>The bill also boosts funding for mental health research and treatment, with hundreds of millions of dollars authorized for dozens of existing and new programs.\u003c/p>\n\u003cp>Mental health, psychology and psychiatry groups spent $1.8 million on lobbying disclosures that included the Cures bill as an issue.\u003c/p>\n\u003cp>\u003cem>Patient groups\u003c/em>. Specialty disease and patient advocacy groups supported the legislation and lobbied vigorously. Many of these groups get a portion of their funding from drug and device companies. The bill includes more patient input in the drug development and approval process, and the bill is a boost to the clout of such groups.\u003c/p>\n\u003cp>More than two dozen patient groups lobbied the bill, and reported spending $6.4 million in disclosures that named the bill as one of their issues.\u003c/p>\n\u003cp>\u003cem>Health information technology and software companies\u003c/em>. The bill pushes federal agencies and health providers nationwide to use electronic health records systems and to collect data to enhance research and treatment. Although it doesn’t specifically fund the effort, IT and data management companies could gain millions of dollars in new business.\u003c/p>\n\u003cp>More than a dozen computer, software and telecom companies reported Cures Act lobbying. The groups’ total lobbying spending was $35 million on Cures as well as other legislation.\u003c/p>\n\u003cp>\u003cstrong>Losers\u003c/strong>\u003c/p>\n\u003cp>\u003cem>Preventive medicine\u003c/em>. The bill cuts $3.5 billion — about 30 percent — from the Prevention and Public Health Fund established under Obamacare to promote prevention of Alzheimer’s disease, hospital acquired infections, chronic illnesses and other ailments.\u003c/p>\n\u003cp>\u003cem>Consumer and patient safety groups\u003c/em>. Groups like Public Citizen and the National Center for Health Research either fought the law outright or sought substantial changes. Although they won on some points, these groups still say Cures opens the door for unsafe drug and device approvals and doesn’t address rising drug costs.\u003c/p>\n\u003cp>\u003cem>Hair growth patients.\u003c/em> The bill says federal Medicaid will no longer help pay for drugs that help patients restore hair. The National Alopecia Areata Foundation spent $40,000 on lobbying disclosures this cycle that included Cures.\u003c/p>\n\u003cp>\u003cem>The FDA.\u003c/em> The bill gives the FDA an additional $500 million through 2026 and more hiring power, but critics say it isn’t enough to cover the additional workload under the bill. The agency also got something it opposed: renewal of a controversial voucher program that awards companies that approve drugs for rare pediatric diseases.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Screen Time Alters Young Brains, But is That Good or Bad?",
"title": "Screen Time Alters Young Brains, But is That Good or Bad?",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>There's new evidence that excessive screen time early in life can change the circuits in a growing brain.\u003c/p>\n\u003cp>Scientists disagree, though, about whether those changes are helpful, or just cause problems. Both views emerged during the Society for Neuroscience meeting in San Diego this week.\u003c/p>\n\u003cp>The debate centered on a study of young mice exposed to six hours daily of a sound and light show reminiscent of a video game. The mice showed \"dramatic changes everywhere in the brain,\" said \u003ca href=\"http://neurosurgery.washington.edu/education/faculty/researchbios/marino-ramirez.asp\">Jan-Marino Ramirez\u003c/a>, director of the Center for Integrative Brain Research at Seattle Children's Hospital.\u003c/p>\n\u003cp>\"Many of those changes suggest that you have a brain that is wired up at a much more baseline excited level,\" Ramirez \u003ca href=\"http://www.sfn.org/~/media/SfN/Documents/Press%20Releases/2016/Sensory%20Development%20FINAL.ashx\">reported\u003c/a>. \"You need much more sensory stimulation to get [the brain's] attention.\"\u003c/p>\n\u003cp>So is that a problem?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On the plus side, it meant that these mice were able to stay calm in an environment that would have stressed out a typical mouse, Ramirez explained. But it also meant they acted like they had an attention deficit disorder, showed signs of learning problems, and were prone to risky behavior.\u003c/p>\n\u003cp>Overall, the results add to the evidence that parents should be very cautious about screen time for young children, Ramirez said. \"I would minimize it.\"\u003c/p>\n\u003cp>A more optimistic interpretation came from \u003ca href=\"http://krubitzer.faculty.ucdavis.edu/leah-krubitzer/\">Leah Krubitzer\u003c/a>, an evolutionary neurobiologist at the University of California, Davis. \"The benefits may outweigh the negative sides to this,\" Krubitzer said, adding that a less sensitive brain might thrive in a world where overstimulation is a common problem.\u003c/p>\n\u003cp>The debate came just weeks after the American Academy of Pediatrics \u003ca href=\"http://www.npr.org/sections/ed/2016/10/21/498550475/american-academy-of-pediatrics-lifts-no-screens-under-2-rule\">relaxed\u003c/a> its longstanding rule against any screen time for kids under two. And it reflected an evolution in our understanding of how sensory stimulation affects developing brains.\u003c/p>\n\u003cp>Researchers learned many decades ago that young brains need a lot of stimulation to develop normally. So, for a long time parents were encouraged to give kids as many sensory experiences as possible.\u003c/p>\n\u003cp>\"The idea was, basically, the more you are exposed to sensory stimulation, the better you are cognitively,\" Ramirez said.\u003c/p>\n\u003cp>Then studies began to suggest that children who spent too much time watching TV or playing video games were more likely to develop ADHD. So scientists began studying rats and mice to see whether intense audio-visual stimulation early in life really can change brain circuits.\u003c/p>\n\u003cp>Studies like the one Ramirez presented confirm that it can. The next question is what that means for children and screen time.\u003c/p>\n\u003cp>\"The big question is, was our brain set up to be exposed to such a fast pace,\" Ramirez said. \"If you think about nature, you would run on the savanna and you would maybe once in your lifetime meet a lion.\"\u003c/p>\n\u003cp>In a video game, he said, you can meet the equivalent of a lion every few seconds. And human brains probably haven't evolved to handle that sort of stimulation, he said.\u003c/p>\n\u003cp>Krubitzer, and many other scientists, said they aren't so sure. It's true this sort of stimulation may desensitize a child's brain in some ways, they said. But it also may prepare the brain for an increasingly fast-paced world.\u003c/p>\n\u003cp>\"Less than 300 years ago we had an industrial revolution and today we're using mobile phones and we interact on a regular basis with machines,\" Krubitzer said. \"So the brain must have changed.\"\u003c/p>\n\u003cp>Krubitzer rejected the idea that the best solution is to somehow turn back the clock.\u003c/p>\n\u003cp>\"There's a tendency to think of the good old days, when you were a kid, and [say], 'I didn't do that and I didn't have TV and look how great I turned out,' \" Krubitzer said.\u003c/p>\n\u003cp>\u003ca href=\"http://www.bio.brandeis.edu/faculty/turrigiano.html\">Gina Turrigiano\u003c/a>, a brain researcher at Brandeis University, thinks lots of screen time may be fine for some young brains, but a problem for others.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Parents have to be really aware of the fact that each kid is going to respond very, very differently to the same kinds of environments,\" she said.\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=Heavy+Screen+Time+Rewires+Young+Brains%2C+For+Better+And+Worse&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There's new evidence that excessive screen time early in life can change the circuits in a growing brain.\u003c/p>\n\u003cp>Scientists disagree, though, about whether those changes are helpful, or just cause problems. Both views emerged during the Society for Neuroscience meeting in San Diego this week.\u003c/p>\n\u003cp>The debate centered on a study of young mice exposed to six hours daily of a sound and light show reminiscent of a video game. The mice showed \"dramatic changes everywhere in the brain,\" said \u003ca href=\"http://neurosurgery.washington.edu/education/faculty/researchbios/marino-ramirez.asp\">Jan-Marino Ramirez\u003c/a>, director of the Center for Integrative Brain Research at Seattle Children's Hospital.\u003c/p>\n\u003cp>\"Many of those changes suggest that you have a brain that is wired up at a much more baseline excited level,\" Ramirez \u003ca href=\"http://www.sfn.org/~/media/SfN/Documents/Press%20Releases/2016/Sensory%20Development%20FINAL.ashx\">reported\u003c/a>. \"You need much more sensory stimulation to get [the brain's] attention.\"\u003c/p>\n\u003cp>So is that a problem?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On the plus side, it meant that these mice were able to stay calm in an environment that would have stressed out a typical mouse, Ramirez explained. But it also meant they acted like they had an attention deficit disorder, showed signs of learning problems, and were prone to risky behavior.\u003c/p>\n\u003cp>Overall, the results add to the evidence that parents should be very cautious about screen time for young children, Ramirez said. \"I would minimize it.\"\u003c/p>\n\u003cp>A more optimistic interpretation came from \u003ca href=\"http://krubitzer.faculty.ucdavis.edu/leah-krubitzer/\">Leah Krubitzer\u003c/a>, an evolutionary neurobiologist at the University of California, Davis. \"The benefits may outweigh the negative sides to this,\" Krubitzer said, adding that a less sensitive brain might thrive in a world where overstimulation is a common problem.\u003c/p>\n\u003cp>The debate came just weeks after the American Academy of Pediatrics \u003ca href=\"http://www.npr.org/sections/ed/2016/10/21/498550475/american-academy-of-pediatrics-lifts-no-screens-under-2-rule\">relaxed\u003c/a> its longstanding rule against any screen time for kids under two. And it reflected an evolution in our understanding of how sensory stimulation affects developing brains.\u003c/p>\n\u003cp>Researchers learned many decades ago that young brains need a lot of stimulation to develop normally. So, for a long time parents were encouraged to give kids as many sensory experiences as possible.\u003c/p>\n\u003cp>\"The idea was, basically, the more you are exposed to sensory stimulation, the better you are cognitively,\" Ramirez said.\u003c/p>\n\u003cp>Then studies began to suggest that children who spent too much time watching TV or playing video games were more likely to develop ADHD. So scientists began studying rats and mice to see whether intense audio-visual stimulation early in life really can change brain circuits.\u003c/p>\n\u003cp>Studies like the one Ramirez presented confirm that it can. The next question is what that means for children and screen time.\u003c/p>\n\u003cp>\"The big question is, was our brain set up to be exposed to such a fast pace,\" Ramirez said. \"If you think about nature, you would run on the savanna and you would maybe once in your lifetime meet a lion.\"\u003c/p>\n\u003cp>In a video game, he said, you can meet the equivalent of a lion every few seconds. And human brains probably haven't evolved to handle that sort of stimulation, he said.\u003c/p>\n\u003cp>Krubitzer, and many other scientists, said they aren't so sure. It's true this sort of stimulation may desensitize a child's brain in some ways, they said. But it also may prepare the brain for an increasingly fast-paced world.\u003c/p>\n\u003cp>\"Less than 300 years ago we had an industrial revolution and today we're using mobile phones and we interact on a regular basis with machines,\" Krubitzer said. \"So the brain must have changed.\"\u003c/p>\n\u003cp>Krubitzer rejected the idea that the best solution is to somehow turn back the clock.\u003c/p>\n\u003cp>\"There's a tendency to think of the good old days, when you were a kid, and [say], 'I didn't do that and I didn't have TV and look how great I turned out,' \" Krubitzer said.\u003c/p>\n\u003cp>\u003ca href=\"http://www.bio.brandeis.edu/faculty/turrigiano.html\">Gina Turrigiano\u003c/a>, a brain researcher at Brandeis University, thinks lots of screen time may be fine for some young brains, but a problem for others.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Parents have to be really aware of the fact that each kid is going to respond very, very differently to the same kinds of environments,\" she said.\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=Heavy+Screen+Time+Rewires+Young+Brains%2C+For+Better+And+Worse&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Magnet Study Offers Fresh Insights Into How Memory Works",
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"content": "\u003cp>Forget where you just left your car keys? A magnetic pulse might help you remember.\u003c/p>\n\u003cp>Some dormant memories can be revived by delivering a pulse of magnetic energy to the right brain cells, researchers \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aah7011\">report\u003c/a> Thursday in the journal \u003cem>Science\u003c/em>.\u003c/p>\n\u003cp>The finding is part of a study that suggests the brain's \"working memory\" system is far less volatile than scientists once thought.\u003c/p>\n\u003cp>\"This changes how we think about the structure of working memory and the processes that support it,\" says \u003ca href=\"http://psychology.nd.edu/faculty/nathan-rose/\">Nathan Rose\u003c/a>, a neurocognitive psychologist studying memory at the University of Notre Dame, and one of the authors of the research.\u003c/p>\n\u003cp>Working memory, he explains, is what allows the brain to retain a new piece of information even when our attention is temporarily directed elsewhere.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Say you're at a cocktail party, for example. You meet two people, learn their names, and start a conversation. As you talk, the conversation shifts to just one of those people.\u003c/p>\n\u003cp>\"But you don't want to forget who the other person is, in case the conversation shifts back,\" Rose says. And, usually, you don't forget, because your brain has been keeping the name in working memory — ready to use at a moment's notice.\u003c/p>\n\u003cp>Since the 1950s, the dominant theory about working memory has been that it required continuous activity in the brain cells associated with a particular item, like someone's name. If the activity level dropped, the memory was gone forever, scientists figured.\u003c/p>\n\u003cp>But Rose and a team of researchers weren't so sure. So they did a series of experiments.\u003c/p>\n\u003cp>In one, people watched a screen while researchers monitored the activity in their brains.\u003c/p>\n\u003cp>\"We presented two items — like a face and a word,\" Rose says. The participants were told they needed to remember both.\u003c/p>\n\u003cp>That caused a distinct pattern of activity in two groups of brain cells: one that was keeping track of the face and another that was keeping track of the word.\u003c/p>\n\u003cp>But then, Rose says, the researchers had people focus on just one of the items they'd seen. And when they did that, the brain activity associated with the other item disappeared.\u003c/p>\n\u003cp>\"It was almost as if the item had been forgotten,\" Rose says.\u003c/p>\n\u003cp>But it wasn't forgotten. When prompted, the participants were able to retrieve their memory of the item. And that caused the associated brain cells to start firing again.\u003c/p>\n\u003cp>Then the researchers provided an even more dramatic demonstration. They used \u003ca href=\"https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml\">transcranial magnetic stimulation\u003c/a> (via an electromagnetic coil held to the forehead) to deliver a pulse of energy to the brain.\u003c/p>\n\u003cp>\"And when we did that, we saw a brief reactivation of the unattended memory item, as if it was brought back into focal attention,\" Rose says. The technique only worked, though, if people believed they would need to remember the item at some later time.\u003c/p>\n\u003cp>This ability to revive a thought with a magnetic pulse quickly became known as \"the Frankenstein effect\" among scientists in the lab, Rose says.\u003c/p>\n\u003cp>The results offer strong evidence that brain cells don't have to remain active to sustain a working memory, Rose says. But he's concerned that the public will assume magnetic stimulation can help them recover memories.\u003c/p>\n\u003cp>\"Boy, wouldn't that be great?\" he says. \"But I think we're a ways away from that.\"\u003c/p>\n\u003cp>What's closer, though, is a better understanding of how short-term memory works.\u003c/p>\n\u003cp>The study strongly suggests that working memories can be stored by changing the connections among neurons, says \u003ca href=\"http://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=24019\">Joel Voss\u003c/a>, a brain scientist at Northwestern University who was not involved in the research\u003c/p>\n\u003cp>\"If you imagine that a particular set of connections can represent a memory, then that set of connections could be reconfigured,\" he says. \"And it could stay in that configuration, even if the neurons aren't persistently active.\"\u003c/p>\n\u003cp>Scientists believe that's how long-term memories are stored. And if some short-term memories also use this mechanism, it could explain how they can become long-term memories.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In order for a long-term memory to happen there has to be some physical trace of that memory,\" he says. And that's exactly what the study seems to have found.\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=Zap%21+Magnet+Study+Offers+Fresh+Insights+Into+How+Memory+Works&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Forget where you just left your car keys? A magnetic pulse might help you remember.\u003c/p>\n\u003cp>Some dormant memories can be revived by delivering a pulse of magnetic energy to the right brain cells, researchers \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aah7011\">report\u003c/a> Thursday in the journal \u003cem>Science\u003c/em>.\u003c/p>\n\u003cp>The finding is part of a study that suggests the brain's \"working memory\" system is far less volatile than scientists once thought.\u003c/p>\n\u003cp>\"This changes how we think about the structure of working memory and the processes that support it,\" says \u003ca href=\"http://psychology.nd.edu/faculty/nathan-rose/\">Nathan Rose\u003c/a>, a neurocognitive psychologist studying memory at the University of Notre Dame, and one of the authors of the research.\u003c/p>\n\u003cp>Working memory, he explains, is what allows the brain to retain a new piece of information even when our attention is temporarily directed elsewhere.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Say you're at a cocktail party, for example. You meet two people, learn their names, and start a conversation. As you talk, the conversation shifts to just one of those people.\u003c/p>\n\u003cp>\"But you don't want to forget who the other person is, in case the conversation shifts back,\" Rose says. And, usually, you don't forget, because your brain has been keeping the name in working memory — ready to use at a moment's notice.\u003c/p>\n\u003cp>Since the 1950s, the dominant theory about working memory has been that it required continuous activity in the brain cells associated with a particular item, like someone's name. If the activity level dropped, the memory was gone forever, scientists figured.\u003c/p>\n\u003cp>But Rose and a team of researchers weren't so sure. So they did a series of experiments.\u003c/p>\n\u003cp>In one, people watched a screen while researchers monitored the activity in their brains.\u003c/p>\n\u003cp>\"We presented two items — like a face and a word,\" Rose says. The participants were told they needed to remember both.\u003c/p>\n\u003cp>That caused a distinct pattern of activity in two groups of brain cells: one that was keeping track of the face and another that was keeping track of the word.\u003c/p>\n\u003cp>But then, Rose says, the researchers had people focus on just one of the items they'd seen. And when they did that, the brain activity associated with the other item disappeared.