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"disqusTitle": "Medical Students Skip Class in Droves, Making Lectures Increasingly Obsolete",
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"content": "\u003cp>The future doctors of America cut class. Not to gossip in the bathroom or flirt behind the bleachers. They skip to learn — at twice the speed.\u003c/p>\n\u003cp class=\"danger-zone\">Some medical students follow along with class remotely, watching sped-up recordings of their professors at home, in their pajamas. Others rarely tune in. At one school, attendance is so bad that a Nobel laureate recently lectured to mostly empty seats.\u003c/p>\n\u003cp class=\"danger-zone\">Nationally, nearly one-quarter of second-year medical students \u003ca href=\"https://www.aamc.org/download/488336/data/y2q2017report.pdf\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> last year that they “almost never” attended class during their first two, preclinical years, a 5 percent increase from 2015.\u003c/p>\n\u003cp>The AWOL students highlight increasing dissatisfaction and anxiety that there’s a mismatch between what they’re taught in class during those years and what they’re expected to know — or how they’re tested — on national licensing exams. Despite paying nearly \u003ca href=\"https://www.aamc.org/data/tuitionandstudentfees/\" target=\"_blank\" rel=\"noopener\">$60,000 a year\u003c/a> in tuition, medical students are turning to unsanctioned online resources to prepare for Step 1, the make-or-break test typically taken at the end of the preclinical years.\u003c/p>\n\u003cp>These self-guided med students are akin to a group of American tourists wandering through Tokyo without a map. Like a tour guide hired on the street, the online learning tools — including memory aids, videos, and online quizzes — can enhance the educational journey, or send the students down a dead end.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lawrence Wang, a third-year M.D.-Ph.D. student at the University of California, San Diego, and the National Institutes of Health, said he relied heavily on these resources during his first two years of medical school.\u003c/p>\n\u003cp>“There were times that I didn’t go to a single class, and then I’d get to the actual exam and it would be my first time seeing the professor,” he said. “Especially, when Step was coming up, I pretty much completely focused on studying outside materials.”\u003c/p>\n\u003cp>Wang isn’t alone. According to 2017 data from the Association for American Medical Colleges, 1 in 4 preclinical students watches educational videos — like those on YouTube — on a daily basis. And according to two video developers, tens of thousands of medical students subscribe to their products — one of which costs $250 for two years, the other $370 for one year.\u003c/p>\n\u003cp>Leaders in medical education have begun to scramble. Some medical schools, like Harvard, have done away with lectures for the most part. Instead of spending hours in an auditorium, Harvard students learn the course content at home and then apply the knowledge in mandatory small group sessions.\u003c/p>\n\u003cp>Other institutions, like Johns Hopkins, are moving in the same direction, but have yet to make a full switch. Hopkins cut down on lectures and boosted sessions that require active student participation. Preclinical lecture attendance hovers around 30 to 40 percent, according to Dr. Nancy Hueppchen, associate dean for curriculum.\u003c/p>\n\u003cp>For many students, she said, licensing exam prep begins on day one of medical school: “They have this parallel curriculum going along with what we’re teaching them.”\u003c/p>\n\u003cp>Step 1, an eight-hour multiple choice test, is a big deal. Performance on the exam, though it’s taken before most students even begin training in a hospital, heavily influences which medical specialties they can eventually pursue after school and at what hospitals they can pursue them.\u003c/p>\n\u003cp>With medical schools grading pass-fail, the Step 1 score is an increasingly significant piece of information that’s used to sort through residency applications, Hueppchen said. When she took the exam, it was only used as a pass-fail test. Today, residency programs rely on the score more heavily; students and faculty suspect that it’s used as a cutoff for making admissions decisions.\u003c/p>\n\u003cp>Ryan Carlson, a third-year M.D.-Ph.D. student at the University of Washington, said that his school focused on teaching “what they thought was important for a physician to know.” But medical students have to know more than what is relevant to a practicing clinician to succeed on Step. The exam focuses on rare diseases and other minutiae, said Carlson, who now tutors for the test.\u003c/p>\n\u003cp>Hueppchen acknowledged that students at Hopkins and elsewhere “express some distrust that they’re getting everything they need — or that we’re being meticulous in pointing out what they need — to study for and excel on the Step 1 exam.”\u003c/p>\n\u003cp>\u003cstrong>Medical Tour Guides\u003c/strong>\u003c/p>\n\u003cp>That distrust has spawned a cottage industry of online study aids. Most are a far cry from your high school SAT prep course.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sketchymedical.com/#!/home\" target=\"_blank\" rel=\"noopener\">SketchyMedical\u003c/a> is one of the most popular guides. The company, built in 2013 by three then-medical students at the University of California, Irvine, produces visual memory aids with elaborate illustrations to help students learn and retain the voluminous material they’re expected to know.\u003c/p>\n\u003cp>Dr. Andrew Berg and his co-founders, Drs. Saud Siddiqui and Bryan Lemieux, started sketching pictures and pairing them with stories while taking microbiology in their second year of medical school.\u003c/p>\n\u003cp>“We were just bombarded with different names of bacteria, viruses, and fungi, and we were having a tough time keeping them all straight,” he said.'\u003c/p>\n\u003cp>The sketches helped them, and now other students are using them, too.\u003c/p>\n\u003cp>Imagine it’s test day and a med student is asked which drug she would use to treat a patient’s postoperative gastrointestinal blockage. The student closes her eyes and mentally enters the world of “Acetyl-Cola,” a bustling port town that’s depicted in one of SketchyMedical’s cartoons. Outside a storefront, the student finds construction workers, motorcyclists wearing brain-shaped helmets, piles of dripping-wet fish, and a man sporting an adrenal gland-shaped beanie.\u003c/p>\n\u003cp>A colon-shaped mixing truck pouring out cement is an unfortunate, but effective, symbol for defecation, and a worker wearing a name tag reading “Beth” and drinking a cola reminds the student of the drug bethanechol, given to treat intestinal obstructions.\u003c/p>\n\u003cp>The illustrations are turned into narrated videos, which teach drug names and their mechanisms and side effects. SketchyMedical has also produced videos on microbiology and pathology.