\u003c/p>\n\u003cp>\"It was almost as if the item had been forgotten,\" Rose says.\u003c/p>\n\u003cp>But it wasn't forgotten. When prompted, the participants were able to retrieve their memory of the item. And that caused the associated brain cells to start firing again.\u003c/p>\n\u003cp>Then the researchers provided an even more dramatic demonstration. They used \u003ca href=\"https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml\">transcranial magnetic stimulation\u003c/a> (via an electromagnetic coil held to the forehead) to deliver a pulse of energy to the brain.\u003c/p>\n\u003cp>\"And when we did that, we saw a brief reactivation of the unattended memory item, as if it was brought back into focal attention,\" Rose says. The technique only worked, though, if people believed they would need to remember the item at some later time.\u003c/p>\n\u003cp>This ability to revive a thought with a magnetic pulse quickly became known as \"the Frankenstein effect\" among scientists in the lab, Rose says.\u003c/p>\n\u003cp>The results offer strong evidence that brain cells don't have to remain active to sustain a working memory, Rose says. But he's concerned that the public will assume magnetic stimulation can help them recover memories.\u003c/p>\n\u003cp>\"Boy, wouldn't that be great?\" he says. \"But I think we're a ways away from that.\"\u003c/p>\n\u003cp>What's closer, though, is a better understanding of how short-term memory works.\u003c/p>\n\u003cp>The study strongly suggests that working memories can be stored by changing the connections among neurons, says \u003ca href=\"http://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=24019\">Joel Voss\u003c/a>, a brain scientist at Northwestern University who was not involved in the research\u003c/p>\n\u003cp>\"If you imagine that a particular set of connections can represent a memory, then that set of connections could be reconfigured,\" he says. \"And it could stay in that configuration, even if the neurons aren't persistently active.\"\u003c/p>\n\u003cp>Scientists believe that's how long-term memories are stored. And if some short-term memories also use this mechanism, it could explain how they can become long-term memories.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"In order for a long-term memory to happen there has to be some physical trace of that memory,\" he says. And that's exactly what the study seems to have found.\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=Zap%21+Magnet+Study+Offers+Fresh+Insights+Into+How+Memory+Works&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A nonprofit research group is giving scientists a new way to study the secret lives of human cells.\u003c/p>\n\u003cp>On Wednesday, the \u003ca href=\"https://www.alleninstitute.org/what-we-do/cell-science/\">Allen Institute for Cell Science\u003c/a> provided access to a collection of living stem cells that have been genetically altered to make internal structures like the nucleus and mitochondria glow.\u003c/p>\n\u003cp>\"What makes these cells special is that they are normal, healthy cells that we can spy on and see what the cell does when it's left alone,\" says Susanne Rafelski, director of assay development at the institute. Under a microscope, \"they are a wonder to behold,\" she says.\u003c/p>\n\u003cp>The cells originally came from skin. But they have the potential to become many different types of cells, including those found in the heart and brain.\u003c/p>\n\u003cp>And they could help scientists answer basic questions about how cells specialize as they develop, how disease changes a cell and how experimental drugs affect certain types of cells.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We're creating a powerful resource and a tool that any biologist can use,\" says Ruwanthi Gunawardane, director of stem cells and gene editing at the Allen institute.\u003c/p>\n\u003cp>Initially, the institute is releasing five cell lines through the \u003ca href=\"https://www.coriell.org/about/overview\">Coriell Institute for Medical Research\u003c/a>. Each line has a different internal structure that glows, allowing researchers to see how that structure moves and changes during a cell's life.\u003c/p>\n\u003cp>\"What's really cool about this is that we can watch the cell as it divides,\" Gunawardane says.\u003c/p>\n\u003cp>Any scientist can order the cells online for a price that reflects only the distribution cost. \"Our goal was to make this absolutely accessible to any person working on stem cells,\" Gunawardane says.\u003c/p>\n\u003cp>Until now, many scientists have had to rely on cells that grow abnormally or have mutations, Gunawardane says. And there has been no good way to see a living cell's internal structures without disrupting its normal operation.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The new cell lines are the product of cutting-edge technology found in just a few labs, Gunawardane says. \"We would not have been able to do this two years ago,\" she says.\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=Glowing+Human+Cells+May+Shed+Light+On+Sickness+And+Health&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Researchers who developed a collection of human stem cells with glowing internal structures have begun sharing them with colleagues. The glow reveals the secret workings of cells.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A nonprofit research group is giving scientists a new way to study the secret lives of human cells.\u003c/p>\n\u003cp>On Wednesday, the \u003ca href=\"https://www.alleninstitute.org/what-we-do/cell-science/\">Allen Institute for Cell Science\u003c/a> provided access to a collection of living stem cells that have been genetically altered to make internal structures like the nucleus and mitochondria glow.\u003c/p>\n\u003cp>\"What makes these cells special is that they are normal, healthy cells that we can spy on and see what the cell does when it's left alone,\" says Susanne Rafelski, director of assay development at the institute. Under a microscope, \"they are a wonder to behold,\" she says.\u003c/p>\n\u003cp>The cells originally came from skin. But they have the potential to become many different types of cells, including those found in the heart and brain.\u003c/p>\n\u003cp>And they could help scientists answer basic questions about how cells specialize as they develop, how disease changes a cell and how experimental drugs affect certain types of cells.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're creating a powerful resource and a tool that any biologist can use,\" says Ruwanthi Gunawardane, director of stem cells and gene editing at the Allen institute.\u003c/p>\n\u003cp>Initially, the institute is releasing five cell lines through the \u003ca href=\"https://www.coriell.org/about/overview\">Coriell Institute for Medical Research\u003c/a>. Each line has a different internal structure that glows, allowing researchers to see how that structure moves and changes during a cell's life.\u003c/p>\n\u003cp>\"What's really cool about this is that we can watch the cell as it divides,\" Gunawardane says.\u003c/p>\n\u003cp>Any scientist can order the cells online for a price that reflects only the distribution cost. \"Our goal was to make this absolutely accessible to any person working on stem cells,\" Gunawardane says.\u003c/p>\n\u003cp>Until now, many scientists have had to rely on cells that grow abnormally or have mutations, Gunawardane says. And there has been no good way to see a living cell's internal structures without disrupting its normal operation.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The new cell lines are the product of cutting-edge technology found in just a few labs, Gunawardane says. \"We would not have been able to do this two years ago,\" she says.\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=Glowing+Human+Cells+May+Shed+Light+On+Sickness+And+Health&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Cuba Has a Lung Cancer Vaccine; Now U.S. Patients Will Test It",
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"content": "\u003cp>Mick Phillips' doctor is surprised he's still alive.\u003c/p>\n\u003cp>The 69-year-old Wisconsin man was diagnosed with late-stage lung cancer in 2010 and his doctor said he had less than a year to live.\u003c/p>\n\u003cp>That was six years ago.\u003c/p>\n\u003cp>\"For all intents and purposes he shouldn’t be here,\" says Phillips' oncologist, \u003ca href=\"http://www.fvho.org/providers/timothy-goggins-md/\" target=\"_blank\">Timothy Goggins\u003c/a>.\u003c/p>\n\u003cp>Dr. Goggins and Phillips both credit his survival to a lung cancer drug that isn't available in the U.S. and that Phillips has had to purchase illegally in Cuba.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Cancer won’t be cured, it will be turned into a chronic condition.’\u003ccite>Agustin Lage,Cuba’s Center of Molecular Immunology\u003c/cite>\u003c/aside>\n\u003cp>U.S. researchers think if the treatment works it could be used to prevent lung cancer in patients that are high risk. \u003ca href=\"https://www.roswellpark.org/\" target=\"_blank\">Roswell Park Cancer Institute\u003c/a> in Buffalo, New York has begun testing CIMAvax, the Cuban-developed immunotherapy for lung cancer. If successful, the trial will pave the way for potential FDA approval, after which the drug could become commercially available in the U.S.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The medicine has relatively minor side effects and appears to have \u003ca href=\"http://clincancerres.aacrjournals.org/content/early/2016/02/27/1078-0432.CCR-15-0855\" target=\"_blank\">prolonged the lives of patients\u003c/a> who have stage four lung cancer.\u003c/p>\n\u003cp>CIMAvax stimulates the body's immune system to fight the lung cancer. In this way it's a vaccine, but one that you take to stop the spread of late-stage cancer rather than prevent it in the first place.\u003c/p>\n\u003cp>“It’s like a flu vaccine,\" says \u003ca href=\"https://www.roswellpark.org/grace-dy\" target=\"_blank\">Dr. Grace Dy\u003c/a>, principal investigator for the trial. \"It’s the same concept. You give a drug so the body develops an antibody to the drug;\u003cb> \u003c/b>you’re using your body’s own natural systems to develop a therapy.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Lung cancer kills \u003ca href=\"http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/learn-about-lung-cancer/lung-cancer-fact-sheet.html?referrer=https://www.google.com/\" target=\"_blank\">nearly 160,000 Americans\u003c/a> annually. \u003c/span>Most people are diagnosed at a late stage and more than half die within a year.\u003c/p>\n\u003cp>This is likely the first time the \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02955290\" target=\"_blank\">FDA has allowed\u003c/a> a clinical trial of a Cuban-made therapy in a U.S. health care facility. It's not uncommon for the\u003cstrong> \u003c/strong>FDA to allow U.S. clinical trials in order to study therapies from other countries. It is extremely rare, however, for that therapy to come from Cuba.\u003c/p>\n\u003cp>And it's popular\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As of mid-November, nearly 200 people had \u003ca href=\"https://www.roswellpark.org/cimavax-form/?utm_source=page&utm_medium=button&utm_term=form1&utm_content=cimavax\" target=\"_blank\">applied online\u003c/a> to participate in the 60-90 person Phase II and Phase III studies.\u003c/span>\u003c/p>\n\u003cp>\"I’m not surprised that there’s interest,” says Dr. Dy. \u003cspan style=\"font-weight: 400\">“When you have cancer and it’s potentially life-threatening you want to explore all the options.\"\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_281617\" class=\"wp-caption aligncenter\" style=\"max-width: 960px\">\u003cimg class=\"size-full wp-image-281617\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/11/DrAgustinLage.jpg\" alt=\"Dr. Augustin Lage (left) in Havana with Mick Phillips, researcher Gisela Gonzalez, and Maya Phillips.\" width=\"960\" height=\"720\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-520x390.jpg 520w\" sizes=\"(max-width: 960px) 100vw, 960px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Augustin Lage (left) in Havana with Mick Phillips, researcher Gisela Gonzalez, and Maya Phillips. \u003ccite>(Courtesy Maya Phillips)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mick Phillips didn't think he had much longer to live when he brought back CIMAvax from Cuba in 2011 and asked a nurse friend to give him the injections.\u003c/p>\n\u003cp>\"He had a 5 percent chance of living five years,\" says Dr. Goggins who practices at \u003ca href=\"http://www.fvho.org/\" target=\"_blank\">Fox Valley Hemotology & Oncology\u003c/a> in Appleton, Wisconsin.\u003c/p>\n\u003cp>Today, Phillips is in remission from stage 4 lung cancer.\u003c/p>\n\u003cp>\"I keep telling people, if you believe in God, it’s God,\" says Dr. Goggins. \"If you believe in science, it’s CIMAvax.”\u003c/p>\n\u003cp>\u003cstrong>How\u003c/strong> \u003cstrong>the Cancer Vaccine Works\u003c/strong>\u003c/p>\n\u003cp>Lung cancer cells feed off a protein called epidermal growth factor or EGF. The protein supports normal cell growth but also fuels cancer cells.\u003c/p>\n\u003cp>The vaccine triggers the immune system to create antibodies that bind to and remove\u003cb> \u003c/b>EGF, thereby starving the cancer of its \"food.\"\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"100%\" src=\"https://www.youtube.com/embed/RaP4TsslJGw?rel=0\" frameborder=\"0\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Normal cells can live without EGF and use other growth-promoting proteins instead. But the cancer cells can't, and without EGF they're unable to multiply and spread.\u003c/p>\n\u003cp>CIMAvax has relatively few side effects when compared to chemotherapy, the traditional standard of care for late stage lung cancer. Chemo is hard on the body because it kills healthy cells (in addition to cancer cells) and causes side effects like hair loss, vomiting, loss of appetite and exhaustion.\u003c/p>\n\u003cp>Because CIMAvax doesn't kill cells, its side effects are relatively minor, such as chills or a fever that can be treated with over-the-counter medications.\u003c/p>\n\u003cp>Cuban patients that responded to CIMAvax had high levels of EGF, and t\u003cspan style=\"font-weight: 400\">heir bodies produced high levels of antibodies to combat the protein after they received the vaccine.\u003cstrong> \u003c/strong>\u003c/span>\u003c/p>\n\u003cp>Roswell Park will be looking to see if the same response emerges in its clinical trial— whether the most significant improvement is in patients with high EGF and antibody levels.\u003c/p>\n\u003cp>If the study shows promise it could be good news for other types of cancer that also rely on EGF, such as prostate, breast and colon cancer.\u003c/p>\n\u003cp>The most recent \u003ca href=\"http://clincancerres.aacrjournals.org/content/early/2016/06/24/1078-0432.CCR-15-0855\" target=\"_blank\">Cuban clinical trial \u003c/a>of CIMAvax is comparatively small at about 400 patients, which raises questions about how reliable the findings are.\u003c/p>\n\u003cp>UCSF oncologist \u003ca href=\"http://www.bivonalab.net/people/\" target=\"_blank\">Trever Bivona\u003c/a> says the study isn't large enough to determine whether the findings are statistically significant.\u003c/p>\n\u003cfigure id=\"attachment_278549\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-278549\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/11/CIMAvax-EGF-3.jpeg\" alt=\"The lung cancer vaccine is currently available in Cuba, Peru, Venezuela, Paraguay, Colombia and Bosnia and Herzegovina. U.S. researchers start clinical trials this month.\" width=\"1920\" height=\"1240\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3.jpeg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-160x103.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-800x517.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-768x496.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-1020x659.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-1180x762.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-960x620.jpeg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-240x155.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-375x242.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-520x336.jpeg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The lung cancer vaccine is currently available in Cuba, Peru, Venezuela, Paraguay, Colombia and Bosnia and Herzegovina. U.S. researchers start clinical trials this month. \u003ccite>(Centro de Inmunología Molecular)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I think we need a bigger more controlled study before making any conclusions,\" Bivona says.\u003c/p>\n\u003cp>The other problem with the Cuba study is that it had no control group. It compared patients getting CIMAvax to patients getting palliative care.\u003c/p>\n\u003cp>\"There may be preliminary findings here,\" Bivona says, \"but it’s certainly not a slam dunk.\"\u003c/p>\n\u003cp>\u003cstrong>Will Cuban Drugs Be Approved Under Trump?\u003c/strong>\u003c/p>\n\u003cp>If you're contemplating a flight to Havana, it's important to note that most U.S. travel to Cuba is still restricted.\u003c/p>\n\u003cp>The \u003cspan style=\"font-weight: 400\">U.S. Treasury Office of Foreign Assets Control says people and companies can \u003ca href=\"https://www.treasury.gov/resource-center/sanctions/Pages/licensing.aspx\" target=\"_blank\">apply for a specific license\u003c/a> to visit Cuba and purchase pharmaceuticals like CIMAvax. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Because the relationship between\u003c/span>\u003cspan style=\"font-weight: 400\"> Cuba and America has warmed, federal officials could potentially approve an application due to this change in \"foreign relations.\"\u003c/span>\u003c/p>\n\u003cp>However, President-elect Donald Trump has vowed to overturn all of President Obama's executive orders. Though it's unclear what that means, Obama's \u003ca href=\"https://www.whitehouse.gov/the-press-office/2014/12/17/fact-sheet-charting-new-course-cuba\" target=\"_blank\">2014 executive order\u003c/a> on Cuba expanded opportunities for Americans to legally visit Cuba.\u003c/p>\n\u003cp>And Vice President-elect Mike Pence has specifically said he will \"\u003ca href=\"http://www.politico.com/story/2016/10/mike-pence-cuba-executive-orders-229827\" target=\"_blank\">reverse Barack Obama’s executive orders on Cuba\u003c/a>.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Regardless, Dr. Dy says CIMAvax won't be available in pharmacies anytime soon. Roswell Park will start phase I of the clinical trial this month and it'll be months before it can start phase II and then phase III. She says an ambitious goal would be to have the medicine available by 2021.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Mick Phillips' doctor is surprised he's still alive.\u003c/p>\n\u003cp>The 69-year-old Wisconsin man was diagnosed with late-stage lung cancer in 2010 and his doctor said he had less than a year to live.\u003c/p>\n\u003cp>That was six years ago.\u003c/p>\n\u003cp>\"For all intents and purposes he shouldn’t be here,\" says Phillips' oncologist, \u003ca href=\"http://www.fvho.org/providers/timothy-goggins-md/\" target=\"_blank\">Timothy Goggins\u003c/a>.\u003c/p>\n\u003cp>Dr. Goggins and Phillips both credit his survival to a lung cancer drug that isn't available in the U.S. and that Phillips has had to purchase illegally in Cuba.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Cancer won’t be cured, it will be turned into a chronic condition.’\u003ccite>Agustin Lage,Cuba’s Center of Molecular Immunology\u003c/cite>\u003c/aside>\n\u003cp>U.S. researchers think if the treatment works it could be used to prevent lung cancer in patients that are high risk. \u003ca href=\"https://www.roswellpark.org/\" target=\"_blank\">Roswell Park Cancer Institute\u003c/a> in Buffalo, New York has begun testing CIMAvax, the Cuban-developed immunotherapy for lung cancer. If successful, the trial will pave the way for potential FDA approval, after which the drug could become commercially available in the U.S.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The medicine has relatively minor side effects and appears to have \u003ca href=\"http://clincancerres.aacrjournals.org/content/early/2016/02/27/1078-0432.CCR-15-0855\" target=\"_blank\">prolonged the lives of patients\u003c/a> who have stage four lung cancer.\u003c/p>\n\u003cp>CIMAvax stimulates the body's immune system to fight the lung cancer. In this way it's a vaccine, but one that you take to stop the spread of late-stage cancer rather than prevent it in the first place.\u003c/p>\n\u003cp>“It’s like a flu vaccine,\" says \u003ca href=\"https://www.roswellpark.org/grace-dy\" target=\"_blank\">Dr. Grace Dy\u003c/a>, principal investigator for the trial. \"It’s the same concept. You give a drug so the body develops an antibody to the drug;\u003cb> \u003c/b>you’re using your body’s own natural systems to develop a therapy.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Lung cancer kills \u003ca href=\"http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/learn-about-lung-cancer/lung-cancer-fact-sheet.html?referrer=https://www.google.com/\" target=\"_blank\">nearly 160,000 Americans\u003c/a> annually. \u003c/span>Most people are diagnosed at a late stage and more than half die within a year.\u003c/p>\n\u003cp>This is likely the first time the \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02955290\" target=\"_blank\">FDA has allowed\u003c/a> a clinical trial of a Cuban-made therapy in a U.S. health care facility. It's not uncommon for the\u003cstrong> \u003c/strong>FDA to allow U.S. clinical trials in order to study therapies from other countries. It is extremely rare, however, for that therapy to come from Cuba.\u003c/p>\n\u003cp>And it's popular\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As of mid-November, nearly 200 people had \u003ca href=\"https://www.roswellpark.org/cimavax-form/?utm_source=page&utm_medium=button&utm_term=form1&utm_content=cimavax\" target=\"_blank\">applied online\u003c/a> to participate in the 60-90 person Phase II and Phase III studies.\u003c/span>\u003c/p>\n\u003cp>\"I’m not surprised that there’s interest,” says Dr. Dy. \u003cspan style=\"font-weight: 400\">“When you have cancer and it’s potentially life-threatening you want to explore all the options.\"\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_281617\" class=\"wp-caption aligncenter\" style=\"max-width: 960px\">\u003cimg class=\"size-full wp-image-281617\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/11/DrAgustinLage.jpg\" alt=\"Dr. Augustin Lage (left) in Havana with Mick Phillips, researcher Gisela Gonzalez, and Maya Phillips.\" width=\"960\" height=\"720\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-520x390.jpg 520w\" sizes=\"(max-width: 960px) 100vw, 960px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Augustin Lage (left) in Havana with Mick Phillips, researcher Gisela Gonzalez, and Maya Phillips. \u003ccite>(Courtesy Maya Phillips)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mick Phillips didn't think he had much longer to live when he brought back CIMAvax from Cuba in 2011 and asked a nurse friend to give him the injections.\u003c/p>\n\u003cp>\"He had a 5 percent chance of living five years,\" says Dr. Goggins who practices at \u003ca href=\"http://www.fvho.org/\" target=\"_blank\">Fox Valley Hemotology & Oncology\u003c/a> in Appleton, Wisconsin.\u003c/p>\n\u003cp>Today, Phillips is in remission from stage 4 lung cancer.\u003c/p>\n\u003cp>\"I keep telling people, if you believe in God, it’s God,\" says Dr. Goggins. \"If you believe in science, it’s CIMAvax.”\u003c/p>\n\u003cp>\u003cstrong>How\u003c/strong> \u003cstrong>the Cancer Vaccine Works\u003c/strong>\u003c/p>\n\u003cp>Lung cancer cells feed off a protein called epidermal growth factor or EGF. The protein supports normal cell growth but also fuels cancer cells.\u003c/p>\n\u003cp>The vaccine triggers the immune system to create antibodies that bind to and remove\u003cb> \u003c/b>EGF, thereby starving the cancer of its \"food.\"\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"100%\" src=\"https://www.youtube.com/embed/RaP4TsslJGw?rel=0\" frameborder=\"0\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Normal cells can live without EGF and use other growth-promoting proteins instead. But the cancer cells can't, and without EGF they're unable to multiply and spread.\u003c/p>\n\u003cp>CIMAvax has relatively few side effects when compared to chemotherapy, the traditional standard of care for late stage lung cancer. Chemo is hard on the body because it kills healthy cells (in addition to cancer cells) and causes side effects like hair loss, vomiting, loss of appetite and exhaustion.\u003c/p>\n\u003cp>Because CIMAvax doesn't kill cells, its side effects are relatively minor, such as chills or a fever that can be treated with over-the-counter medications.\u003c/p>\n\u003cp>Cuban patients that responded to CIMAvax had high levels of EGF, and t\u003cspan style=\"font-weight: 400\">heir bodies produced high levels of antibodies to combat the protein after they received the vaccine.\u003cstrong> \u003c/strong>\u003c/span>\u003c/p>\n\u003cp>Roswell Park will be looking to see if the same response emerges in its clinical trial— whether the most significant improvement is in patients with high EGF and antibody levels.\u003c/p>\n\u003cp>If the study shows promise it could be good news for other types of cancer that also rely on EGF, such as prostate, breast and colon cancer.\u003c/p>\n\u003cp>The most recent \u003ca href=\"http://clincancerres.aacrjournals.org/content/early/2016/06/24/1078-0432.CCR-15-0855\" target=\"_blank\">Cuban clinical trial \u003c/a>of CIMAvax is comparatively small at about 400 patients, which raises questions about how reliable the findings are.\u003c/p>\n\u003cp>UCSF oncologist \u003ca href=\"http://www.bivonalab.net/people/\" target=\"_blank\">Trever Bivona\u003c/a> says the study isn't large enough to determine whether the findings are statistically significant.\u003c/p>\n\u003cfigure id=\"attachment_278549\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-278549\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/11/CIMAvax-EGF-3.jpeg\" alt=\"The lung cancer vaccine is currently available in Cuba, Peru, Venezuela, Paraguay, Colombia and Bosnia and Herzegovina. U.S. researchers start clinical trials this month.\" width=\"1920\" height=\"1240\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3.jpeg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-160x103.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-800x517.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-768x496.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-1020x659.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-1180x762.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-960x620.jpeg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-240x155.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-375x242.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-520x336.jpeg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The lung cancer vaccine is currently available in Cuba, Peru, Venezuela, Paraguay, Colombia and Bosnia and Herzegovina. U.S. researchers start clinical trials this month. \u003ccite>(Centro de Inmunología Molecular)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I think we need a bigger more controlled study before making any conclusions,\" Bivona says.\u003c/p>\n\u003cp>The other problem with the Cuba study is that it had no control group. It compared patients getting CIMAvax to patients getting palliative care.\u003c/p>\n\u003cp>\"There may be preliminary findings here,\" Bivona says, \"but it’s certainly not a slam dunk.\"\u003c/p>\n\u003cp>\u003cstrong>Will Cuban Drugs Be Approved Under Trump?\u003c/strong>\u003c/p>\n\u003cp>If you're contemplating a flight to Havana, it's important to note that most U.S. travel to Cuba is still restricted.\u003c/p>\n\u003cp>The \u003cspan style=\"font-weight: 400\">U.S. Treasury Office of Foreign Assets Control says people and companies can \u003ca href=\"https://www.treasury.gov/resource-center/sanctions/Pages/licensing.aspx\" target=\"_blank\">apply for a specific license\u003c/a> to visit Cuba and purchase pharmaceuticals like CIMAvax. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Because the relationship between\u003c/span>\u003cspan style=\"font-weight: 400\"> Cuba and America has warmed, federal officials could potentially approve an application due to this change in \"foreign relations.\"\u003c/span>\u003c/p>\n\u003cp>However, President-elect Donald Trump has vowed to overturn all of President Obama's executive orders. Though it's unclear what that means, Obama's \u003ca href=\"https://www.whitehouse.gov/the-press-office/2014/12/17/fact-sheet-charting-new-course-cuba\" target=\"_blank\">2014 executive order\u003c/a> on Cuba expanded opportunities for Americans to legally visit Cuba.\u003c/p>\n\u003cp>And Vice President-elect Mike Pence has specifically said he will \"\u003ca href=\"http://www.politico.com/story/2016/10/mike-pence-cuba-executive-orders-229827\" target=\"_blank\">reverse Barack Obama’s executive orders on Cuba\u003c/a>.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Regardless, Dr. Dy says CIMAvax won't be available in pharmacies anytime soon. Roswell Park will start phase I of the clinical trial this month and it'll be months before it can start phase II and then phase III. She says an ambitious goal would be to have the medicine available by 2021.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The market for products designed specifically for older adults could reach \u003ca href=\"http://semico.com/content/aging-place-internet-things-golden-years\">$30 billion by next year,\u003c/a> and startups want in on the action. What they sometimes lack is feedback from the people they hope will use their product. So \u003ca href=\"https://www.brookdale.com/en.html\">Brookdale\u003c/a>, the country's largest owner of retirement communities, has been inviting a few select entrepreneurs just to move in for a few days, show off their products and hear what the residents have to say.\u003c/p>\n\u003cp>That's what brought Dayle Rodriguez, 28, all the way from England to the dining room of \u003ca href=\"https://www.brookdale.com/en/communities/brookdale-south-bay-ca.html\">Brookdale South Bay\u003c/a> in Torrance, Calif. Rodriguez is the community and marketing manager for a company called Sentab. The startup's \u003ca href=\"https://www.sentab.com/\">product\u003c/a>, SentabTV, enables older adults who may not be comfortable with computers to access email, video chat and social media using just their televisions and a remote control.\u003c/p>\n\u003cp>\"It's nothing new, it's nothing too complicated and it's intuitive because lots of people have TV remotes,\" says Rodriguez.\u003c/p>\n\u003cp>But none of that is the topic of conversation in the Brookdale dining room. Instead, Rodriguez solicits residents' advice on what he should get on his cheeseburger and how he should spend the afternoon. Billiards was on the agenda, as well as learning to play \u003ca href=\"https://en.wikipedia.org/wiki/Mahjong\">mahjong\u003c/a>.\u003c/p>\n\u003cp>Rodriguez says it's important that residents here don't feel like he's selling them something. \"I've had more feedback in a passive approach\" he says. \"Playing pool, playing cards, having dinner, having lunch,\" all work better \"than going through a survey of questions. Them getting to know me and to trust me and knowing I'm not selling them something — there's more honest feedback that way.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Rodriguez is just the seventh entrepreneur to move into one of \u003ca href=\"https://www.sentab.com/\">Brookdale\u003c/a>'s 1,100 senior living communities. Other new products in the program have included a kind of full-body blow dryer and specially designed clothing that allows people with disabilities to dress and undress themselves.\u003c/p>\n\u003cp>Brookdale has no financial relationship with these startups. But that's not what motivates the program, says Andrew Smith, Brookdale's director of strategy and innovation.\u003c/p>\n\u003cp>\"First and foremost, the residents love it,\" says Smith. \"It also provides Brookdale the opportunity to learn about and experience new technologies quickly and inexpensively and to make sure that we understand what residents want and need.\"\u003c/p>\n\u003cp>Mary Lou Busch, 93, agreed to try the Sentab system. She tells Rodriguez that it might be good for \u003cem>someone\u003c/em>, but not for her.\u003c/p>\n\u003cp>\"I have the computer and FaceTime, which I talk with my family on,\" she explains. She also has an iPad and a smart phone. \"So I do pretty much everything I need to do.\"\u003c/p>\n\u003cp>Rodriguez takes it pretty well.\u003c/p>\n\u003cp>\"I'm not going to lie to you, I would've liked a more positive response,\" he says. But \"if people don't need it or want it, it's up to us to change, adapt it or make it more useful.\"\u003c/p>\n\u003cp>To be fair, if Rodriguez wanted feedback from some more technophobic seniors, he may have ended up in the wrong Brookdale community. This one's located in the heart of Southern California's aerospace corridor. Many residents have backgrounds in engineering, business and academia.\u003c/p>\n\u003cp>But Rodriguez says he's still learning something important by moving into to this Brookdale community: \"People are more tech-savvy than we thought.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And besides, where else would he learn to play mahjong?\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=For+Startups+Marketing+To+Seniors%2C+A+Novel+Idea%3A+Move+In+With+Them&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The market for products designed specifically for older adults could reach \u003ca href=\"http://semico.com/content/aging-place-internet-things-golden-years\">$30 billion by next year,\u003c/a> and startups want in on the action. What they sometimes lack is feedback from the people they hope will use their product. So \u003ca href=\"https://www.brookdale.com/en.html\">Brookdale\u003c/a>, the country's largest owner of retirement communities, has been inviting a few select entrepreneurs just to move in for a few days, show off their products and hear what the residents have to say.\u003c/p>\n\u003cp>That's what brought Dayle Rodriguez, 28, all the way from England to the dining room of \u003ca href=\"https://www.brookdale.com/en/communities/brookdale-south-bay-ca.html\">Brookdale South Bay\u003c/a> in Torrance, Calif. Rodriguez is the community and marketing manager for a company called Sentab. The startup's \u003ca href=\"https://www.sentab.com/\">product\u003c/a>, SentabTV, enables older adults who may not be comfortable with computers to access email, video chat and social media using just their televisions and a remote control.\u003c/p>\n\u003cp>\"It's nothing new, it's nothing too complicated and it's intuitive because lots of people have TV remotes,\" says Rodriguez.\u003c/p>\n\u003cp>But none of that is the topic of conversation in the Brookdale dining room. Instead, Rodriguez solicits residents' advice on what he should get on his cheeseburger and how he should spend the afternoon. Billiards was on the agenda, as well as learning to play \u003ca href=\"https://en.wikipedia.org/wiki/Mahjong\">mahjong\u003c/a>.\u003c/p>\n\u003cp>Rodriguez says it's important that residents here don't feel like he's selling them something. \"I've had more feedback in a passive approach\" he says. \"Playing pool, playing cards, having dinner, having lunch,\" all work better \"than going through a survey of questions. Them getting to know me and to trust me and knowing I'm not selling them something — there's more honest feedback that way.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Rodriguez is just the seventh entrepreneur to move into one of \u003ca href=\"https://www.sentab.com/\">Brookdale\u003c/a>'s 1,100 senior living communities. Other new products in the program have included a kind of full-body blow dryer and specially designed clothing that allows people with disabilities to dress and undress themselves.\u003c/p>\n\u003cp>Brookdale has no financial relationship with these startups. But that's not what motivates the program, says Andrew Smith, Brookdale's director of strategy and innovation.\u003c/p>\n\u003cp>\"First and foremost, the residents love it,\" says Smith. \"It also provides Brookdale the opportunity to learn about and experience new technologies quickly and inexpensively and to make sure that we understand what residents want and need.\"\u003c/p>\n\u003cp>Mary Lou Busch, 93, agreed to try the Sentab system. She tells Rodriguez that it might be good for \u003cem>someone\u003c/em>, but not for her.\u003c/p>\n\u003cp>\"I have the computer and FaceTime, which I talk with my family on,\" she explains. She also has an iPad and a smart phone. \"So I do pretty much everything I need to do.\"\u003c/p>\n\u003cp>Rodriguez takes it pretty well.\u003c/p>\n\u003cp>\"I'm not going to lie to you, I would've liked a more positive response,\" he says. But \"if people don't need it or want it, it's up to us to change, adapt it or make it more useful.\"\u003c/p>\n\u003cp>To be fair, if Rodriguez wanted feedback from some more technophobic seniors, he may have ended up in the wrong Brookdale community. This one's located in the heart of Southern California's aerospace corridor. Many residents have backgrounds in engineering, business and academia.\u003c/p>\n\u003cp>But Rodriguez says he's still learning something important by moving into to this Brookdale community: \"People are more tech-savvy than we thought.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And besides, where else would he learn to play mahjong?\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=For+Startups+Marketing+To+Seniors%2C+A+Novel+Idea%3A+Move+In+With+Them&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Biomedical research is going big-time: Megaprojects that collect vast stores of data are proliferating rapidly. But scientists' ability to make sense of all that information isn't keeping up.\u003c/p>\n\u003cp>This conundrum took center stage at a meeting of patient advocates, called \u003ca href=\"http://www.partneringforcures.org/\">Partnering For Cures\u003c/a>, in New York City on Nov. 15.\u003c/p>\n\u003cp>On the one hand, there's an embarrassment of riches, as billions of dollars are spent on these megaprojects.\u003c/p>\n\u003cp>There's the White House's \u003ca href=\"https://www.whitehouse.gov/CancerMoonshot\">Cancer Moonshot\u003c/a> (which seeks to make 10 years of progress in cancer research over the next five years), the \u003ca href=\"https://www.nih.gov/research-training/allofus-research-program\">Precision Medicine Initiative\u003c/a> (which is trying to recruit a million Americans to glean hints about health and disease from their data), \u003ca href=\"https://www.braininitiative.nih.gov/\">The BRAIN Initiative\u003c/a> (to map the neural circuits and understand the mechanics of thought and memory) and the \u003ca href=\"http://www.sanger.ac.uk/news/view/international-human-cell-atlas-initiative\">International Human Cell Atlas Initiative\u003c/a> (to identify and describe all human cell types).\u003c/p>\n\u003cp>\"It's not just that any one data repository is growing exponentially, the \u003cem>number\u003c/em> of data repositories is growing exponentially,\" said \u003ca href=\"https://www.ucsf.edu/news/2015/01/122656/ucsf-taps-atul-butte-lead-big-data-center\">Dr. Atul Butte\u003c/a>, who leads the Institute for Computational Health Sciences at the University of California, San Francisco.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One of the most remarkable efforts is the federal government's push to get doctors and hospitals to put medical records in digital form. That shift to electronic records is costing billions of dollars — including \u003ca href=\"http://www.modernhealthcare.com/article/20150213/NEWS/302139932/federal-health-it-payments-top-28-billion-after-december-surge\">more than $28 billion\u003c/a> alone in federal incentives to hospitals, doctors and others to adopt them. The investment is creating a vast data repository that could potentially be mined for clues about health and disease, the way websites and merchants gather data about you to personalize the online ads you see and for other commercial purposes.\u003c/p>\n\u003cp>But, unlike the data scientists at Google and Facebook, medical researchers have done almost nothing as yet to systematically analyze the information in these records, Butte said. \"As a country, I think we're investing close to zero analyzing any of that data,\" he said.