\u003c/p>\n\u003cp>\u003ca href=\"https://www.youtube.com/watch?v=8Dv3zZbDvig\" target=\"_blank\" rel=\"noopener\">Berg compares\u003c/a> the work of Sketchy to hieroglyphics in ancient Egypt. But for many, Sketchy evokes a different technique used a thousand years later in ancient Greece: method of loci, also called a memory palace or journey.\u003c/p>\n\u003cp>Memory palaces are typically imagined spaces in which a person can store information like a string of numbers or a series of words. Each piece of information is placed somewhere inside the palace. When the palace builder wants to recall an item, she can take a mental stroll through the space to retrieve it. This technique famously enabled Cicero, the Roman statesman and philosopher, to commit his speeches to memory.\u003c/p>\n\u003cp>“We accidentally stumbled upon these visual learning techniques, but now looking back we see there’s a lot of evidence supporting visual learning,” Berg said.\u003c/p>\n\u003cp>SketchyMedical is not the only extracurricular resource students rely on. An entire industry cropped up in the last few years, marketing videos and self-quizzing features to preclinical students. Dr. Jason Ryan, the creator of Boards and Beyond, is a name (and voice) familiar to medical students across the country.\u003c/p>\n\u003cp>Ryan, a faculty member at University of Connecticut School of Medicine, creates explanatory videos that track along with the content in First Aid, a Step preparatory book that Ryan said is more like “an encyclopedia of terms” than a real study aid. Ask any medical student if they use First Aid, and they’ll point you to their heavily annotated, tattered copy.\u003c/p>\n\u003cp>While both Ryan and Berg consider their products supplements to regular medical education, many students view them as necessary investments for success. Choosing which ones to use can be a challenge, however.\u003c/p>\n\u003cp>“That was the biggest learning curve of med school — it wasn’t so much how do I do well in it, it was, how do I use all these crazy resources that are being marketed to me to best meet my goal of passing Step,” Carlson said.\u003c/p>\n\u003cp>\u003cstrong>Old Players React\u003c/strong>\u003c/p>\n\u003cp>This expanding corner of the medical education industry is both a product of a new attitude among students — born from anxiety surrounding exam prep — and a disrupter of the traditional classroom education. Med schools now have to think more creatively about how they train their future doctors, Berg said.\u003c/p>\n\u003cp>In 2015, Harvard Medical School revamped its curriculum for the first two years to enable clinical exposure and boost class attendance with a flipped-classroom model: Students learn the content at home, and then apply it during in-class exercises. Dr. Richard Schwartzstein, director of education scholarship, said the program now emphasizes problem-solving and critical thinking — skills seen as essential to practicing medicine — instead of factual recall.\u003c/p>\n\u003cp>But while medical schools are de-emphasizing pure memorization, the national licensing exams have yet to reconsider, he acknowledged. Still, Schwartzstein is not a huge fan of external resources, citing their focus on memorization and pattern recognition as major weaknesses.\u003c/p>\n\u003cp>“You don’t have to actually teach pattern recognition,” he said. “We all are born with the capability of recognizing pattern.” He advises students to stick to Harvard-developed videos and their recommended readings. Like many medical schools, Harvard gives students a dedicated study period — six to eight weeks without coursework — to “prepare in whatever way they deem most appropriate to take the boards,” he said.\u003c/p>\n\u003cp>Hueppchen said that the outside resources “may have value in day-to-day studying, they may have value in studying for Step 1,” but Hopkins has not vetted them so it doesn’t recommend them to students either.\u003c/p>\n\u003cp>The National Board of Medical Examiners, which works with state medical boards to set the minimum standards for medical licensing and administers the Step exam, also doesn’t endorse these products — or their use as hard lines for residency admissions, said Dr. Michael Barone, vice president of licensure programs. The group “is aware of some secondary uses of scores,” he said, but the test’s primary purpose is to report licensure alone.\u003c/p>\n\u003cp>So long as Step still requires intensive rote memorization, companies like SketchyMedical and Boards and Beyond will likely remain in business.\u003c/p>\n\u003cp>Both Berg and Ryan agree that physicians no longer need to memorize as much as they did in the past. Ryan’s grandmother was one of the first female physicians to graduate from her medical school in the 1940s. Back then, he said, she had to remember everything. “If she had to go to a book every time she saw a patient, she’d never be able to work through the day.”\u003c/p>\n\u003cp>Today, there’s much more to know, and medicine is evolving so rapidly — with new drugs, guidelines, and practices — that physicians can’t possibly remember it all. Instead, they look information up on their cellphones, using a variety of apps on the clinic floors. But preclinical students still need to commit board-tested material to memory, a task often compared to drinking from a firehose.\u003c/p>\n\u003cp>Needing to memorize for boards and learn in parallel for their institutions is the breeding ground for anxiety that Hueppchen said “has truly detracted from the joy of learning.” It has even detracted from the joy of teaching, she added.\u003c/p>\n\u003cp>Berg said he tries to bring joy to memorization: “I think that what I hope to contribute the most is making studying more fun.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/08/14/medical-students-skipping-class/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The future doctors of America cut class. Not to gossip in the bathroom or flirt behind the bleachers. They skip to learn — at twice the speed.\u003c/p>\n\u003cp class=\"danger-zone\">Some medical students follow along with class remotely, watching sped-up recordings of their professors at home, in their pajamas. Others rarely tune in. At one school, attendance is so bad that a Nobel laureate recently lectured to mostly empty seats.\u003c/p>\n\u003cp class=\"danger-zone\">Nationally, nearly one-quarter of second-year medical students \u003ca href=\"https://www.aamc.org/download/488336/data/y2q2017report.pdf\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> last year that they “almost never” attended class during their first two, preclinical years, a 5 percent increase from 2015.\u003c/p>\n\u003cp>The AWOL students highlight increasing dissatisfaction and anxiety that there’s a mismatch between what they’re taught in class during those years and what they’re expected to know — or how they’re tested — on national licensing exams. Despite paying nearly \u003ca href=\"https://www.aamc.org/data/tuitionandstudentfees/\" target=\"_blank\" rel=\"noopener\">$60,000 a year\u003c/a> in tuition, medical students are turning to unsanctioned online resources to prepare for Step 1, the make-or-break test typically taken at the end of the preclinical years.