\u003c/p>\n\u003cp>Prospecting for hints about health and disease isn't going to be easy. The raw data aren't very robust and reliable. Electronic medical records are often kept in databases that aren't compatible with one another, at least without a struggle. Some of the potentially revealing details are also kept as free-form notes, which can be hard to extract and interpret. Errors \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797550/#B22\">commonly creep\u003c/a> into these records.\u003c/p>\n\u003cp>And data culled from scientific studies aren't entirely trustworthy, either.\u003c/p>\n\u003cp>\"So many articles that are published today are going to be wrong in 10 years,\" said Greg Simon, who leads the Cancer Moonshot. \"That's just the history of scientific research, and the question is you just don't know which ones are going to be wrong.\"\u003c/p>\n\u003cp>Scientists trying to figure out how to analyze that flood of big data are going to have to cut through the dissonance to find a melody. That takes skill.\u003c/p>\n\u003cp>\"In a world when anything is possible because you have so much data, how do you figure out who has done the math right?\" asked Food and Drug Administration Commissioner \u003ca href=\"http://www.fda.gov/AboutFDA/CentersOffices/ucm452317.htm\">Robert Califf\u003c/a>.\u003c/p>\n\u003cp>He said the only way to know for sure is to take ideas gleaned from the big datasets and then try them out in people. That means persuading patients to participate in studies.\u003c/p>\n\u003cp>Just a small percentage do today, \"and what we're seeing in our best academic centers, the clinicians say they don't have time to talk to patients about participating in studies,\" Califf said. \"So, far and away this is our No. 1 issue that we're focused on with big data.\"\u003c/p>\n\u003cp>These problems aren't just abstractions for \u003ca href=\"http://news.harvard.edu/gazette/story/2016/03/strength-in-love-hope-in-science/\">Sonia Vallabh\u003c/a>. Her mother died of a rare, fatal genetic disease in middle age, called \u003ca href=\"http://www.prionalliance.org/\">prion disease\u003c/a>. Vallabh carries the same mutation that afflicted her mother. Vallabh quit her job as a lawyer and is now seeking a doctorate in biological and biomedical sciences at the Broad Institute in Cambridge, Mass.\u003c/p>\n\u003cp>Vallabh turned to a huge data set of genetic information to see what she could learn about her condition. \"It basically confirmed what we thought we knew about my genetic mutation, which is it makes me almost 100 percent likely to die this way by midlife,\" she said.\u003c/p>\n\u003cp>But the data also yielded a surprise. Her disease is caused by having too much of a certain protein in her body. And some people with only half as much of this dangerous protein didn't get sick and die.\u003c/p>\n\u003cp>\"So, here's an experiment of nature handed to us on a platter by big data, that says if we can find a way to turn down this disease protein, this protein that wants to kill me, that should be a safe way to delay or prevent disease.\"\u003c/p>\n\u003cp>But that's not a question to be answered through data-crunching. Vallabh needs the old-fashioned kind of medical research — laboratory and clinical science — to develop a drug that would reduce the protein safely and effectively.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>You can email Richard Harris at\u003c/em> \u003ca href=\"mailto:rharris@npr.org\">rharris@npr.org\u003c/a>.\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=Big+Data+Coming+In+Faster+Than+Biomedical+Researchers+Can+Process+It&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Biomedical research is going big-time: Megaprojects that collect vast stores of data are proliferating rapidly. But scientists' ability to make sense of all that information isn't keeping up.\u003c/p>\n\u003cp>This conundrum took center stage at a meeting of patient advocates, called \u003ca href=\"http://www.partneringforcures.org/\">Partnering For Cures\u003c/a>, in New York City on Nov. 15.\u003c/p>\n\u003cp>On the one hand, there's an embarrassment of riches, as billions of dollars are spent on these megaprojects.\u003c/p>\n\u003cp>There's the White House's \u003ca href=\"https://www.whitehouse.gov/CancerMoonshot\">Cancer Moonshot\u003c/a> (which seeks to make 10 years of progress in cancer research over the next five years), the \u003ca href=\"https://www.nih.gov/research-training/allofus-research-program\">Precision Medicine Initiative\u003c/a> (which is trying to recruit a million Americans to glean hints about health and disease from their data), \u003ca href=\"https://www.braininitiative.nih.gov/\">The BRAIN Initiative\u003c/a> (to map the neural circuits and understand the mechanics of thought and memory) and the \u003ca href=\"http://www.sanger.ac.uk/news/view/international-human-cell-atlas-initiative\">International Human Cell Atlas Initiative\u003c/a> (to identify and describe all human cell types).\u003c/p>\n\u003cp>\"It's not just that any one data repository is growing exponentially, the \u003cem>number\u003c/em> of data repositories is growing exponentially,\" said \u003ca href=\"https://www.ucsf.edu/news/2015/01/122656/ucsf-taps-atul-butte-lead-big-data-center\">Dr. Atul Butte\u003c/a>, who leads the Institute for Computational Health Sciences at the University of California, San Francisco.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One of the most remarkable efforts is the federal government's push to get doctors and hospitals to put medical records in digital form. That shift to electronic records is costing billions of dollars — including \u003ca href=\"http://www.modernhealthcare.com/article/20150213/NEWS/302139932/federal-health-it-payments-top-28-billion-after-december-surge\">more than $28 billion\u003c/a> alone in federal incentives to hospitals, doctors and others to adopt them. The investment is creating a vast data repository that could potentially be mined for clues about health and disease, the way websites and merchants gather data about you to personalize the online ads you see and for other commercial purposes.\u003c/p>\n\u003cp>But, unlike the data scientists at Google and Facebook, medical researchers have done almost nothing as yet to systematically analyze the information in these records, Butte said. \"As a country, I think we're investing close to zero analyzing any of that data,\" he said.\u003c/p>\n\u003cp>Prospecting for hints about health and disease isn't going to be easy. The raw data aren't very robust and reliable. Electronic medical records are often kept in databases that aren't compatible with one another, at least without a struggle. Some of the potentially revealing details are also kept as free-form notes, which can be hard to extract and interpret. Errors \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797550/#B22\">commonly creep\u003c/a> into these records.\u003c/p>\n\u003cp>And data culled from scientific studies aren't entirely trustworthy, either.\u003c/p>\n\u003cp>\"So many articles that are published today are going to be wrong in 10 years,\" said Greg Simon, who leads the Cancer Moonshot. \"That's just the history of scientific research, and the question is you just don't know which ones are going to be wrong.\"\u003c/p>\n\u003cp>Scientists trying to figure out how to analyze that flood of big data are going to have to cut through the dissonance to find a melody. That takes skill.\u003c/p>\n\u003cp>\"In a world when anything is possible because you have so much data, how do you figure out who has done the math right?\" asked Food and Drug Administration Commissioner \u003ca href=\"http://www.fda.gov/AboutFDA/CentersOffices/ucm452317.htm\">Robert Califf\u003c/a>.\u003c/p>\n\u003cp>He said the only way to know for sure is to take ideas gleaned from the big datasets and then try them out in people. That means persuading patients to participate in studies.\u003c/p>\n\u003cp>Just a small percentage do today, \"and what we're seeing in our best academic centers, the clinicians say they don't have time to talk to patients about participating in studies,\" Califf said. \"So, far and away this is our No. 1 issue that we're focused on with big data.\"\u003c/p>\n\u003cp>These problems aren't just abstractions for \u003ca href=\"http://news.harvard.edu/gazette/story/2016/03/strength-in-love-hope-in-science/\">Sonia Vallabh\u003c/a>. Her mother died of a rare, fatal genetic disease in middle age, called \u003ca href=\"http://www.prionalliance.org/\">prion disease\u003c/a>. Vallabh carries the same mutation that afflicted her mother. Vallabh quit her job as a lawyer and is now seeking a doctorate in biological and biomedical sciences at the Broad Institute in Cambridge, Mass.\u003c/p>\n\u003cp>Vallabh turned to a huge data set of genetic information to see what she could learn about her condition. \"It basically confirmed what we thought we knew about my genetic mutation, which is it makes me almost 100 percent likely to die this way by midlife,\" she said.\u003c/p>\n\u003cp>But the data also yielded a surprise. Her disease is caused by having too much of a certain protein in her body. And some people with only half as much of this dangerous protein didn't get sick and die.\u003c/p>\n\u003cp>\"So, here's an experiment of nature handed to us on a platter by big data, that says if we can find a way to turn down this disease protein, this protein that wants to kill me, that should be a safe way to delay or prevent disease.\"\u003c/p>\n\u003cp>But that's not a question to be answered through data-crunching. Vallabh needs the old-fashioned kind of medical research — laboratory and clinical science — to develop a drug that would reduce the protein safely and effectively.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>You can email Richard Harris at\u003c/em> \u003ca href=\"mailto:rharris@npr.org\">rharris@npr.org\u003c/a>.\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=Big+Data+Coming+In+Faster+Than+Biomedical+Researchers+Can+Process+It&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The Ethics of Withholding Life-Saving Treatment",
"title": "The Ethics of Withholding Life-Saving Treatment",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>\u003cem>From the authors of \"\u003ca href=\"http://us.macmillan.com/algorithmstoliveby/brianchristian\" target=\"_blank\">ALGORITHMS TO LIVE BY: The Computer Science of Human Decisions\u003c/a>,\" published by Henry Hold and Co.\u003c/em>\u003c/p>\n\u003cp>Every day we make a series of choices that are all really the same choice underneath: between our \u003cem>favorite\u003c/em> things and \u003cem>new\u003c/em> ones. Do we go to the restaurant we adore, or the place down the road that just opened up? Get our “usual,” or try the special? Invite our best friend, or reach out to a new acquaintance we’d like to get to know better? We intuitively understand that life is a balance between novelty and familiarity, between the latest and the greatest, between taking chances and savoring what we know and love. But the unanswered question is: What is that balance?\u003c/p>\n\u003caside class=\"pullquote alignright\">The cost of knowledge: Twenty-four more infants died in a group receiving conventional treatment than in a group receiving the treatment being tested.\u003c/aside>\n\u003cp>It’s a question with higher stakes than we might realize. And it has a more explicit answer, from a field we don’t often turn to in moments of human indecision, though perhaps we should: computer science. Indeed, computer scientists have been working on finding this balance for more than 50 years. They even have a name for it: the “explore/exploit” tradeoff.\u003c/p>\n\u003cp>Today, algorithms derived from studying the explore/exploit tradeoff power a sizable fraction of the Internet economy, including the advertising business responsible for almost all of Google’s revenue -- they determine when to display the ad that has performed the best so far and when to experiment with potentially superior alternatives. Algorithms have also become essential to political campaigning, an indispensable part of honing messaging and donation appeals.\u003c/p>\n\u003cp>The single most important application of explore/exploit algorithms, however, is a domain where human lives are directly on the line. That domain is clinical trials, and a growing community of doctors, statisticians, and computer scientists think we’re doing them wrong.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In English, the words “explore” and “exploit” come loaded with opposite connotations. But to a computer scientist, these words have much more specific and neutral meanings. Simply put, exploration is \u003cem>gathering\u003c/em> information, and exploitation is \u003cem>using\u003c/em> the information you have to get a known good result. It’s fairly intuitive that never exploring is no way to live. But computer science shows that failing to exploit can be every bit as bad.\u003c/p>\n\u003cfigure id=\"attachment_180526\" class=\"wp-caption aligncenter\" style=\"max-width: 2592px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program.jpg\">\u003cimg class=\"size-full wp-image-180526\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program.jpg\" alt=\"Respiratory therapist Michelle Sirra takes a blood sample from 3-day-old Stuart Parker in preparation for transfer to an Extracorporeal Membrane Oxygenation unit on Friday, July 21, in San Juan, Puerto Rico. An ECMO team comprised Air Force and Army medical specialists from the Wilford Hall Medical Center at Lackland Air Force Base, Texas, flew to Puerto Rico to transport Stuart to San Antonio for more advanced care. \" width=\"2592\" height=\"1944\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program.jpg 2592w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-960x720.jpg 960w\" sizes=\"(max-width: 2592px) 100vw, 2592px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Michelle Sirra takes a blood sample from 3-day-old Stuart Parker in preparation for transfer to an Extracorporeal Membrane Oxygenation unit on Friday, July 21, in San Juan, Puerto Rico. An ECMO team comprised Air Force and Army medical specialists from the Wilford Hall Medical Center at Lackland Air Force Base, Texas, flew to Puerto Rico to transport Stuart to San Antonio for more advanced care. \u003ccite>(Staff Sgt. Matthew Rosine)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the fundamental maxims in medical ethics is the oath to “first, do no harm.” But this is not always as straightforward as it sounds. In clinical trials, doctors and scientists encounter directly the tension between acting on one’s best knowledge and gathering more. Do you give someone the best known conventional treatment, even if it’s not very good? Or do you give them an experimental treatment that \u003cem>might \u003c/em>be significantly better—but might also be worse? Computer science is no substitute for ethics, but perhaps it can offer a degree of precision that ethics alone cannot.\u003c/p>\n\u003cp>The question that has arisen over the last several decades is whether the standard approach to conducting clinical trials really does minimize risk to patients. In a conventional clinical trial, patients are split into equal groups, and each group is assigned to receive a different treatment for the duration of the study. (Only in exceptional cases does a trial get stopped early.) This procedure focuses on decisively resolving the question of which treatment is better, rather than on providing the best treatment to each patient in the trial itself. Maybe this is a false choice. Doctors are gaining some information about which option is better \u003cem>while\u003c/em> the trial proceeds—information that could be used to improve outcomes not only for future patients beyond the trial, but also for the patients currently in it.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/iStock_17372419_LARGE.jpg\">\u003cimg class=\"aligncenter size-full wp-image-180561\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/iStock_17372419_LARGE.jpg\" alt=\"Juggling balls\" width=\"2715\" height=\"1810\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE.jpg 2715w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-960x640.jpg 960w\" sizes=\"(max-width: 2715px) 100vw, 2715px\">\u003c/a>In 1969, Marvin Zelen, a biostatistician who spent most of his career at Harvard, proposed conducting “adaptive” trials, in which the chance of using a given treatment increases with each success and decreases with each failure. In his proposal, you start with a hat that contains one ball for each of the two treatment options being studied. The treatment for the first patient is selected by drawing a ball at random from the hat. (The ball is put back afterward.) If the chosen treatment is a success, you put another ball of the same kind into the hat—now you have three balls, two of which are for the successful treatment. If it fails, however, then you instead put another ball for the \u003cem>other\u003c/em> treatment into the hat, making it more likely you’ll choose the alternative.\u003c/p>\n\u003cp>Zelen’s algorithm was first used in a clinical trial 16 years later, for a study of extracorporeal membrane oxygenation, or “ECMO”—an audacious approach to treating respiratory failure in infants. Developed in the 1970s by Robert Bartlett of the University of Michigan, ECMO takes blood that’s heading for the lungs and routes it instead out of the body, where it is oxygenated by a machine and returned to the heart. It is a drastic measure, with risks of its own (including the possibility of embolism), but it offered a possible approach in situations where no other options remained. In 1975 ECMO saved the life of a newborn girl in Orange County, California, for whom even a ventilator was not providing enough oxygen. But in its early days the ECMO technology and procedure were considered highly experimental, and early studies in adults showed no benefit compared to conventional treatments.\u003c/p>\n\u003cp>From 1982 to 1984, Bartlett and his colleagues at the University of Michigan performed a study on newborns with respiratory failure. The team was clear that they wanted to address, as they put it, “the ethical issue of withholding an unproven but potentially lifesaving treatment,” and were “reluctant to withhold a lifesaving treatment from alternate patients simply to meet conventional random assignment technique.” Hence they turned to Zelen’s algorithm. The strategy resulted in one infant being assigned the “conventional” treatment and dying, and 11 infants in a row being assigned the experimental ECMO treatment, all of them surviving. Between April and November of 1984, after the end of the official study, 10 additional infants met the criteria for ECMO treatment. Eight were treated with ECMO, and all eight survived. Two were treated conventionally, and both died.\u003c/p>\n\u003cp>These are eye-catching numbers, yet shortly after the University of Michigan study on ECMO was completed, it became mired in controversy. Having so few patients in a trial receive the conventional treatment deviated significantly from standard methodology, and the procedure itself was highly invasive and potentially risky. After the publication of the paper, Jim Ware, professor of biostatistics at the Harvard School of Public Health, and his medical colleagues examined the data carefully and concluded that they “did not justify routine use of ECMO without further study.” So Ware and his colleagues designed a second clinical trial, still trying to balance the acquisition of knowledge with the effective treatment of patients but using a less radical design. They would randomly assign patients to either ECMO or the conventional treatment until a pre-specified number of deaths was observed in one of the groups. Then they would switch all the patients in the study to the more effective treatment of the two.\u003c/p>\n\u003cp>In the first phase of Ware’s study, four of 10 infants receiving conventional treatment died, and all of the nine infants receiving ECMO survived. The four deaths were enough to trigger a transition to the second phase, where all 20 patients were treated with ECMO and 19 survived. Ware and colleagues were convinced, concluding that “it is difficult to defend further randomization ethically.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"4oUXD2ItgXLntfzkJ3EfFLruRYG726oT\"]But some had already concluded this \u003cem>before\u003c/em> the Ware study, and were vocal about it. The critics included Don Berry, one of the world’s leading experts on the explore/exploit tradeoff. In a comment that was published alongside the Ware study, Berry wrote that “randomizing patients to non-ECMO therapy as in the Ware study was unethical. . . . In my view, the Ware study should not have been conducted.”\u003c/p>\n\u003cp>And yet even the Ware study was not conclusive for all in the medical community. In the 1990s yet another study on ECMO was conducted, enrolling nearly 200 infants in the United Kingdom. Instead of using adaptive algorithms, this study followed the traditional methods, splitting the infants randomly into two equal groups. The researchers justified the experiment by saying that ECMO’s usefulness “is controversial because of varying interpretation of the available evidence.” As it turned out, the difference between the treatments wasn’t as pronounced in the United Kingdom as it had been in the two American studies, but the results were nonetheless declared “in accord with the earlier preliminary findings that a policy of ECMO support reduces the risk of death.” The cost of that knowledge? Twenty-four more infants died in the “conventional” group than in the group receiving ECMO treatment.\u003c/p>\n\u003cp>Zelen’s algorithm offers one simple way to navigate the explore/exploit tradeoff, and in the decades since it was first proposed, computer scientists have developed a host of even more refined strategies for how best to gain new information while leveraging what’s been gained so far. These approaches are finally beginning to gain acceptance within the medical mainstream\u003cstrong>.\u003c/strong> Don Berry, for example, has joined the MD Anderson Cancer Center in Houston, where he uses methods developed by studying the explore/exploit tradeoff to design clinical trials for a variety of cancer treatments. And in 2010 and 2015, the FDA released a pair of draft “guidance” documents on “Adaptive Design Clinical Trials” for drugs and medical devices, which suggests that—despite a long history of sticking to an option they trust—they might at last be willing to explore alternatives.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>We don’t think of a doctor choosing which treatment to give a patient as being in the same position as Google’s servers deciding which ad to show next. And we don’t think of Google’s ad servers when we waver over whether to get our favorite dish yet again or branch out. But computer science shows us that these are, in a fundamental and real way, the same problem. In so doing, it offers a profound glimpse into the structure of human decision-making. And a guide for us, in the times when it matters most.\u003c/p>\n\n",
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"excerpt": "The authors of 'Algorithms to Live By' say the conventional way clinical trials are conducted do not always live up to the medical maxim 'First, do no harm.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>From the authors of \"\u003ca href=\"http://us.macmillan.com/algorithmstoliveby/brianchristian\" target=\"_blank\">ALGORITHMS TO LIVE BY: The Computer Science of Human Decisions\u003c/a>,\" published by Henry Hold and Co.\u003c/em>\u003c/p>\n\u003cp>Every day we make a series of choices that are all really the same choice underneath: between our \u003cem>favorite\u003c/em> things and \u003cem>new\u003c/em> ones. Do we go to the restaurant we adore, or the place down the road that just opened up? Get our “usual,” or try the special? Invite our best friend, or reach out to a new acquaintance we’d like to get to know better? We intuitively understand that life is a balance between novelty and familiarity, between the latest and the greatest, between taking chances and savoring what we know and love. But the unanswered question is: What is that balance?\u003c/p>\n\u003caside class=\"pullquote alignright\">The cost of knowledge: Twenty-four more infants died in a group receiving conventional treatment than in a group receiving the treatment being tested.\u003c/aside>\n\u003cp>It’s a question with higher stakes than we might realize. And it has a more explicit answer, from a field we don’t often turn to in moments of human indecision, though perhaps we should: computer science. Indeed, computer scientists have been working on finding this balance for more than 50 years. They even have a name for it: the “explore/exploit” tradeoff.\u003c/p>\n\u003cp>Today, algorithms derived from studying the explore/exploit tradeoff power a sizable fraction of the Internet economy, including the advertising business responsible for almost all of Google’s revenue -- they determine when to display the ad that has performed the best so far and when to experiment with potentially superior alternatives. Algorithms have also become essential to political campaigning, an indispensable part of honing messaging and donation appeals.\u003c/p>\n\u003cp>The single most important application of explore/exploit algorithms, however, is a domain where human lives are directly on the line. That domain is clinical trials, and a growing community of doctors, statisticians, and computer scientists think we’re doing them wrong.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In English, the words “explore” and “exploit” come loaded with opposite connotations. But to a computer scientist, these words have much more specific and neutral meanings. Simply put, exploration is \u003cem>gathering\u003c/em> information, and exploitation is \u003cem>using\u003c/em> the information you have to get a known good result. It’s fairly intuitive that never exploring is no way to live. But computer science shows that failing to exploit can be every bit as bad.\u003c/p>\n\u003cfigure id=\"attachment_180526\" class=\"wp-caption aligncenter\" style=\"max-width: 2592px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program.jpg\">\u003cimg class=\"size-full wp-image-180526\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program.jpg\" alt=\"Respiratory therapist Michelle Sirra takes a blood sample from 3-day-old Stuart Parker in preparation for transfer to an Extracorporeal Membrane Oxygenation unit on Friday, July 21, in San Juan, Puerto Rico. An ECMO team comprised Air Force and Army medical specialists from the Wilford Hall Medical Center at Lackland Air Force Base, Texas, flew to Puerto Rico to transport Stuart to San Antonio for more advanced care. \" width=\"2592\" height=\"1944\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program.jpg 2592w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/A_Resperatory_Therapist_treating_a_newborn_child_Pulaski_County_Technical_College_Respiratory_Therapist_Program-960x720.jpg 960w\" sizes=\"(max-width: 2592px) 100vw, 2592px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Respiratory therapist Michelle Sirra takes a blood sample from 3-day-old Stuart Parker in preparation for transfer to an Extracorporeal Membrane Oxygenation unit on Friday, July 21, in San Juan, Puerto Rico. An ECMO team comprised Air Force and Army medical specialists from the Wilford Hall Medical Center at Lackland Air Force Base, Texas, flew to Puerto Rico to transport Stuart to San Antonio for more advanced care. \u003ccite>(Staff Sgt. Matthew Rosine)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the fundamental maxims in medical ethics is the oath to “first, do no harm.” But this is not always as straightforward as it sounds. In clinical trials, doctors and scientists encounter directly the tension between acting on one’s best knowledge and gathering more. Do you give someone the best known conventional treatment, even if it’s not very good? Or do you give them an experimental treatment that \u003cem>might \u003c/em>be significantly better—but might also be worse? Computer science is no substitute for ethics, but perhaps it can offer a degree of precision that ethics alone cannot.\u003c/p>\n\u003cp>The question that has arisen over the last several decades is whether the standard approach to conducting clinical trials really does minimize risk to patients. In a conventional clinical trial, patients are split into equal groups, and each group is assigned to receive a different treatment for the duration of the study. (Only in exceptional cases does a trial get stopped early.) This procedure focuses on decisively resolving the question of which treatment is better, rather than on providing the best treatment to each patient in the trial itself. Maybe this is a false choice. Doctors are gaining some information about which option is better \u003cem>while\u003c/em> the trial proceeds—information that could be used to improve outcomes not only for future patients beyond the trial, but also for the patients currently in it.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/iStock_17372419_LARGE.jpg\">\u003cimg class=\"aligncenter size-full wp-image-180561\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/iStock_17372419_LARGE.jpg\" alt=\"Juggling balls\" width=\"2715\" height=\"1810\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE.jpg 2715w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/06/iStock_17372419_LARGE-960x640.jpg 960w\" sizes=\"(max-width: 2715px) 100vw, 2715px\">\u003c/a>In 1969, Marvin Zelen, a biostatistician who spent most of his career at Harvard, proposed conducting “adaptive” trials, in which the chance of using a given treatment increases with each success and decreases with each failure. In his proposal, you start with a hat that contains one ball for each of the two treatment options being studied. The treatment for the first patient is selected by drawing a ball at random from the hat. (The ball is put back afterward.) If the chosen treatment is a success, you put another ball of the same kind into the hat—now you have three balls, two of which are for the successful treatment. If it fails, however, then you instead put another ball for the \u003cem>other\u003c/em> treatment into the hat, making it more likely you’ll choose the alternative.\u003c/p>\n\u003cp>Zelen’s algorithm was first used in a clinical trial 16 years later, for a study of extracorporeal membrane oxygenation, or “ECMO”—an audacious approach to treating respiratory failure in infants. Developed in the 1970s by Robert Bartlett of the University of Michigan, ECMO takes blood that’s heading for the lungs and routes it instead out of the body, where it is oxygenated by a machine and returned to the heart. It is a drastic measure, with risks of its own (including the possibility of embolism), but it offered a possible approach in situations where no other options remained. In 1975 ECMO saved the life of a newborn girl in Orange County, California, for whom even a ventilator was not providing enough oxygen. But in its early days the ECMO technology and procedure were considered highly experimental, and early studies in adults showed no benefit compared to conventional treatments.\u003c/p>\n\u003cp>From 1982 to 1984, Bartlett and his colleagues at the University of Michigan performed a study on newborns with respiratory failure. The team was clear that they wanted to address, as they put it, “the ethical issue of withholding an unproven but potentially lifesaving treatment,” and were “reluctant to withhold a lifesaving treatment from alternate patients simply to meet conventional random assignment technique.” Hence they turned to Zelen’s algorithm. The strategy resulted in one infant being assigned the “conventional” treatment and dying, and 11 infants in a row being assigned the experimental ECMO treatment, all of them surviving. Between April and November of 1984, after the end of the official study, 10 additional infants met the criteria for ECMO treatment. Eight were treated with ECMO, and all eight survived. Two were treated conventionally, and both died.\u003c/p>\n\u003cp>These are eye-catching numbers, yet shortly after the University of Michigan study on ECMO was completed, it became mired in controversy. Having so few patients in a trial receive the conventional treatment deviated significantly from standard methodology, and the procedure itself was highly invasive and potentially risky. After the publication of the paper, Jim Ware, professor of biostatistics at the Harvard School of Public Health, and his medical colleagues examined the data carefully and concluded that they “did not justify routine use of ECMO without further study.” So Ware and his colleagues designed a second clinical trial, still trying to balance the acquisition of knowledge with the effective treatment of patients but using a less radical design. They would randomly assign patients to either ECMO or the conventional treatment until a pre-specified number of deaths was observed in one of the groups. Then they would switch all the patients in the study to the more effective treatment of the two.\u003c/p>\n\u003cp>In the first phase of Ware’s study, four of 10 infants receiving conventional treatment died, and all of the nine infants receiving ECMO survived. The four deaths were enough to trigger a transition to the second phase, where all 20 patients were treated with ECMO and 19 survived. Ware and colleagues were convinced, concluding that “it is difficult to defend further randomization ethically.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But some had already concluded this \u003cem>before\u003c/em> the Ware study, and were vocal about it. The critics included Don Berry, one of the world’s leading experts on the explore/exploit tradeoff. In a comment that was published alongside the Ware study, Berry wrote that “randomizing patients to non-ECMO therapy as in the Ware study was unethical. . . . In my view, the Ware study should not have been conducted.”\u003c/p>\n\u003cp>And yet even the Ware study was not conclusive for all in the medical community. In the 1990s yet another study on ECMO was conducted, enrolling nearly 200 infants in the United Kingdom. Instead of using adaptive algorithms, this study followed the traditional methods, splitting the infants randomly into two equal groups. The researchers justified the experiment by saying that ECMO’s usefulness “is controversial because of varying interpretation of the available evidence.” As it turned out, the difference between the treatments wasn’t as pronounced in the United Kingdom as it had been in the two American studies, but the results were nonetheless declared “in accord with the earlier preliminary findings that a policy of ECMO support reduces the risk of death.” The cost of that knowledge? Twenty-four more infants died in the “conventional” group than in the group receiving ECMO treatment.\u003c/p>\n\u003cp>Zelen’s algorithm offers one simple way to navigate the explore/exploit tradeoff, and in the decades since it was first proposed, computer scientists have developed a host of even more refined strategies for how best to gain new information while leveraging what’s been gained so far. These approaches are finally beginning to gain acceptance within the medical mainstream\u003cstrong>.\u003c/strong> Don Berry, for example, has joined the MD Anderson Cancer Center in Houston, where he uses methods developed by studying the explore/exploit tradeoff to design clinical trials for a variety of cancer treatments. And in 2010 and 2015, the FDA released a pair of draft “guidance” documents on “Adaptive Design Clinical Trials” for drugs and medical devices, which suggests that—despite a long history of sticking to an option they trust—they might at last be willing to explore alternatives.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We don’t think of a doctor choosing which treatment to give a patient as being in the same position as Google’s servers deciding which ad to show next. And we don’t think of Google’s ad servers when we waver over whether to get our favorite dish yet again or branch out. But computer science shows us that these are, in a fundamental and real way, the same problem. In so doing, it offers a profound glimpse into the structure of human decision-making. And a guide for us, in the times when it matters most.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Do You Know Which Medical Information on Wikipedia to Trust?",
"title": "How Do You Know Which Medical Information on Wikipedia to Trust?",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>James Heilman isn't an easy man to get a hold of; he kept offering us odd, off-hour windows of availability to do a phone interview. When we finally connected, he explained: He works the night shift as an emergency room physician in British Columbia. He also puts in time as a clinical assistant professor in emergency medicine.\u003c/p>\n\u003caside class=\"alignright\">\u003cspan style=\"font-weight: normal\">\u003cstrong>How to check the accuracy of Wikipedia pages\u003c/strong>\u003cbr>\nYou can check how Wikipedians rate the quality and thoroughness of every entry on the encyclopedia by clicking on the \"Talk\" tab near the top left of each page. There you will find the page's rating, which will fall somewhere on this \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Assessment#Quality_scale\" target=\"_blank\" rel=\"noopener noreferrer\">scale\u003c/a>. Here are lists of the health articles with the \u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=FA-Classhttps://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=FA-Class\" target=\"_blank\" rel=\"noopener noreferrer\">highest\u003c/a> and \u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=GA-Class\" target=\"_blank\" rel=\"noopener noreferrer\">second-highest ratings\u003c/a>; these are the most trustworthy health entries.\u003c/span>\u003c/aside>\n\u003cp>Then there's the 60 -- count'em, 60 -- hours a week he toils away editing Wikipedia, the massive online encyclopedia written and edited by, well, anyone who wants to give it a whirl.\u003c/p>\n\u003cp>\"My wife likes to joke that Wikipedia's my mistress; I prefer to call it our first child,” he says, chuckling with a tinge of self-awareness that he's gone a bit off the rails in his goal of making the copious health-related pages on the site more accurate.\u003c/p>\n\u003cp>So how does an emergency doc become an obsessive Wikipedian?\u003c/p>\n\u003cp>About 10 years ago, he says, during a quiet night shift, he got to browsing one of the medical articles.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"I thought, 'Oh, my God this is really bad,'\" he says. \"And then I saw the edit button, and I realized, oh, my God, I could fix the internet! I sort of got madly hooked. I’ve been trying to fix the Internet ever since.\"\u003c/p>\n\u003cp>\u003cstrong>Accuracy Questioned\u003c/strong>\u003c/p>\n\u003cp>Part of that quest was creating the \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine\" target=\"_blank\" rel=\"noopener noreferrer\">WikiProject Medicine\u003c/a> group, where 320 like-minded editors work on the site's \u003ca href=\"https://en.wikipedia.org/wiki/Health_information_on_Wikipedia\" target=\"_blank\" rel=\"noopener noreferrer\">health content. \u003c/a>Heilman estimates about half are medical professionals.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"I thought ‘Oh, my God this is really bad.' And then I saw the edit button, and I realized, oh, my God, I could fix the internet!\"\u003c/aside>\n\u003cp>Reworking Wikipedia health entries is not a trivial task. A 2014 study found about 25,000 pages of English-language health-related articles. That number is now up to 32,000, Heilman says. The health pages worldwide attracted almost \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376174/\" target=\"_blank\" rel=\"noopener noreferrer\">4.9 billion pageviews\u003c/a> in 2013. A 2012 \u003ca href=\"http://www.tandfonline.com/doi/full/10.3109/0142159X.2012.737064?scroll=top&needAccess=true&\" target=\"_blank\" rel=\"noopener noreferrer\">survey\u003c/a> of several hundred medical students found 94 percent use the site for health information.