\u003c/p>\n\u003cp>These self-guided med students are akin to a group of American tourists wandering through Tokyo without a map. Like a tour guide hired on the street, the online learning tools — including memory aids, videos, and online quizzes — can enhance the educational journey, or send the students down a dead end.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lawrence Wang, a third-year M.D.-Ph.D. student at the University of California, San Diego, and the National Institutes of Health, said he relied heavily on these resources during his first two years of medical school.\u003c/p>\n\u003cp>“There were times that I didn’t go to a single class, and then I’d get to the actual exam and it would be my first time seeing the professor,” he said. “Especially, when Step was coming up, I pretty much completely focused on studying outside materials.”\u003c/p>\n\u003cp>Wang isn’t alone. According to 2017 data from the Association for American Medical Colleges, 1 in 4 preclinical students watches educational videos — like those on YouTube — on a daily basis. And according to two video developers, tens of thousands of medical students subscribe to their products — one of which costs $250 for two years, the other $370 for one year.\u003c/p>\n\u003cp>Leaders in medical education have begun to scramble. Some medical schools, like Harvard, have done away with lectures for the most part. Instead of spending hours in an auditorium, Harvard students learn the course content at home and then apply the knowledge in mandatory small group sessions.\u003c/p>\n\u003cp>Other institutions, like Johns Hopkins, are moving in the same direction, but have yet to make a full switch. Hopkins cut down on lectures and boosted sessions that require active student participation. Preclinical lecture attendance hovers around 30 to 40 percent, according to Dr. Nancy Hueppchen, associate dean for curriculum.\u003c/p>\n\u003cp>For many students, she said, licensing exam prep begins on day one of medical school: “They have this parallel curriculum going along with what we’re teaching them.”\u003c/p>\n\u003cp>Step 1, an eight-hour multiple choice test, is a big deal. Performance on the exam, though it’s taken before most students even begin training in a hospital, heavily influences which medical specialties they can eventually pursue after school and at what hospitals they can pursue them.\u003c/p>\n\u003cp>With medical schools grading pass-fail, the Step 1 score is an increasingly significant piece of information that’s used to sort through residency applications, Hueppchen said. When she took the exam, it was only used as a pass-fail test. Today, residency programs rely on the score more heavily; students and faculty suspect that it’s used as a cutoff for making admissions decisions.\u003c/p>\n\u003cp>Ryan Carlson, a third-year M.D.-Ph.D. student at the University of Washington, said that his school focused on teaching “what they thought was important for a physician to know.” But medical students have to know more than what is relevant to a practicing clinician to succeed on Step. The exam focuses on rare diseases and other minutiae, said Carlson, who now tutors for the test.\u003c/p>\n\u003cp>Hueppchen acknowledged that students at Hopkins and elsewhere “express some distrust that they’re getting everything they need — or that we’re being meticulous in pointing out what they need — to study for and excel on the Step 1 exam.”\u003c/p>\n\u003cp>\u003cstrong>Medical Tour Guides\u003c/strong>\u003c/p>\n\u003cp>That distrust has spawned a cottage industry of online study aids. Most are a far cry from your high school SAT prep course.\u003c/p>\n\u003cp>\u003ca href=\"https://www.sketchymedical.com/#!/home\" target=\"_blank\" rel=\"noopener\">SketchyMedical\u003c/a> is one of the most popular guides. The company, built in 2013 by three then-medical students at the University of California, Irvine, produces visual memory aids with elaborate illustrations to help students learn and retain the voluminous material they’re expected to know.\u003c/p>\n\u003cp>Dr. Andrew Berg and his co-founders, Drs. Saud Siddiqui and Bryan Lemieux, started sketching pictures and pairing them with stories while taking microbiology in their second year of medical school.\u003c/p>\n\u003cp>“We were just bombarded with different names of bacteria, viruses, and fungi, and we were having a tough time keeping them all straight,” he said.'\u003c/p>\n\u003cp>The sketches helped them, and now other students are using them, too.\u003c/p>\n\u003cp>Imagine it’s test day and a med student is asked which drug she would use to treat a patient’s postoperative gastrointestinal blockage. The student closes her eyes and mentally enters the world of “Acetyl-Cola,” a bustling port town that’s depicted in one of SketchyMedical’s cartoons. Outside a storefront, the student finds construction workers, motorcyclists wearing brain-shaped helmets, piles of dripping-wet fish, and a man sporting an adrenal gland-shaped beanie.\u003c/p>\n\u003cp>A colon-shaped mixing truck pouring out cement is an unfortunate, but effective, symbol for defecation, and a worker wearing a name tag reading “Beth” and drinking a cola reminds the student of the drug bethanechol, given to treat intestinal obstructions.\u003c/p>\n\u003cp>The illustrations are turned into narrated videos, which teach drug names and their mechanisms and side effects. SketchyMedical has also produced videos on microbiology and pathology.\u003c/p>\n\u003cp>\u003ca href=\"https://www.youtube.com/watch?v=8Dv3zZbDvig\" target=\"_blank\" rel=\"noopener\">Berg compares\u003c/a> the work of Sketchy to hieroglyphics in ancient Egypt. But for many, Sketchy evokes a different technique used a thousand years later in ancient Greece: method of loci, also called a memory palace or journey.\u003c/p>\n\u003cp>Memory palaces are typically imagined spaces in which a person can store information like a string of numbers or a series of words. Each piece of information is placed somewhere inside the palace. When the palace builder wants to recall an item, she can take a mental stroll through the space to retrieve it. This technique famously enabled Cicero, the Roman statesman and philosopher, to commit his speeches to memory.\u003c/p>\n\u003cp>“We accidentally stumbled upon these visual learning techniques, but now looking back we see there’s a lot of evidence supporting visual learning,” Berg said.\u003c/p>\n\u003cp>SketchyMedical is not the only extracurricular resource students rely on. An entire industry cropped up in the last few years, marketing videos and self-quizzing features to preclinical students. Dr. Jason Ryan, the creator of Boards and Beyond, is a name (and voice) familiar to medical students across the country.