\u003c/p>\n\u003cp>But despite its popularity, the reliability of Wikipedia's medical content has often been questioned. A 2011 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241521/\" target=\"_blank\" rel=\"noopener noreferrer\">review \u003c/a>on the accuracy and thoroughness of the site's medical entries found mixed results. Other studies show that the site fell short in \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24276492\" target=\"_blank\" rel=\"noopener noreferrer\">gastroenterology and hepatology\u003c/a>, \u003ca href=\"http://aop.sagepub.com/content/42/12/1814.abstract\" target=\"_blank\" rel=\"noopener noreferrer\">drug information\u003c/a>, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193353/\" target=\"_blank\" rel=\"noopener noreferrer\">statins\u003c/a> (later \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0106930#pone.0106930-Kupferberg1\" target=\"_blank\" rel=\"noopener noreferrer\">improved\u003c/a>), and issues of the \u003ca href=\"http://www.ijporlonline.com/article/S0165-5876(12)00336-9/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">ear, nose and throat\u003c/a>. Other studies found the website provided better information in \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/sdi.12059/epdf?r3_referer=wol&tracking_action=preview_click&show_checkout=1&purchase_referrer=onlinelibrary.wiley.com&purchase_site_license=LICENSE_DENIED_NO_CUSTOMER\" target=\"_blank\" rel=\"noopener noreferrer\">nephrology\u003c/a> and \u003ca href=\"https://www.cambridge.org/core/journals/psychological-medicine/article/quality-of-information-sources-about-mental-disorders-a-comparison-of-wikipedia-with-centrally-controlled-web-and-printed-sources/595CEE672BB7C503101FAF5A9E303673\" target=\"_blank\" rel=\"noopener noreferrer\">depression and schizophrenia\u003c/a>.\u003c/p>\n\u003caside class=\"alignright\">\u003cspan style=\"font-weight: normal\">\u003cspan style=\"font-weight: normal\">To get good health info online:\u003c/span>\u003c/span>\n\u003cul>\n\u003cli>Check multiple, high-quality sources like those from academic and government institutions.\u003c/li>\n\u003cli>Be alert for sites that contain information that conflicts with other sources, a possible indication of low-quality information.\u003c/li>\n\u003cli>Consult \u003ca href=\"http://www.uptodate.com/home\" target=\"_blank\" rel=\"noopener noreferrer\">UpToDate\u003c/a>, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed\u003c/a>, and peer-reviewed journals for primary research on a topic.\u003c/li>\n\u003cli>If using Wikipedia, click the 'Talk' tab at the top of each page to see how the site's editors have rated the quality of the article. Look at the footnotes to check the sources of assertions.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>But just recently, in \u003cem>\u003ca href=\"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30254-6/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">The Lancet: Global Health, \u003c/a>\u003c/em>researchers reported that Wikipedia entries on stillbirths were missing critical information.\u003c/p>\n\u003cp>And a 2014 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24778001\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> comparing peer-reviewed literature to the site's articles on 10 different widespread diseases and conditions found a significant number of assertions in the Wikipedia material that were unsupported by the evidence.\u003c/p>\n\u003cp>Heilman doesn't think much of that study; he co-wrote a \u003ca href=\"http://community-archive.cochrane.org/news/blog/wikipedia%E2%80%99s-medical-content-really-90-wrong\" target=\"_blank\" rel=\"noopener noreferrer\">rebuttal\u003c/a> to it with other medical experts/Wikipedians. Still, he acknowledges \"there's a lot of work to do\" to bring health entries up to snuff. The reality of that is borne out by the small number of 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\" rel=\"noopener noreferrer\">63\u003c/a> -- that have received the highest grade by Wikipedia editors. Those articles qualify as featured articles on the encyclopedia's front page. (The next-best level -- \"good\" -- contains a mere \u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=GA-Class\" target=\"_blank\" rel=\"noopener noreferrer\">200 articles\u003c/a>.) The \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Assessment#Quality_scale\" target=\"_blank\" rel=\"noopener noreferrer\">criteria\u003c/a> for a \"featured\" article is comprehensiveness, neutrality and accuracy. That means the information has been verified against high-quality sources.\u003c/p>\n\u003cp>\u003cstrong>Calls to Action\u003c/strong>\u003c/p>\n\u003cp>An \u003ca href=\"https://theconversation.com/wikipedia-is-already-the-worlds-dr-google-its-time-for-doctors-and-researchers-to-make-it-better-66769\" target=\"_blank\" rel=\"noopener noreferrer\">article\u003c/a> last month on the academic publishing site \"The Conversation\" by Thomas Shafee, one of the researchers who wrote about Wikipedia's inadequate \"stillbirth\" entries, is headlined \"Wikipedia is already the world’s ‘Dr Google’ -- it’s time for doctors and researchers to make it better.\"\u003c/p>\n\u003cp>\"Health professionals have a duty to improve the accuracy of medical entries in Wikipedia, because it’s the first port of call for people all over the world seeking medical information,\" Shafee wrote. \"The accuracy of the site is vital, because every medical entry... has the potential for immediate \u003ca href=\"http://www.who.int/bulletin/volumes/87/4/08-056713/en/\">real-world health consequences\u003c/a>.\"\u003c/p>\n\u003cp>Others agree. University of California, San Francisco psychiatrist Amin Azzam recently co-authored a \u003ca href=\"http://journals.lww.com/academicmedicine/Abstract/publishahead/Why_Medical_Schools_Should_Embrace_Wikipedia__.98408.aspx\">report\u003c/a> published in the journal \u003cem>Academic Medicine \u003c/em>titled “Why Medical Schools Should Embrace Wikipedia.”\u003c/p>\n\u003cp>\u003cstrong>Improving Wikipedia\u003c/strong>\u003c/p>\n\u003cp>Efforts to improve the entire site, including the health section, are underway. Hundreds of students in both the U.S. and Canada, for example, are working as editors through the \u003ca href=\"https://wikiedu.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Wiki Education Foundation\u003c/a>, a nonprofit organization based in San Francisco that acts as a bridge between Wikipedia and academia. The organization encourages university faculty to assign students Wikipedia entries as a part of coursework.\u003c/p>\n\u003cp>\"Rather than write a biography of a woman scientist for their class that their instructor would read and throw away and never engage in again,\" says the foundation's LiAnna Davis, \"these students instead have the opportunity to create content for Wikipedia where thousands of people can gain from their work.\"\u003c/p>\n\u003cp>Pharmacology students at the University of California, San Francisco, for example, are \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:UCSF_School_of_Medicine\" target=\"_blank\" rel=\"noopener noreferrer\">working to improve entries\u003c/a> on popular drugs like the HIV antiviral drug \u003ca href=\"https://en.wikipedia.org/wiki/Abacavir\" target=\"_blank\" rel=\"noopener noreferrer\">Abacavir\u003c/a>. Students in a voice disorders class at McGill University in Montreal are adding information about \u003ca href=\"https://en.wikipedia.org/wiki/Laryngitis\" target=\"_blank\" rel=\"noopener noreferrer\">laryngitis\u003c/a>. Students fill in missing information, improve gross inadequacies, and rewrite articles using fewer technical terms to appeal to the general public.\u003c/p>\n\u003cp>In 2016, 280 science classes at universities in the U.S. and Canada have added content to 3,650 articles and generated 300 new entries receiving more than 102 million views, says Davis.\u003c/p>\n\u003cp>Heilman points to many efforts to improve articles, and a \u003ca href=\"http://translatorswithoutborders.org/?s=wikipedia\" target=\"_blank\" rel=\"noopener noreferrer\">collaboration\u003c/a> with the group Translators Without Borders to rewrite Wikipedia medical content in as many languages as possible. That \u003ca href=\"https://opensource.com/life/16/11/support-indian-languages\" target=\"_blank\" rel=\"noopener noreferrer\">includes Odia\u003c/a>, spoken by tens of millions of people in India that is not included in\u003ca href=\"https://translate.google.com/\" target=\"_blank\" rel=\"noopener noreferrer\"> Google Translate\u003c/a>. Heilman also cites as a success the Wikipedia entry for dengue fever, which was published in the peer-reviewed open-access journal \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242787/\" target=\"_blank\" rel=\"noopener noreferrer\">Open Medicine\u003c/a>.\u003c/p>\n\u003cp>Federal agencies are also tapping Wikipedia. The National Institutes of Health is creating an online biomedical \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/topics/health/a/\" target=\"_blank\" rel=\"noopener noreferrer\">dictionary\u003c/a> for PubMed Health. which provides consumer-friendly research information.\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/topics/health/a/\" target=\"_blank\" rel=\"noopener noreferrer\"> \u003c/a>The NIH usually creates the definitions by drawing on material in its own collection, but sometimes It will use Wikipedia as a source. Both organizations benefit, as the NIH will flag Heilman if it comes across something inaccurate in the material.\u003c/p>\n\u003cp>Heilman fervently hopes more health and science academics and professionals will help expand the accuracy of the project.\u003c/p>\n\u003cp>\"I spend a fair amount of time trying to convince my colleagues to come work on Wikipedia,\" he says. \"As a physician I believe all people deserve access to quality health care information.\"\u003c/p>\n\u003cp>\u003cstrong>How to Find Good Health Info\u003c/strong>\u003c/p>\n\u003cp>So ... after all is said and done, how should the average person approach looking for health information on the Web?\u003c/p>\n\u003cp>Azzam, the UCSF psychiatrist who called for medical schools to embrace Wikipedia, would actually first send patients to government sites like the National Institutes of Health, Centers for Disease Control and National Library of Medicine.\u003c/p>\n\u003cp>\"Many of those sites have information targeting 'lay' people,\" he wrote in an email. \"Additionally there are national advocacy organizations for specific disease and/or health conditions. For example, as a psychiatrist I will refer my patients and their families to the National Alliance on Mental Illness (NAMI).\"\u003c/p>\n\u003cp>For those who do use Wikipedia, he recommends using the \"Talk\" tab near the top left of every page. That will take you to a rating of how thorough and accurate Wikipedia editors think the page is. He also looks at the references that each assertion of fact in Wikipedia entries are required to link to. (You can do this by clicking on the superscript numbers at the end of a sentence.)\u003c/p>\n\u003cp>\"That gives me some idea of how much to trust the content,\" Azzam says.\u003c/p>\n\u003cp>He recommends consulting multiple sources to ferret out any outliers, a method that is \"effectively a proxy measure for validity.\"\u003c/p>\n\u003cp>If you want to consult material that health professionals use themselves, he recommends \u003ca href=\"http://www.uptodate.com/home\" target=\"_blank\" rel=\"noopener noreferrer\">UpToDate\u003c/a>, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed\u003c/a>, and peer-reviewed journals.\u003c/p>\n\u003cp>Health information is on a \"continuum,\" he believes, with subscription-only top tier scholarly journals on one end and the user-created Wikipedia on the other.\u003c/p>\n\u003cp>\"We believe [journal] content to be the scientific truth as we know it because content experts have peer-reviewed the manuscripts,\" he says. \"But the challenge at that extreme is gaining access to that knowledge, especially with high-cost subscription charges.\"\u003c/p>\n\u003cp>That is why he's working with students to improve Wikipedia, \"pulling that pole toward the other end of the spectrum.\"\u003c/p>\n\u003cp>\"Since so many consumers of health information online are reading that content, I want to be a part of a movement to make it as high quality as possible!\"\u003c/p>\n\u003cp>As for Heilman, the avid health editor, he also recommends checking multiple, high-quality sources when looking for specific health information, paying attention to what they agree on. But that doesn't mean he's going to give up on improving Wikipedia.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"As a physician, I can help one person at a time,\" he says. \"But as a Wikipedian, I can make a difference in millions and millions of people’s lives.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>James Heilman isn't an easy man to get a hold of; he kept offering us odd, off-hour windows of availability to do a phone interview. When we finally connected, he explained: He works the night shift as an emergency room physician in British Columbia. He also puts in time as a clinical assistant professor in emergency medicine.\u003c/p>\n\u003caside class=\"alignright\">\u003cspan style=\"font-weight: normal\">\u003cstrong>How to check the accuracy of Wikipedia pages\u003c/strong>\u003cbr>\nYou can check how Wikipedians rate the quality and thoroughness of every entry on the encyclopedia by clicking on the \"Talk\" tab near the top left of each page. There you will find the page's rating, which will fall somewhere on this \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Assessment#Quality_scale\" target=\"_blank\" rel=\"noopener noreferrer\">scale\u003c/a>. Here are lists of the health articles with the \u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=FA-Classhttps://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=FA-Class\" target=\"_blank\" rel=\"noopener noreferrer\">highest\u003c/a> and \u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=GA-Class\" target=\"_blank\" rel=\"noopener noreferrer\">second-highest ratings\u003c/a>; these are the most trustworthy health entries.\u003c/span>\u003c/aside>\n\u003cp>Then there's the 60 -- count'em, 60 -- hours a week he toils away editing Wikipedia, the massive online encyclopedia written and edited by, well, anyone who wants to give it a whirl.\u003c/p>\n\u003cp>\"My wife likes to joke that Wikipedia's my mistress; I prefer to call it our first child,” he says, chuckling with a tinge of self-awareness that he's gone a bit off the rails in his goal of making the copious health-related pages on the site more accurate.\u003c/p>\n\u003cp>So how does an emergency doc become an obsessive Wikipedian?\u003c/p>\n\u003cp>About 10 years ago, he says, during a quiet night shift, he got to browsing one of the medical articles.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I thought, 'Oh, my God this is really bad,'\" he says. \"And then I saw the edit button, and I realized, oh, my God, I could fix the internet! I sort of got madly hooked. I’ve been trying to fix the Internet ever since.\"\u003c/p>\n\u003cp>\u003cstrong>Accuracy Questioned\u003c/strong>\u003c/p>\n\u003cp>Part of that quest was creating the \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine\" target=\"_blank\" rel=\"noopener noreferrer\">WikiProject Medicine\u003c/a> group, where 320 like-minded editors work on the site's \u003ca href=\"https://en.wikipedia.org/wiki/Health_information_on_Wikipedia\" target=\"_blank\" rel=\"noopener noreferrer\">health content. \u003c/a>Heilman estimates about half are medical professionals.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"I thought ‘Oh, my God this is really bad.' And then I saw the edit button, and I realized, oh, my God, I could fix the internet!\"\u003c/aside>\n\u003cp>Reworking Wikipedia health entries is not a trivial task. A 2014 study found about 25,000 pages of English-language health-related articles. That number is now up to 32,000, Heilman says. The health pages worldwide attracted almost \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376174/\" target=\"_blank\" rel=\"noopener noreferrer\">4.9 billion pageviews\u003c/a> in 2013. A 2012 \u003ca href=\"http://www.tandfonline.com/doi/full/10.3109/0142159X.2012.737064?scroll=top&needAccess=true&\" target=\"_blank\" rel=\"noopener noreferrer\">survey\u003c/a> of several hundred medical students found 94 percent use the site for health information.\u003c/p>\n\u003cp>But despite its popularity, the reliability of Wikipedia's medical content has often been questioned. A 2011 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241521/\" target=\"_blank\" rel=\"noopener noreferrer\">review \u003c/a>on the accuracy and thoroughness of the site's medical entries found mixed results. Other studies show that the site fell short in \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24276492\" target=\"_blank\" rel=\"noopener noreferrer\">gastroenterology and hepatology\u003c/a>, \u003ca href=\"http://aop.sagepub.com/content/42/12/1814.abstract\" target=\"_blank\" rel=\"noopener noreferrer\">drug information\u003c/a>, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193353/\" target=\"_blank\" rel=\"noopener noreferrer\">statins\u003c/a> (later \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0106930#pone.0106930-Kupferberg1\" target=\"_blank\" rel=\"noopener noreferrer\">improved\u003c/a>), and issues of the \u003ca href=\"http://www.ijporlonline.com/article/S0165-5876(12)00336-9/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">ear, nose and throat\u003c/a>. Other studies found the website provided better information in \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/sdi.12059/epdf?r3_referer=wol&tracking_action=preview_click&show_checkout=1&purchase_referrer=onlinelibrary.wiley.com&purchase_site_license=LICENSE_DENIED_NO_CUSTOMER\" target=\"_blank\" rel=\"noopener noreferrer\">nephrology\u003c/a> and \u003ca href=\"https://www.cambridge.org/core/journals/psychological-medicine/article/quality-of-information-sources-about-mental-disorders-a-comparison-of-wikipedia-with-centrally-controlled-web-and-printed-sources/595CEE672BB7C503101FAF5A9E303673\" target=\"_blank\" rel=\"noopener noreferrer\">depression and schizophrenia\u003c/a>.\u003c/p>\n\u003caside class=\"alignright\">\u003cspan style=\"font-weight: normal\">\u003cspan style=\"font-weight: normal\">To get good health info online:\u003c/span>\u003c/span>\n\u003cul>\n\u003cli>Check multiple, high-quality sources like those from academic and government institutions.\u003c/li>\n\u003cli>Be alert for sites that contain information that conflicts with other sources, a possible indication of low-quality information.\u003c/li>\n\u003cli>Consult \u003ca href=\"http://www.uptodate.com/home\" target=\"_blank\" rel=\"noopener noreferrer\">UpToDate\u003c/a>, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed\u003c/a>, and peer-reviewed journals for primary research on a topic.\u003c/li>\n\u003cli>If using Wikipedia, click the 'Talk' tab at the top of each page to see how the site's editors have rated the quality of the article. Look at the footnotes to check the sources of assertions.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>But just recently, in \u003cem>\u003ca href=\"http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30254-6/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">The Lancet: Global Health, \u003c/a>\u003c/em>researchers reported that Wikipedia entries on stillbirths were missing critical information.\u003c/p>\n\u003cp>And a 2014 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24778001\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> comparing peer-reviewed literature to the site's articles on 10 different widespread diseases and conditions found a significant number of assertions in the Wikipedia material that were unsupported by the evidence.\u003c/p>\n\u003cp>Heilman doesn't think much of that study; he co-wrote a \u003ca href=\"http://community-archive.cochrane.org/news/blog/wikipedia%E2%80%99s-medical-content-really-90-wrong\" target=\"_blank\" rel=\"noopener noreferrer\">rebuttal\u003c/a> to it with other medical experts/Wikipedians. Still, he acknowledges \"there's a lot of work to do\" to bring health entries up to snuff. The reality of that is borne out by the small number of 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\" rel=\"noopener noreferrer\">63\u003c/a> -- that have received the highest grade by Wikipedia editors. Those articles qualify as featured articles on the encyclopedia's front page. (The next-best level -- \"good\" -- contains a mere \u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=GA-Class\" target=\"_blank\" rel=\"noopener noreferrer\">200 articles\u003c/a>.) The \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine/Assessment#Quality_scale\" target=\"_blank\" rel=\"noopener noreferrer\">criteria\u003c/a> for a \"featured\" article is comprehensiveness, neutrality and accuracy. That means the information has been verified against high-quality sources.\u003c/p>\n\u003cp>\u003cstrong>Calls to Action\u003c/strong>\u003c/p>\n\u003cp>An \u003ca href=\"https://theconversation.com/wikipedia-is-already-the-worlds-dr-google-its-time-for-doctors-and-researchers-to-make-it-better-66769\" target=\"_blank\" rel=\"noopener noreferrer\">article\u003c/a> last month on the academic publishing site \"The Conversation\" by Thomas Shafee, one of the researchers who wrote about Wikipedia's inadequate \"stillbirth\" entries, is headlined \"Wikipedia is already the world’s ‘Dr Google’ -- it’s time for doctors and researchers to make it better.\"\u003c/p>\n\u003cp>\"Health professionals have a duty to improve the accuracy of medical entries in Wikipedia, because it’s the first port of call for people all over the world seeking medical information,\" Shafee wrote. \"The accuracy of the site is vital, because every medical entry... has the potential for immediate \u003ca href=\"http://www.who.int/bulletin/volumes/87/4/08-056713/en/\">real-world health consequences\u003c/a>.\"\u003c/p>\n\u003cp>Others agree. University of California, San Francisco psychiatrist Amin Azzam recently co-authored a \u003ca href=\"http://journals.lww.com/academicmedicine/Abstract/publishahead/Why_Medical_Schools_Should_Embrace_Wikipedia__.98408.aspx\">report\u003c/a> published in the journal \u003cem>Academic Medicine \u003c/em>titled “Why Medical Schools Should Embrace Wikipedia.”\u003c/p>\n\u003cp>\u003cstrong>Improving Wikipedia\u003c/strong>\u003c/p>\n\u003cp>Efforts to improve the entire site, including the health section, are underway. Hundreds of students in both the U.S. and Canada, for example, are working as editors through the \u003ca href=\"https://wikiedu.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Wiki Education Foundation\u003c/a>, a nonprofit organization based in San Francisco that acts as a bridge between Wikipedia and academia. The organization encourages university faculty to assign students Wikipedia entries as a part of coursework.\u003c/p>\n\u003cp>\"Rather than write a biography of a woman scientist for their class that their instructor would read and throw away and never engage in again,\" says the foundation's LiAnna Davis, \"these students instead have the opportunity to create content for Wikipedia where thousands of people can gain from their work.\"\u003c/p>\n\u003cp>Pharmacology students at the University of California, San Francisco, for example, are \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:UCSF_School_of_Medicine\" target=\"_blank\" rel=\"noopener noreferrer\">working to improve entries\u003c/a> on popular drugs like the HIV antiviral drug \u003ca href=\"https://en.wikipedia.org/wiki/Abacavir\" target=\"_blank\" rel=\"noopener noreferrer\">Abacavir\u003c/a>. Students in a voice disorders class at McGill University in Montreal are adding information about \u003ca href=\"https://en.wikipedia.org/wiki/Laryngitis\" target=\"_blank\" rel=\"noopener noreferrer\">laryngitis\u003c/a>. Students fill in missing information, improve gross inadequacies, and rewrite articles using fewer technical terms to appeal to the general public.\u003c/p>\n\u003cp>In 2016, 280 science classes at universities in the U.S. and Canada have added content to 3,650 articles and generated 300 new entries receiving more than 102 million views, says Davis.\u003c/p>\n\u003cp>Heilman points to many efforts to improve articles, and a \u003ca href=\"http://translatorswithoutborders.org/?s=wikipedia\" target=\"_blank\" rel=\"noopener noreferrer\">collaboration\u003c/a> with the group Translators Without Borders to rewrite Wikipedia medical content in as many languages as possible. That \u003ca href=\"https://opensource.com/life/16/11/support-indian-languages\" target=\"_blank\" rel=\"noopener noreferrer\">includes Odia\u003c/a>, spoken by tens of millions of people in India that is not included in\u003ca href=\"https://translate.google.com/\" target=\"_blank\" rel=\"noopener noreferrer\"> Google Translate\u003c/a>. Heilman also cites as a success the Wikipedia entry for dengue fever, which was published in the peer-reviewed open-access journal \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242787/\" target=\"_blank\" rel=\"noopener noreferrer\">Open Medicine\u003c/a>.\u003c/p>\n\u003cp>Federal agencies are also tapping Wikipedia. The National Institutes of Health is creating an online biomedical \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/topics/health/a/\" target=\"_blank\" rel=\"noopener noreferrer\">dictionary\u003c/a> for PubMed Health. which provides consumer-friendly research information.\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/topics/health/a/\" target=\"_blank\" rel=\"noopener noreferrer\"> \u003c/a>The NIH usually creates the definitions by drawing on material in its own collection, but sometimes It will use Wikipedia as a source. Both organizations benefit, as the NIH will flag Heilman if it comes across something inaccurate in the material.\u003c/p>\n\u003cp>Heilman fervently hopes more health and science academics and professionals will help expand the accuracy of the project.\u003c/p>\n\u003cp>\"I spend a fair amount of time trying to convince my colleagues to come work on Wikipedia,\" he says. \"As a physician I believe all people deserve access to quality health care information.\"\u003c/p>\n\u003cp>\u003cstrong>How to Find Good Health Info\u003c/strong>\u003c/p>\n\u003cp>So ... after all is said and done, how should the average person approach looking for health information on the Web?\u003c/p>\n\u003cp>Azzam, the UCSF psychiatrist who called for medical schools to embrace Wikipedia, would actually first send patients to government sites like the National Institutes of Health, Centers for Disease Control and National Library of Medicine.\u003c/p>\n\u003cp>\"Many of those sites have information targeting 'lay' people,\" he wrote in an email. \"Additionally there are national advocacy organizations for specific disease and/or health conditions. For example, as a psychiatrist I will refer my patients and their families to the National Alliance on Mental Illness (NAMI).\"\u003c/p>\n\u003cp>For those who do use Wikipedia, he recommends using the \"Talk\" tab near the top left of every page. That will take you to a rating of how thorough and accurate Wikipedia editors think the page is. He also looks at the references that each assertion of fact in Wikipedia entries are required to link to. (You can do this by clicking on the superscript numbers at the end of a sentence.)\u003c/p>\n\u003cp>\"That gives me some idea of how much to trust the content,\" Azzam says.\u003c/p>\n\u003cp>He recommends consulting multiple sources to ferret out any outliers, a method that is \"effectively a proxy measure for validity.\"\u003c/p>\n\u003cp>If you want to consult material that health professionals use themselves, he recommends \u003ca href=\"http://www.uptodate.com/home\" target=\"_blank\" rel=\"noopener noreferrer\">UpToDate\u003c/a>, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed\" target=\"_blank\" rel=\"noopener noreferrer\">PubMed\u003c/a>, and peer-reviewed journals.\u003c/p>\n\u003cp>Health information is on a \"continuum,\" he believes, with subscription-only top tier scholarly journals on one end and the user-created Wikipedia on the other.\u003c/p>\n\u003cp>\"We believe [journal] content to be the scientific truth as we know it because content experts have peer-reviewed the manuscripts,\" he says. \"But the challenge at that extreme is gaining access to that knowledge, especially with high-cost subscription charges.\"\u003c/p>\n\u003cp>That is why he's working with students to improve Wikipedia, \"pulling that pole toward the other end of the spectrum.\"\u003c/p>\n\u003cp>\"Since so many consumers of health information online are reading that content, I want to be a part of a movement to make it as high quality as possible!\"\u003c/p>\n\u003cp>As for Heilman, the avid health editor, he also recommends checking multiple, high-quality sources when looking for specific health information, paying attention to what they agree on. But that doesn't mean he's going to give up on improving Wikipedia.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"As a physician, I can help one person at a time,\" he says. \"But as a Wikipedian, I can make a difference in millions and millions of people’s lives.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "LGBT Health Advocates Fear Backlash as Trump Picks Tom Price for HHS",
"title": "LGBT Health Advocates Fear Backlash as Trump Picks Tom Price for HHS",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp class=\"p1\">\u003cstrong>Update Tuesday, Nov. 29\u003c/strong> Donald Trump \u003ca href=\"http://www.npr.org/sections/health-shots/2016/11/28/502566553/trump-chooses-rep-tom-price-an-obamacare-foe-to-run-hhs\" target=\"_blank\">will nominate\u003c/a> Rep. Tom Price (R-Ga.) as secretary of Health and Human Services. Price is an avowed opponent of the Affordable Care Act, repeatedly introducing legislation to repeal President Obama's signature health care legislation.\u003c/p>\n\u003cp class=\"p1\">If you're wondering about Price's record on LGBT issues, the former orthopedic surgeon, like many other Republicans, has received a zero over the last three sessions of Congress on the Human Rights Campaign's \u003ca href=\"http://hrc-assets.s3-website-us-east-1.amazonaws.com//files/assets/resources/114thCongressionalScorecard.pdf\" target=\"_blank\">congressional scorecard\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">More from \u003ca href=\"http://www.npr.org/sections/health-shots/2016/11/29/503720671/5-things-to-know-about-rep-tom-prices-health-care-ideas\" target=\"_blank\">NPR \u003c/a>...\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Original post\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Since Donald Trump’s surprise election Nov. 8, \u003c/span>\u003cspan class=\"s1\">LGBT health advocates have been holding their breath to see who the president-elect will pick for the cabinet-level position of secretary of Health and Human Services. Like many other health care stakeholders, these leaders are keeping a weather eye on whether Trump is serious about his \u003ca href=\"https://www.donaldjtrump.com/positions/healthcare-reform\" target=\"_blank\">campaign promise\u003c/a> to dismantle the Affordable Care Act — a long-sought but out-of-reach goal for congressional Republicans under President Obama — as well as a proposed reform of Medicaid that would result in reductions in aid to the poor.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A number of names have been bandied about for the HHS job, including newest rumored frontrunner Rep. Tom Price\u003cb>, \u003c/b>R-Georgia, and Andrew Bremberg, who is \u003ca href=\"http://www.modernhealthcare.com/article/20161111/NEWS/161119989?utm_source=modernhealthcare&utm_medium=email&utm_content=20161111-NEWS-161119989&utm_campaign=mh-alert\" target=\"_blank\">leading Trump's health transition\u003c/a> and worked at the agency during the administration of President George W. Bush. Other familiar names include Florida Gov. Rick Scott, ex-Arkansas Gov. Mike Huckabee and ex-Louisiana Gov. Bobby Jindal. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">While Trump has been skimpy on details of what may replace the health care law, he has proposed allowing insurers to sell health plans across state lines, establishing block grants for state Medicaid programs, and allowing people to deduct their health care premiums from their federal income tax. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A study by The Commonwealth Fund estimates the repeal of the ACA and the implementation of these replacement policies\u003cstrong> \u003c/strong>would cause more than 20 million people, most of whom are low-income, to lose health coverage.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>LGBT Issues\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Trump's agenda has progressives worried about the possible rollback of health services for gay people. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan style=\"line-height: 1.5\">“It’s an agenda that destroys the national health safety net,” says Matt Kavanaugh, a seasoned health policy activist with the Global Health Access Project, which campaigns for drug access for people with HIV across the globe. \"We have a lot of people with HIV who depend on these programs.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">He’s particularly worried about a shift in Medicaid to block grants awarded to states, which could spell cuts in HIV programs — something seen in the 1990s. Before the ACA extended health coverage of expensive anti-retroviral drugs, those with HIV relied on the federal AIDS Drug Assistance Program (ADAP) to gain access to medication. But state-administered ADAP programs were plagued by budget cuts, creating long waiting lists for drug access. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“One of the most important things that happened with Medicaid expansion is that people were able to move off of ADAP and not just get HIV drugs but full [health] insurance,” Kavanaugh says. “If that rolls back, it’s likely we will see huge problems with ADAP.” That in turn could hurt the U.S. effort to control HIV, he says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">As evidence of what he says is the incoming administration's “clear, intensely anti-gay agenda,\" Kavanaugh points to the GOP party platform’s last-minute promotion of so-called \"gay conversion therapy,\" long \u003ca href=\"http://www.apa.org/pi/lgbt/resources/just-the-facts.aspx\" target=\"_blank\">discredited by the psychological profession\u003c/a> and illegal as a treatment for minors in a \u003ca href=\"http://www.lgbtmap.org/equality-maps/conversion_therapy\" target=\"_blank\">number of states\u003c/a>. The therapy is also \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/11/19/gays-can-be-reformed-just-like-arsonists-trumps-new-domestic-policy-adviser-has-said/\" target=\"_blank\">endorsed\u003c/a> by the head of Trump's domestic policy transition team, former Ohio Secretary of State Ken Blackwell, a senior fellow at the Family Research Council, which publicly \u003ca href=\"http://www.frc.org/homosexuality\" target=\"_blank\">states\u003c/a> that homosexuality \"is harmful to the persons who engage in it and to society at large.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Vice President-elect Mike Pence also has a \u003ca href=\"http://time.com/4406337/mike-pence-gay-rights-lgbt-religious-freedom/\" target=\"_blank\">record\u003c/a> of opposing LGBT rights and is a staunch social conservative. \u003c/span>\u003cspan class=\"s1\">Ben Plumley, head of the Pangaea Global AIDS project, pointed to a 2015 spike of 90 new HIV cases linked to injection drug use in rural Scott County, Indiana, where Pence was governor, as an example of ineffective health policy. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">S\u003c/span>tate health officials had urged Pence to implement a needle exchange program, but that was a nonstarter with the governor. With cases rising, however, the Centers for Disease Control and Prevention weighed in with the same recommendation. Pence said he would pray on the matter, and eventually he issued an executive order to implement needle exchange in Scott County. Tens of thousands of clean disposable needles were quickly distributed, and HIV cases diminished to a trickle. AmfAR, The Foundation for AIDS Research, later called the epidemic \"\u003ca href=\"http://www.politico.com/story/2016/08/under-pences-leadership-response-to-heroin-epidemic-criticized-as-ineffective-226759\" target=\"_blank\">totally preventable\u003c/a>.\" Meanwhile, heroin-related hepatitis C cases are still \u003ca href=\"http://www.fox19.com/story/30451992/hiv-hepatitis-c-outbreak-continues-in-indiana\" target=\"_blank\">snowballing\u003c/a> in the area.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Kavanaugh is also worried about the push for religious waivers at the state and local levels, which would allow agencies, individuals and private health providers with federal contracts to opt out of providing services to LGBT citizens. Two such bills are pending in Florida and Texas, and copycat bills are being drafted in other states. One of the potential health care leaders in a Trump administration, Bobby Jindal, issued an executive order in Louisiana to give a religious waiver to those opposed to same-sex marriage. \u003c/span>\u003c/p>\n\u003cp>Violence is also a potential issue. Since the election, the Southern Poverty Law Center has tracked a \u003ca href=\"https://www.splcenter.org/hatewatch/2016/11/18/update-incidents-hateful-harassment-election-day-now-number-701\" target=\"_blank\">spike in hate crimes\u003c/a> — including 80 reported against LGBT individuals. Almost two-thirds of the incidents, some of which were anecdotal, occurred in the first three days following the election, the group says, and \"the trend line points to a steady drop-off.\"\u003c/p>\n\u003cp>There is no doubt the LGBT community is feeling increased pressure. Calls to LGBT suicide prevention hotlines went way up in the immediate wake of Trump’s election, \u003ca href=\"http://www.motherjones.com/politics/2016/11/suicide-hotline-calls-lgbt-trump\" target=\"_blank\">Mother Jones\u003c/a> has reported. Callers worried about loss of health access to hormones and gender surgery, as well as fear of discrimination from health providers.\u003c/p>\n\u003cp class=\"p1\">“You’re going to see increasing numbers of people with challenges,\" says Kavanaugh. \"It's going to be a test of our solidarity.\"\u003c/p>\n\u003cp class=\"p1\">LGBT leaders interviewed by KQED said they repeatedly tried during and since the election to meet with Trump officials to discuss their concerns, including the choice for HHS, to no avail.\u003c/p>\n\u003cp class=\"p1\">\"We've gotten no response,\" said Pangaea head Ben Plumley.\u003c/p>\n\u003cp class=\"p1\">KQED's efforts to reach the campaign for comment were unsuccessful. So were efforts to obtain comments from health policy aides at Rep. Nancy Pelosi's office about Democratic efforts to influence the top health pick.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp class=\"p1\">\u003cem>Jon Brooks contributed to this report.\u003c/em>\u003c/p>\n\n",