\u003c/p>\n\u003cp>Ryan, a faculty member at University of Connecticut School of Medicine, creates explanatory videos that track along with the content in First Aid, a Step preparatory book that Ryan said is more like “an encyclopedia of terms” than a real study aid. Ask any medical student if they use First Aid, and they’ll point you to their heavily annotated, tattered copy.\u003c/p>\n\u003cp>While both Ryan and Berg consider their products supplements to regular medical education, many students view them as necessary investments for success. Choosing which ones to use can be a challenge, however.\u003c/p>\n\u003cp>“That was the biggest learning curve of med school — it wasn’t so much how do I do well in it, it was, how do I use all these crazy resources that are being marketed to me to best meet my goal of passing Step,” Carlson said.\u003c/p>\n\u003cp>\u003cstrong>Old Players React\u003c/strong>\u003c/p>\n\u003cp>This expanding corner of the medical education industry is both a product of a new attitude among students — born from anxiety surrounding exam prep — and a disrupter of the traditional classroom education. Med schools now have to think more creatively about how they train their future doctors, Berg said.\u003c/p>\n\u003cp>In 2015, Harvard Medical School revamped its curriculum for the first two years to enable clinical exposure and boost class attendance with a flipped-classroom model: Students learn the content at home, and then apply it during in-class exercises. Dr. Richard Schwartzstein, director of education scholarship, said the program now emphasizes problem-solving and critical thinking — skills seen as essential to practicing medicine — instead of factual recall.\u003c/p>\n\u003cp>But while medical schools are de-emphasizing pure memorization, the national licensing exams have yet to reconsider, he acknowledged. Still, Schwartzstein is not a huge fan of external resources, citing their focus on memorization and pattern recognition as major weaknesses.\u003c/p>\n\u003cp>“You don’t have to actually teach pattern recognition,” he said. “We all are born with the capability of recognizing pattern.” He advises students to stick to Harvard-developed videos and their recommended readings. Like many medical schools, Harvard gives students a dedicated study period — six to eight weeks without coursework — to “prepare in whatever way they deem most appropriate to take the boards,” he said.\u003c/p>\n\u003cp>Hueppchen said that the outside resources “may have value in day-to-day studying, they may have value in studying for Step 1,” but Hopkins has not vetted them so it doesn’t recommend them to students either.\u003c/p>\n\u003cp>The National Board of Medical Examiners, which works with state medical boards to set the minimum standards for medical licensing and administers the Step exam, also doesn’t endorse these products — or their use as hard lines for residency admissions, said Dr. Michael Barone, vice president of licensure programs. The group “is aware of some secondary uses of scores,” he said, but the test’s primary purpose is to report licensure alone.\u003c/p>\n\u003cp>So long as Step still requires intensive rote memorization, companies like SketchyMedical and Boards and Beyond will likely remain in business.\u003c/p>\n\u003cp>Both Berg and Ryan agree that physicians no longer need to memorize as much as they did in the past. Ryan’s grandmother was one of the first female physicians to graduate from her medical school in the 1940s. Back then, he said, she had to remember everything. “If she had to go to a book every time she saw a patient, she’d never be able to work through the day.”\u003c/p>\n\u003cp>Today, there’s much more to know, and medicine is evolving so rapidly — with new drugs, guidelines, and practices — that physicians can’t possibly remember it all. Instead, they look information up on their cellphones, using a variety of apps on the clinic floors. But preclinical students still need to commit board-tested material to memory, a task often compared to drinking from a firehose.\u003c/p>\n\u003cp>Needing to memorize for boards and learn in parallel for their institutions is the breeding ground for anxiety that Hueppchen said “has truly detracted from the joy of learning.” It has even detracted from the joy of teaching, she added.\u003c/p>\n\u003cp>Berg said he tries to bring joy to memorization: “I think that what I hope to contribute the most is making studying more fun.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Promoting the HPV Vaccine Doesn’t Lead to More Teen Sex, Study Shows",
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"content": "\u003cp>Teens are no more sexually promiscuous in states that have passed legislation promoting the HPV vaccine than those living in states that have not, according to a newly published study.\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study, released in the journal Pediatrics, compared the District of Columbia and 23 U.S. states that passed legislation to promote the vaccine for human papillomavirus (HPV) with states with no such policies. Researchers then analyzed the results of a \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf\" target=\"_blank\" rel=\"noopener\">multi-year survey\u003c/a> conducted by the Centers for Disease Control and Prevention to determine whether teens living in states with pro-HPV vaccine policies had more sex. They didn’t, the study concluded.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Concern that legislation will increase risky adolescent sexual behaviors should not be used when deciding to pass HPV legislation,” the study said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In states that promoted vaccines, these policies ranged from in-school awareness programs to incentivizing insurance companies to cover the vaccine’s cost, said Erin Cook, the study’s primary author who led this research as part of her doctoral dissertation in epidemiology at the Harvard T.H. Chan School of Public Health.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“The big takeaway is that passage of legislation regarding HPV didn’t seem to be associated with any changes in adolescent sexual behaviors in the sample of states we were able to look at,” Cook said.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study did not examine how well these policies were implemented but simply used the mere presence or absence of such legislation as an indicator of a state’s political will to act on HPV vaccine, cancer prevention and public health, she cautioned.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">According to the CDC, some 79 million Americans have HPV; it’s the most common sexually transmitted infection in the U.S., this latest study says. Another 14 million people are infected with HPV each year, the CDC says, many of them in their teens and early 20s. Cervical cancer cases \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31206-5/fulltext\" target=\"_blank\" rel=\"noopener\">almost always link\u003c/a> back to the human papillomavirus, according to the Lancet.