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"excerpt": "The president-elect's health care proposals plus the conservative names floated as possible health officials in the new administration have LGBT health advocates extremely concerned. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">\u003cstrong>Update Tuesday, Nov. 29\u003c/strong> Donald Trump \u003ca href=\"http://www.npr.org/sections/health-shots/2016/11/28/502566553/trump-chooses-rep-tom-price-an-obamacare-foe-to-run-hhs\" target=\"_blank\">will nominate\u003c/a> Rep. Tom Price (R-Ga.) as secretary of Health and Human Services. Price is an avowed opponent of the Affordable Care Act, repeatedly introducing legislation to repeal President Obama's signature health care legislation.\u003c/p>\n\u003cp class=\"p1\">If you're wondering about Price's record on LGBT issues, the former orthopedic surgeon, like many other Republicans, has received a zero over the last three sessions of Congress on the Human Rights Campaign's \u003ca href=\"http://hrc-assets.s3-website-us-east-1.amazonaws.com//files/assets/resources/114thCongressionalScorecard.pdf\" target=\"_blank\">congressional scorecard\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">More from \u003ca href=\"http://www.npr.org/sections/health-shots/2016/11/29/503720671/5-things-to-know-about-rep-tom-prices-health-care-ideas\" target=\"_blank\">NPR \u003c/a>...\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Original post\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Since Donald Trump’s surprise election Nov. 8, \u003c/span>\u003cspan class=\"s1\">LGBT health advocates have been holding their breath to see who the president-elect will pick for the cabinet-level position of secretary of Health and Human Services. Like many other health care stakeholders, these leaders are keeping a weather eye on whether Trump is serious about his \u003ca href=\"https://www.donaldjtrump.com/positions/healthcare-reform\" target=\"_blank\">campaign promise\u003c/a> to dismantle the Affordable Care Act — a long-sought but out-of-reach goal for congressional Republicans under President Obama — as well as a proposed reform of Medicaid that would result in reductions in aid to the poor.\u003c/span>\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\">A number of names have been bandied about for the HHS job, including newest rumored frontrunner Rep. Tom Price\u003cb>, \u003c/b>R-Georgia, and Andrew Bremberg, who is \u003ca href=\"http://www.modernhealthcare.com/article/20161111/NEWS/161119989?utm_source=modernhealthcare&utm_medium=email&utm_content=20161111-NEWS-161119989&utm_campaign=mh-alert\" target=\"_blank\">leading Trump's health transition\u003c/a> and worked at the agency during the administration of President George W. Bush. Other familiar names include Florida Gov. Rick Scott, ex-Arkansas Gov. Mike Huckabee and ex-Louisiana Gov. Bobby Jindal. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">While Trump has been skimpy on details of what may replace the health care law, he has proposed allowing insurers to sell health plans across state lines, establishing block grants for state Medicaid programs, and allowing people to deduct their health care premiums from their federal income tax. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A study by The Commonwealth Fund estimates the repeal of the ACA and the implementation of these replacement policies\u003cstrong> \u003c/strong>would cause more than 20 million people, most of whom are low-income, to lose health coverage.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>LGBT Issues\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Trump's agenda has progressives worried about the possible rollback of health services for gay people. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan style=\"line-height: 1.5\">“It’s an agenda that destroys the national health safety net,” says Matt Kavanaugh, a seasoned health policy activist with the Global Health Access Project, which campaigns for drug access for people with HIV across the globe. \"We have a lot of people with HIV who depend on these programs.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">He’s particularly worried about a shift in Medicaid to block grants awarded to states, which could spell cuts in HIV programs — something seen in the 1990s. Before the ACA extended health coverage of expensive anti-retroviral drugs, those with HIV relied on the federal AIDS Drug Assistance Program (ADAP) to gain access to medication. But state-administered ADAP programs were plagued by budget cuts, creating long waiting lists for drug access. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“One of the most important things that happened with Medicaid expansion is that people were able to move off of ADAP and not just get HIV drugs but full [health] insurance,” Kavanaugh says. “If that rolls back, it’s likely we will see huge problems with ADAP.” That in turn could hurt the U.S. effort to control HIV, he says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">As evidence of what he says is the incoming administration's “clear, intensely anti-gay agenda,\" Kavanaugh points to the GOP party platform’s last-minute promotion of so-called \"gay conversion therapy,\" long \u003ca href=\"http://www.apa.org/pi/lgbt/resources/just-the-facts.aspx\" target=\"_blank\">discredited by the psychological profession\u003c/a> and illegal as a treatment for minors in a \u003ca href=\"http://www.lgbtmap.org/equality-maps/conversion_therapy\" target=\"_blank\">number of states\u003c/a>. The therapy is also \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/11/19/gays-can-be-reformed-just-like-arsonists-trumps-new-domestic-policy-adviser-has-said/\" target=\"_blank\">endorsed\u003c/a> by the head of Trump's domestic policy transition team, former Ohio Secretary of State Ken Blackwell, a senior fellow at the Family Research Council, which publicly \u003ca href=\"http://www.frc.org/homosexuality\" target=\"_blank\">states\u003c/a> that homosexuality \"is harmful to the persons who engage in it and to society at large.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Vice President-elect Mike Pence also has a \u003ca href=\"http://time.com/4406337/mike-pence-gay-rights-lgbt-religious-freedom/\" target=\"_blank\">record\u003c/a> of opposing LGBT rights and is a staunch social conservative. \u003c/span>\u003cspan class=\"s1\">Ben Plumley, head of the Pangaea Global AIDS project, pointed to a 2015 spike of 90 new HIV cases linked to injection drug use in rural Scott County, Indiana, where Pence was governor, as an example of ineffective health policy. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">S\u003c/span>tate health officials had urged Pence to implement a needle exchange program, but that was a nonstarter with the governor. With cases rising, however, the Centers for Disease Control and Prevention weighed in with the same recommendation. Pence said he would pray on the matter, and eventually he issued an executive order to implement needle exchange in Scott County. Tens of thousands of clean disposable needles were quickly distributed, and HIV cases diminished to a trickle. AmfAR, The Foundation for AIDS Research, later called the epidemic \"\u003ca href=\"http://www.politico.com/story/2016/08/under-pences-leadership-response-to-heroin-epidemic-criticized-as-ineffective-226759\" target=\"_blank\">totally preventable\u003c/a>.\" Meanwhile, heroin-related hepatitis C cases are still \u003ca href=\"http://www.fox19.com/story/30451992/hiv-hepatitis-c-outbreak-continues-in-indiana\" target=\"_blank\">snowballing\u003c/a> in the area.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Kavanaugh is also worried about the push for religious waivers at the state and local levels, which would allow agencies, individuals and private health providers with federal contracts to opt out of providing services to LGBT citizens. Two such bills are pending in Florida and Texas, and copycat bills are being drafted in other states. One of the potential health care leaders in a Trump administration, Bobby Jindal, issued an executive order in Louisiana to give a religious waiver to those opposed to same-sex marriage. \u003c/span>\u003c/p>\n\u003cp>Violence is also a potential issue. Since the election, the Southern Poverty Law Center has tracked a \u003ca href=\"https://www.splcenter.org/hatewatch/2016/11/18/update-incidents-hateful-harassment-election-day-now-number-701\" target=\"_blank\">spike in hate crimes\u003c/a> — including 80 reported against LGBT individuals. Almost two-thirds of the incidents, some of which were anecdotal, occurred in the first three days following the election, the group says, and \"the trend line points to a steady drop-off.\"\u003c/p>\n\u003cp>There is no doubt the LGBT community is feeling increased pressure. Calls to LGBT suicide prevention hotlines went way up in the immediate wake of Trump’s election, \u003ca href=\"http://www.motherjones.com/politics/2016/11/suicide-hotline-calls-lgbt-trump\" target=\"_blank\">Mother Jones\u003c/a> has reported. Callers worried about loss of health access to hormones and gender surgery, as well as fear of discrimination from health providers.\u003c/p>\n\u003cp class=\"p1\">“You’re going to see increasing numbers of people with challenges,\" says Kavanaugh. \"It's going to be a test of our solidarity.\"\u003c/p>\n\u003cp class=\"p1\">LGBT leaders interviewed by KQED said they repeatedly tried during and since the election to meet with Trump officials to discuss their concerns, including the choice for HHS, to no avail.\u003c/p>\n\u003cp class=\"p1\">\"We've gotten no response,\" said Pangaea head Ben Plumley.\u003c/p>\n\u003cp class=\"p1\">KQED's efforts to reach the campaign for comment were unsuccessful. So were efforts to obtain comments from health policy aides at Rep. Nancy Pelosi's office about Democratic efforts to influence the top health pick.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cem>Jon Brooks contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Have pity on those poor parents desperately trying to coax a protesting toddler to eat something she has pushed away in disgust. While moms and dads may fault themselves for an inability to evoke the magic words that will open-sesame their offspring's mouth, it turns out there's a good chance some of that child's -- er, shall we say \"discretion\" -- is innate.\u003c/p>\n\u003caside class=\"pullquote alignright\">Parents who model good eating habits and avoid conflict at the table do better at getting their kids to eat foods they find unappealing. Two weeks of exposure to vegetables -- with a reward -- has also been shown to work.\u003c/aside>\n\u003cp>Once again, it's in the genes.\u003c/p>\n\u003cp>A new \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27739065\" target=\"_blank\">study \u003c/a>concludes that around half of toddlers' fussiness probably is genetically determined. Researchers at University College London looked at 1,932 Welsh and English twin pairs and their families. When the children were 16 months old, the parents were given the 35-item \u003ca href=\"https://www.ucl.ac.uk/hbrc/resources/resources_eb/CEBQwithscores.pdf\">Child Eating Behaviour Questionnaire\u003c/a> as a gauge of how fussy each child was about food.\u003c/p>\n\u003cp>To figure out how much of this behavior was genetic, the researchers looked at 626 identical twin pairs to see how often both children scored similarly on the questionnaire. Since identical twins essentially have the same DNA, both children will exhibit a purely genetic trait -- every time.\u003c/p>\n\u003cp>This is not what the researchers found. While the identical twins often shared the same level of food fussiness, it did not occur 100 percent of the time.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So genetics appears not to be the whole story: It could be the twins’ shared environment accounts for their similar but not identical eating habits.\u003c/p>\n\u003cp>To test the role of environment in shaping the toddlers' pickiness, the study also\u003cstrong> \u003c/strong>looked at\u003cstrong> \u003c/strong>1,306 pairs of fraternal twins, who share the same amount of DNA as any two siblings—around 50 percent on average.\u003c/p>\n\u003cp>If something is purely environmental, two twins in a fraternal pair should share the same trait as often as two twins in an identical pair. The researchers found that this was not the case. The fraternal twins were actually less likely to share the same eating behavior compared to identical twins.\u003c/p>\n\u003cp>This study suggests that both genetics \u003cem>and\u003c/em> the environment play a role in food fussiness. After crunching the data, the researchers conclude that each accounts for somewhere between 41 and 52 percent of the behavior.\u003c/p>\n\u003cp>\u003cstrong>Getting Your Toddler to Eat\u003c/strong>\u003c/p>\n\u003cp>But enough with the numbers. The takeaway for parents: Don't give up hope that you can have an influence on what your fussy children are willing to eat. Skillful parenting can make a difference if you start early, and the sooner the better.\u003c/p>\n\u003cp>For example, a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2530930/\">study \u003c/a>from 2005 suggested that parents could best affect their children's eating habits by eating well themselves and avoiding conflicts at the dinner table.\u003c/p>\n\u003caside class=\"alignright\">\u003cspan style=\"font-weight: normal\">\u003cstrong>A note about twin studies\u003c/strong>\u003cbr>\nThere is some \u003ca href=\"https://www.madinamerica.com/2013/03/the-trouble-with-twin-studies/\" target=\"_blank\">debate\u003c/a> about how well studies of identical versus fraternal twins determine the level of genetic influence in a particular trait. These comparisons rely on the assumption that the shared environment of fraternal twins is the same as the shared environment of identical twins. The potential flaw is that identical twins may be treated more alike than fraternal twins. If that is true, twin studies would \u003cem>overestimate\u003c/em> the role of genetics, as environmental factors could be the real reason for greater levels of similarity in identical twins.\u003c/span>\u003c/aside>\n\u003cp>These researchers examined the eating habits of 173 girls, once when they were 7 years old and again when they were 9. At both junctures, the parents were interviewed to understand both their eating habits and how they tried to encourage their daughters to eat healthier foods.\u003c/p>\n\u003cp>The results showed that modeling food behaviors worked far better than trying to force a child to eat better. In other words: Don't preach broccoli when you're sneaking hot dogs yourself.\u003c/p>\n\u003cp>Another \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037818/\">study \u003c/a>from University College London, this one from 2014, suggests an alternative to pitched battles at the dinner table. Try repeatedly exposing your children to a food they dislike and reward offer a reward when they venture a bite.\u003c/p>\n\u003cp>This approach can pay off big. The researchers had parents offer a small bite of a \"target vegetable\" that their three-year-olds didn’t like each day for 14 days. If the children ate it, they were rewarded with a sticker.\u003c/p>\n\u003cp>After two weeks of repeated exposure and reward, only around 13 percent of these kids still said they disliked the food.\u003c/p>\n\u003cp>That's a big contrast to the control group, for which no instructions were issued. A whopping 90 percent of these kids still would not unclamp their jaws and eat the yucky food at the end of the trial period.\u003c/p>\n\u003cp>So a little bit of parental effort and some stickers can go a long way. Genetics plays a big role in kids' fussiness but it isn't the only factor. If parents eat a wide variety of food and patiently keep offering new foods to their kids, these parents may end up with less fussy kids.\u003c/p>\n\u003cp>Or ... you could do it this way:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=KNNpydUfduo\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Have pity on those poor parents desperately trying to coax a protesting toddler to eat something she has pushed away in disgust. While moms and dads may fault themselves for an inability to evoke the magic words that will open-sesame their offspring's mouth, it turns out there's a good chance some of that child's -- er, shall we say \"discretion\" -- is innate.\u003c/p>\n\u003caside class=\"pullquote alignright\">Parents who model good eating habits and avoid conflict at the table do better at getting their kids to eat foods they find unappealing. Two weeks of exposure to vegetables -- with a reward -- has also been shown to work.\u003c/aside>\n\u003cp>Once again, it's in the genes.\u003c/p>\n\u003cp>A new \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27739065\" target=\"_blank\">study \u003c/a>concludes that around half of toddlers' fussiness probably is genetically determined. Researchers at University College London looked at 1,932 Welsh and English twin pairs and their families. When the children were 16 months old, the parents were given the 35-item \u003ca href=\"https://www.ucl.ac.uk/hbrc/resources/resources_eb/CEBQwithscores.pdf\">Child Eating Behaviour Questionnaire\u003c/a> as a gauge of how fussy each child was about food.\u003c/p>\n\u003cp>To figure out how much of this behavior was genetic, the researchers looked at 626 identical twin pairs to see how often both children scored similarly on the questionnaire. Since identical twins essentially have the same DNA, both children will exhibit a purely genetic trait -- every time.\u003c/p>\n\u003cp>This is not what the researchers found. While the identical twins often shared the same level of food fussiness, it did not occur 100 percent of the time.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So genetics appears not to be the whole story: It could be the twins’ shared environment accounts for their similar but not identical eating habits.\u003c/p>\n\u003cp>To test the role of environment in shaping the toddlers' pickiness, the study also\u003cstrong> \u003c/strong>looked at\u003cstrong> \u003c/strong>1,306 pairs of fraternal twins, who share the same amount of DNA as any two siblings—around 50 percent on average.\u003c/p>\n\u003cp>If something is purely environmental, two twins in a fraternal pair should share the same trait as often as two twins in an identical pair. The researchers found that this was not the case. The fraternal twins were actually less likely to share the same eating behavior compared to identical twins.\u003c/p>\n\u003cp>This study suggests that both genetics \u003cem>and\u003c/em> the environment play a role in food fussiness. After crunching the data, the researchers conclude that each accounts for somewhere between 41 and 52 percent of the behavior.\u003c/p>\n\u003cp>\u003cstrong>Getting Your Toddler to Eat\u003c/strong>\u003c/p>\n\u003cp>But enough with the numbers. The takeaway for parents: Don't give up hope that you can have an influence on what your fussy children are willing to eat. Skillful parenting can make a difference if you start early, and the sooner the better.\u003c/p>\n\u003cp>For example, a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2530930/\">study \u003c/a>from 2005 suggested that parents could best affect their children's eating habits by eating well themselves and avoiding conflicts at the dinner table.\u003c/p>\n\u003caside class=\"alignright\">\u003cspan style=\"font-weight: normal\">\u003cstrong>A note about twin studies\u003c/strong>\u003cbr>\nThere is some \u003ca href=\"https://www.madinamerica.com/2013/03/the-trouble-with-twin-studies/\" target=\"_blank\">debate\u003c/a> about how well studies of identical versus fraternal twins determine the level of genetic influence in a particular trait. These comparisons rely on the assumption that the shared environment of fraternal twins is the same as the shared environment of identical twins. The potential flaw is that identical twins may be treated more alike than fraternal twins. If that is true, twin studies would \u003cem>overestimate\u003c/em> the role of genetics, as environmental factors could be the real reason for greater levels of similarity in identical twins.\u003c/span>\u003c/aside>\n\u003cp>These researchers examined the eating habits of 173 girls, once when they were 7 years old and again when they were 9. At both junctures, the parents were interviewed to understand both their eating habits and how they tried to encourage their daughters to eat healthier foods.\u003c/p>\n\u003cp>The results showed that modeling food behaviors worked far better than trying to force a child to eat better. In other words: Don't preach broccoli when you're sneaking hot dogs yourself.\u003c/p>\n\u003cp>Another \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037818/\">study \u003c/a>from University College London, this one from 2014, suggests an alternative to pitched battles at the dinner table. Try repeatedly exposing your children to a food they dislike and reward offer a reward when they venture a bite.\u003c/p>\n\u003cp>This approach can pay off big. The researchers had parents offer a small bite of a \"target vegetable\" that their three-year-olds didn’t like each day for 14 days. If the children ate it, they were rewarded with a sticker.\u003c/p>\n\u003cp>After two weeks of repeated exposure and reward, only around 13 percent of these kids still said they disliked the food.\u003c/p>\n\u003cp>That's a big contrast to the control group, for which no instructions were issued. A whopping 90 percent of these kids still would not unclamp their jaws and eat the yucky food at the end of the trial period.\u003c/p>\n\u003cp>So a little bit of parental effort and some stickers can go a long way. Genetics plays a big role in kids' fussiness but it isn't the only factor. If parents eat a wide variety of food and patiently keep offering new foods to their kids, these parents may end up with less fussy kids.\u003c/p>\n\u003cp>Or ... you could do it this way:\u003c/p>\n\u003cp>\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/KNNpydUfduo'\n title='//www.youtube.com/embed/KNNpydUfduo'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\n\u003c/div>\u003c/p>",
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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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