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. approved use of the three-dose HPV vaccine for girls in 2006 and for boys in 2011. By 2014, just a third of U.S. girls — 37 percent — and 13 percent of American boys had completed the vaccination course. By 2016, nearly half of U.S. girls were vaccinated.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Still, half of U.S. states have not implemented policies to promote the vaccine, which scientific research shows can effectively \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/vaccines/parents/diseases/teen/hpv.html\" target=\"_blank\" rel=\"noopener\">prevent cancers caused by HPV infection\u003c/a>, according to the CDC.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">These findings are not new, despite persistent attitudes that the HPV vaccine could encourage sexual promiscuity. In 2015, JAMA published a Harvard Medical School study that showed \u003ca style=\"color: #000000\" href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2109856\" target=\"_blank\" rel=\"noopener\">no link between the vaccine\u003c/a>and a change in teen sexual behavior.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In 2007, Gary Freed, a pediatrician and professor at the University of Michigan, chaired the National Vaccine Advisory Council, and told \u003ca style=\"color: #000000\" href=\"http://www.pbs.org/now/shows/308/hpv-vaccine.html\" target=\"_blank\" rel=\"noopener\">Now on PBS\u003c/a>: “If we have the ability to prevent any cancer deaths, much less a significant number of cancer deaths that affect a segment of our population that historically have not been necessarily as well served as they could have been, then I think it’s incumbent upon society to make sure that we’re able to prevent these cancers.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Freed said this latest study reinforces the idea that teens are not deciding whether to have sex based on the threat of receiving an HPV infection. This is partly because so few people have heard of HPV, and because “adolescents think in the here and now, not 40 years from now.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“We as a society need to decide how much we want to prevent cervical cancer for the children of today,” Freed said. “That’s really what this is all about. We can make pap smears a thing of the past.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. is not alone in its sluggish implementation of a vaccine that can prevent illness and death as a result of cervical cancer. In 2016, \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30099-7/fulltext?code=lancet-site\" target=\"_blank\" rel=\"noopener\">a study published in the Lancet\u003c/a> reported that out of 64 nations and 12 territories, only 47 million women finished the three-dose HPV vaccine course. Most of those women lived in high-income or upper middle income countries, the study said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Access to HPV vaccination in low-income and lower-middle-income countries is almost non-existent, despite these countries carrying most of the burden of cervical cancer cases worldwide,” the report said.\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Teens are no more sexually promiscuous in states that have passed legislation promoting the HPV vaccine than those living in states that have not, according to a newly published study.\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study, released in the journal Pediatrics, compared the District of Columbia and 23 U.S. states that passed legislation to promote the vaccine for human papillomavirus (HPV) with states with no such policies. Researchers then analyzed the results of a \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf\" target=\"_blank\" rel=\"noopener\">multi-year survey\u003c/a> conducted by the Centers for Disease Control and Prevention to determine whether teens living in states with pro-HPV vaccine policies had more sex. They didn’t, the study concluded.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Concern that legislation will increase risky adolescent sexual behaviors should not be used when deciding to pass HPV legislation,” the study said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In states that promoted vaccines, these policies ranged from in-school awareness programs to incentivizing insurance companies to cover the vaccine’s cost, said Erin Cook, the study’s primary author who led this research as part of her doctoral dissertation in epidemiology at the Harvard T.H. Chan School of Public Health.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“The big takeaway is that passage of legislation regarding HPV didn’t seem to be associated with any changes in adolescent sexual behaviors in the sample of states we were able to look at,” Cook said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study did not examine how well these policies were implemented but simply used the mere presence or absence of such legislation as an indicator of a state’s political will to act on HPV vaccine, cancer prevention and public health, she cautioned.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">According to the CDC, some 79 million Americans have HPV; it’s the most common sexually transmitted infection in the U.S., this latest study says. Another 14 million people are infected with HPV each year, the CDC says, many of them in their teens and early 20s. Cervical cancer cases \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31206-5/fulltext\" target=\"_blank\" rel=\"noopener\">almost always link\u003c/a> back to the human papillomavirus, according to the Lancet.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. approved use of the three-dose HPV vaccine for girls in 2006 and for boys in 2011. By 2014, just a third of U.S. girls — 37 percent — and 13 percent of American boys had completed the vaccination course. By 2016, nearly half of U.S. girls were vaccinated.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Still, half of U.S. states have not implemented policies to promote the vaccine, which scientific research shows can effectively \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/vaccines/parents/diseases/teen/hpv.html\" target=\"_blank\" rel=\"noopener\">prevent cancers caused by HPV infection\u003c/a>, according to the CDC.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">These findings are not new, despite persistent attitudes that the HPV vaccine could encourage sexual promiscuity. In 2015, JAMA published a Harvard Medical School study that showed \u003ca style=\"color: #000000\" href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2109856\" target=\"_blank\" rel=\"noopener\">no link between the vaccine\u003c/a>and a change in teen sexual behavior.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In 2007, Gary Freed, a pediatrician and professor at the University of Michigan, chaired the National Vaccine Advisory Council, and told \u003ca style=\"color: #000000\" href=\"http://www.pbs.org/now/shows/308/hpv-vaccine.html\" target=\"_blank\" rel=\"noopener\">Now on PBS\u003c/a>: “If we have the ability to prevent any cancer deaths, much less a significant number of cancer deaths that affect a segment of our population that historically have not been necessarily as well served as they could have been, then I think it’s incumbent upon society to make sure that we’re able to prevent these cancers.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Freed said this latest study reinforces the idea that teens are not deciding whether to have sex based on the threat of receiving an HPV infection. This is partly because so few people have heard of HPV, and because “adolescents think in the here and now, not 40 years from now.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“We as a society need to decide how much we want to prevent cervical cancer for the children of today,” Freed said. “That’s really what this is all about. We can make pap smears a thing of the past.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. is not alone in its sluggish implementation of a vaccine that can prevent illness and death as a result of cervical cancer. In 2016, \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30099-7/fulltext?code=lancet-site\" target=\"_blank\" rel=\"noopener\">a study published in the Lancet\u003c/a> reported that out of 64 nations and 12 territories, only 47 million women finished the three-dose HPV vaccine course. Most of those women lived in high-income or upper middle income countries, the study said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Access to HPV vaccination in low-income and lower-middle-income countries is almost non-existent, despite these countries carrying most of the burden of cervical cancer cases worldwide,” the report said.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Ambitious 'Human Cell Atlas' Aims To Catalog Every Type Of Cell In The Body",
"title": "Ambitious 'Human Cell Atlas' Aims To Catalog Every Type Of Cell In The Body",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>\u003ca href=\"https://visitor.r20.constantcontact.com/manage/optin?v=001_E1ee4Kj9gBjf5py2sBtL-47gyrIXV_gSD2QylhrTvks5INjcehh4OTbt1TnUgDKomnPSWBQ3lm4NYbUJBMek2yviIHXnKVAOLjoUMMieTvSjNjB63IqMh9YG026R7gmdK7rGtkm55RtE4gOjB5EGZnCEwptndWGLAvuVLQh3c909XJSbGPjZKFTBuYqcp7rsrwCn4BxH6wH3dUKrBAiCQ%3D%3D\" target=\"_blank\" rel=\"noopener\">\u003cem>Sign up for the CommonHealth newsletter\u003c/em>\u003c/a>\u003cem> to receive a weekly digest of WBUR's best health, medicine and science coverage.\u003c/em>\u003c/p>\n\u003cp>If you flip open a biology textbook or do a quick \u003ca href=\"https://www.google.com/search?q=how+many+cell+types+in+the+human+body&oq=how+many+cell+types+in+the+human+body&aqs=chrome..69i57j0l5.6903j0j8&sourceid=chrome&ie=UTF-8\" target=\"_blank\" rel=\"noopener\">search\u003c/a> on Google, you'll quickly learn that there are a few hundred types of cells in the human body.\u003c/p>\n\u003cp>\"And it's true, because in broad categories, a few hundred is a good characterization,\" says \u003ca href=\"https://biology.mit.edu/profile/aviv-regev/\" target=\"_blank\" rel=\"noopener\">Aviv Regev\u003c/a>, a core member of the Broad Institute, a genetics research center in Cambridge, Mass.\u003c/p>\n\u003cp>But look a little closer, as Regev has been doing, and a far more complicated picture emerges.\u003c/p>\n\u003cp>\"No one really knows how many there will be,\" she says. Immunologists had already counted more than 300 in the immune system alone. The eye's retina, other research showed, has more than 100. How many in the whole body? Regev won't even try to predict.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"People guess anything from the thousands to the tens of thousands. I'm not guessing,\" she says. \"I would rather actually get the measurements done and have a precise answer.\"\u003c/p>\n\u003cp>For the last two years Regev, a professor of biology at MIT, has been co-leading a massive international effort to get that answer. Called the \u003ca href=\"https://www.humancellatlas.org/\" target=\"_blank\" rel=\"noopener\">Human Cell Atlas Consortium\u003c/a>, the effort aims to account for and better understand every cell type and sub-type, and how they interact.\u003c/p>\n\u003cp>The Human Cell Atlas has received less attention than the $3 billion \u003ca href=\"https://www.genome.gov/10001772/all-about-the--human-genome-project-hgp/\" target=\"_blank\" rel=\"noopener\">Human Genome Project\u003c/a>, which was completed in 2003 after 15 years of work. But it's equally ambitious.\u003c/p>\n\u003cp>Regev's co-chair, \u003ca href=\"https://www.sanger.ac.uk/people/directory/teichmann-sarah\" target=\"_blank\" rel=\"noopener\">Sarah Teichmann\u003c/a>, uses Legos as a metaphor for their quest.\u003c/p>\n\u003cp>\"It's kind of like we're trying to find out what are all the different colors of Lego building blocks that we have in our bodies,\" Teichmann says. \"We're trying to find out how those building blocks — how those Lego parts — fit together in three dimensions within each tissue.\"\u003c/p>\n\u003cp>Looking at all those building blocks, Teichmann and Regev say, will offer many new insights into how the body works and what goes wrong in disease.\u003c/p>\n\u003cp>Regev and colleagues at Massachusetts General Hospital published t\u003ca href=\"https://www.nature.com/articles/s41586-018-0393-7\" target=\"_blank\" rel=\"noopener\">heir first major Human Cell Atlas\u003c/a> finding earlier this month in the journal \u003cem>Nature\u003c/em>. Working first in mice and then human tissue, they discovered that the lining of the windpipe — the tube that connects the throat and lungs — has seven cell types instead of the expected six.\u003c/p>\n\u003cp>And that new type of cell could prove crucial for understanding and eventually developing a cure for \u003ca href=\"https://www.cff.org/What-is-CF/About-Cystic-Fibrosis/\" target=\"_blank\" rel=\"noopener\">cystic fibrosis\u003c/a>.\u003c/p>\n\u003cp>Researchers had believed that the disease was caused by a faulty protein made by a common cell in the windpipe's lining. But instead, the Broad-MGH team discovered that the bad protein is made in this rare, seventh cell type, which they named a pulmonary ionocyte.\u003c/p>\n\u003cp>The difference sounds small, but it could save years of wasted research effort trying to repair the wrong cell.\u003c/p>\n\u003cp>\"It sort of changes the problem,\" says \u003ca href=\"https://hsci.harvard.edu/people/jayaraj-rajagopal-md\" target=\"_blank\" rel=\"noopener\">Dr. Jay Rajagopal\u003c/a> of MGH and the Harvard Stem Cell Institute, who helped lead the windpipe work. Another team of researchers, led by \u003ca href=\"https://klein.hms.harvard.edu/people/allon-klein\" target=\"_blank\" rel=\"noopener\">Allon Klein \u003c/a>from Harvard Medical School and \u003ca href=\"https://www.novartis.com/our-science/postdoc-program/leadership/aron-b-jaffe-phd\" target=\"_blank\" rel=\"noopener\">Aron B. Jaffe\u003c/a> from the Novartis Institutes for BioMedical Research in Cambridge, \u003ca href=\"https://www.nature.com/articles/s41586-018-0394-6\" target=\"_blank\" rel=\"noopener\">confirmed the finding\u003c/a> in a separate \u003cem>Nature \u003c/em>paper.\u003c/p>\n\u003cp>Even without knowing about this seventh cell type, scientists have been able to develop drugs that have given cystic fibrosis patients hope of living into middle age. \"The progress has been amazing,\" Rajagopal says.\u003c/p>\n\u003cp>However, while the drugs treat the disease they can't cure it. A cure, Rajagopal says, will require targeting the precise cell where the faulty protein is made.\u003c/p>\n\u003cp>\"Now that we have this new piece of the puzzle I think it will direct research that much more,\" he says.\u003c/p>\n\u003cp>In another new paper related to the atlas, British researchers reported Friday in the journal \u003ca href=\"http://science.sciencemag.org/content/361/6402/594\" target=\"_blank\" rel=\"noopener\">Science\u003c/a> that kidney cancer in children starts in different cell types than kidney cancer in adults.\u003c/p>\n\u003cp>One of the technological advances that enabled the Human Cell Atlas came in 2014, when Regev and colleagues at Harvard — Steve McCarroll and David Weitz — made improvements to a technology called single-cell RNA sequencing, which reads the RNA in each cell to see which genes are active and identifies different cell types.\u003c/p>\n\u003cp>\"All of a sudden, we moved from something that was very laborious and we could do maybe a few dozen or a few hundred, to something where we could do many, many thousands in a 15- to 20-minute experiment,\" Regev says. \"We said, 'That's at the right scale that we could actually do the human body.' \"\u003c/p>\n\u003cp>Regev and Teichmann, head of cellular genetics at the Wellcome Sanger Institute in the United Kingdom, formed the Human Cell Atlas Consortium in late 2016. The consortium includes 500 scientists from around the world; projects related to the Human Cell Atlas have received $200 million from the National Institutes of Health.\u003c/p>\n\u003cp>Regev says she got interested in the project because human cells are so fascinating. As soon as she realized she could feasibly count and analyze them, she wanted to dig in.\u003c/p>\n\u003cp>\"There is nothing more remarkable than the cell,\" she says. \"It's the basic unit of life. It cannot be reduced to anything simpler — not the DNA, not the genes. It's this phenomenal entity that knows how to take many different pieces of information, make very quick and sophisticated decisions, act on them and continue on its way.\"\u003c/p>\n\u003cp>Rajagopal says he's also excited to learn more about how cells \"talk\" with each other.\u003c/p>\n\u003cp>\"I tend to think of cell tissues really as, like, societies — where cells are the individuals and there's a lot of communication from one cell to another, and some cells are sensing the environment and then sending signals to their neighbors,\" he says. Technological advances are allowing the cell atlas researchers to eavesdrop on this \"conversation\" for the first time.\u003c/p>\n\u003cp>Making the atlas won't solve every problem in medicine, just as having the entire map of the human genome from the Human Genome Project didn't fix everything. But, Regev says, it's a good place to start.\u003c/p>\n\u003cp>\"We knew the lessons from the Human Genome Project were [that] rallying together the entire community would really let you get a full answer to a question. And that full answer will empower everyone to do better and faster and higher-resolution biology,\" she says.\u003c/p>\n\u003cp>Teichmann, who specializes in immunology, says she expects the cell atlas will take another five to 10 years to complete. But she sees possibilities for improving treatments for diseases – asthma, perhaps, or cancer.\u003c/p>\n\u003cp>\"There is huge potential — huge potential,\" she says. \"You know there are very clear things that we can learn by drilling down to the single cell level in those diseases.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story originally ran on WBUR's \u003c/em>\u003ca href=\"http://www.wbur.org/commonhealth\" target=\"_blank\" rel=\"noopener\">Common Health\u003c/a>\u003cem>. \u003c/em>\u003ca href=\"http://www.wbur.org/inside/staff/karen-weintraub\" target=\"_blank\" rel=\"noopener\">\u003cem>Karen Weintraub\u003c/em>\u003c/a>\u003cem> is a Common Health contributing writer.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\" target=\"_blank\" rel=\"noopener\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Ambitious+%27Human+Cell+Atlas%27+Aims+To+Catalog+Every+Type+Of+Cell+In+The+Body&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://visitor.r20.constantcontact.com/manage/optin?v=001_E1ee4Kj9gBjf5py2sBtL-47gyrIXV_gSD2QylhrTvks5INjcehh4OTbt1TnUgDKomnPSWBQ3lm4NYbUJBMek2yviIHXnKVAOLjoUMMieTvSjNjB63IqMh9YG026R7gmdK7rGtkm55RtE4gOjB5EGZnCEwptndWGLAvuVLQh3c909XJSbGPjZKFTBuYqcp7rsrwCn4BxH6wH3dUKrBAiCQ%3D%3D\" target=\"_blank\" rel=\"noopener\">\u003cem>Sign up for the CommonHealth newsletter\u003c/em>\u003c/a>\u003cem> to receive a weekly digest of WBUR's best health, medicine and science coverage.\u003c/em>\u003c/p>\n\u003cp>If you flip open a biology textbook or do a quick \u003ca href=\"https://www.google.com/search?q=how+many+cell+types+in+the+human+body&oq=how+many+cell+types+in+the+human+body&aqs=chrome..69i57j0l5.6903j0j8&sourceid=chrome&ie=UTF-8\" target=\"_blank\" rel=\"noopener\">search\u003c/a> on Google, you'll quickly learn that there are a few hundred types of cells in the human body.\u003c/p>\n\u003cp>\"And it's true, because in broad categories, a few hundred is a good characterization,\" says \u003ca href=\"https://biology.mit.edu/profile/aviv-regev/\" target=\"_blank\" rel=\"noopener\">Aviv Regev\u003c/a>, a core member of the Broad Institute, a genetics research center in Cambridge, Mass.\u003c/p>\n\u003cp>But look a little closer, as Regev has been doing, and a far more complicated picture emerges.\u003c/p>\n\u003cp>\"No one really knows how many there will be,\" she says. Immunologists had already counted more than 300 in the immune system alone. The eye's retina, other research showed, has more than 100. How many in the whole body? Regev won't even try to predict.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"People guess anything from the thousands to the tens of thousands. I'm not guessing,\" she says. \"I would rather actually get the measurements done and have a precise answer.\"\u003c/p>\n\u003cp>For the last two years Regev, a professor of biology at MIT, has been co-leading a massive international effort to get that answer. Called the \u003ca href=\"https://www.humancellatlas.org/\" target=\"_blank\" rel=\"noopener\">Human Cell Atlas Consortium\u003c/a>, the effort aims to account for and better understand every cell type and sub-type, and how they interact.\u003c/p>\n\u003cp>The Human Cell Atlas has received less attention than the $3 billion \u003ca href=\"https://www.genome.gov/10001772/all-about-the--human-genome-project-hgp/\" target=\"_blank\" rel=\"noopener\">Human Genome Project\u003c/a>, which was completed in 2003 after 15 years of work. But it's equally ambitious.\u003c/p>\n\u003cp>Regev's co-chair, \u003ca href=\"https://www.sanger.ac.uk/people/directory/teichmann-sarah\" target=\"_blank\" rel=\"noopener\">Sarah Teichmann\u003c/a>, uses Legos as a metaphor for their quest.\u003c/p>\n\u003cp>\"It's kind of like we're trying to find out what are all the different colors of Lego building blocks that we have in our bodies,\" Teichmann says. \"We're trying to find out how those building blocks — how those Lego parts — fit together in three dimensions within each tissue.\"\u003c/p>\n\u003cp>Looking at all those building blocks, Teichmann and Regev say, will offer many new insights into how the body works and what goes wrong in disease.\u003c/p>\n\u003cp>Regev and colleagues at Massachusetts General Hospital published t\u003ca href=\"https://www.nature.com/articles/s41586-018-0393-7\" target=\"_blank\" rel=\"noopener\">heir first major Human Cell Atlas\u003c/a> finding earlier this month in the journal \u003cem>Nature\u003c/em>. Working first in mice and then human tissue, they discovered that the lining of the windpipe — the tube that connects the throat and lungs — has seven cell types instead of the expected six.\u003c/p>\n\u003cp>And that new type of cell could prove crucial for understanding and eventually developing a cure for \u003ca href=\"https://www.cff.org/What-is-CF/About-Cystic-Fibrosis/\" target=\"_blank\" rel=\"noopener\">cystic fibrosis\u003c/a>.\u003c/p>\n\u003cp>Researchers had believed that the disease was caused by a faulty protein made by a common cell in the windpipe's lining. But instead, the Broad-MGH team discovered that the bad protein is made in this rare, seventh cell type, which they named a pulmonary ionocyte.\u003c/p>\n\u003cp>The difference sounds small, but it could save years of wasted research effort trying to repair the wrong cell.\u003c/p>\n\u003cp>\"It sort of changes the problem,\" says \u003ca href=\"https://hsci.harvard.edu/people/jayaraj-rajagopal-md\" target=\"_blank\" rel=\"noopener\">Dr. Jay Rajagopal\u003c/a> of MGH and the Harvard Stem Cell Institute, who helped lead the windpipe work. Another team of researchers, led by \u003ca href=\"https://klein.hms.harvard.edu/people/allon-klein\" target=\"_blank\" rel=\"noopener\">Allon Klein \u003c/a>from Harvard Medical School and \u003ca href=\"https://www.novartis.com/our-science/postdoc-program/leadership/aron-b-jaffe-phd\" target=\"_blank\" rel=\"noopener\">Aron B. Jaffe\u003c/a> from the Novartis Institutes for BioMedical Research in Cambridge, \u003ca href=\"https://www.nature.com/articles/s41586-018-0394-6\" target=\"_blank\" rel=\"noopener\">confirmed the finding\u003c/a> in a separate \u003cem>Nature \u003c/em>paper.\u003c/p>\n\u003cp>Even without knowing about this seventh cell type, scientists have been able to develop drugs that have given cystic fibrosis patients hope of living into middle age. \"The progress has been amazing,\" Rajagopal says.\u003c/p>\n\u003cp>However, while the drugs treat the disease they can't cure it. A cure, Rajagopal says, will require targeting the precise cell where the faulty protein is made.\u003c/p>\n\u003cp>\"Now that we have this new piece of the puzzle I think it will direct research that much more,\" he says.\u003c/p>\n\u003cp>In another new paper related to the atlas, British researchers reported Friday in the journal \u003ca href=\"http://science.sciencemag.org/content/361/6402/594\" target=\"_blank\" rel=\"noopener\">Science\u003c/a> that kidney cancer in children starts in different cell types than kidney cancer in adults.\u003c/p>\n\u003cp>One of the technological advances that enabled the Human Cell Atlas came in 2014, when Regev and colleagues at Harvard — Steve McCarroll and David Weitz — made improvements to a technology called single-cell RNA sequencing, which reads the RNA in each cell to see which genes are active and identifies different cell types.\u003c/p>\n\u003cp>\"All of a sudden, we moved from something that was very laborious and we could do maybe a few dozen or a few hundred, to something where we could do many, many thousands in a 15- to 20-minute experiment,\" Regev says. \"We said, 'That's at the right scale that we could actually do the human body.' \"\u003c/p>\n\u003cp>Regev and Teichmann, head of cellular genetics at the Wellcome Sanger Institute in the United Kingdom, formed the Human Cell Atlas Consortium in late 2016. The consortium includes 500 scientists from around the world; projects related to the Human Cell Atlas have received $200 million from the National Institutes of Health.\u003c/p>\n\u003cp>Regev says she got interested in the project because human cells are so fascinating. As soon as she realized she could feasibly count and analyze them, she wanted to dig in.\u003c/p>\n\u003cp>\"There is nothing more remarkable than the cell,\" she says. \"It's the basic unit of life. It cannot be reduced to anything simpler — not the DNA, not the genes. It's this phenomenal entity that knows how to take many different pieces of information, make very quick and sophisticated decisions, act on them and continue on its way.\"\u003c/p>\n\u003cp>Rajagopal says he's also excited to learn more about how cells \"talk\" with each other.\u003c/p>\n\u003cp>\"I tend to think of cell tissues really as, like, societies — where cells are the individuals and there's a lot of communication from one cell to another, and some cells are sensing the environment and then sending signals to their neighbors,\" he says. Technological advances are allowing the cell atlas researchers to eavesdrop on this \"conversation\" for the first time.\u003c/p>\n\u003cp>Making the atlas won't solve every problem in medicine, just as having the entire map of the human genome from the Human Genome Project didn't fix everything. But, Regev says, it's a good place to start.\u003c/p>\n\u003cp>\"We knew the lessons from the Human Genome Project were [that] rallying together the entire community would really let you get a full answer to a question. And that full answer will empower everyone to do better and faster and higher-resolution biology,\" she says.\u003c/p>\n\u003cp>Teichmann, who specializes in immunology, says she expects the cell atlas will take another five to 10 years to complete. But she sees possibilities for improving treatments for diseases – asthma, perhaps, or cancer.\u003c/p>\n\u003cp>\"There is huge potential — huge potential,\" she says. \"You know there are very clear things that we can learn by drilling down to the single cell level in those diseases.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story originally ran on WBUR's \u003c/em>\u003ca href=\"http://www.wbur.org/commonhealth\" target=\"_blank\" rel=\"noopener\">Common Health\u003c/a>\u003cem>. \u003c/em>\u003ca href=\"http://www.wbur.org/inside/staff/karen-weintraub\" target=\"_blank\" rel=\"noopener\">\u003cem>Karen Weintraub\u003c/em>\u003c/a>\u003cem> is a Common Health contributing writer.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\" target=\"_blank\" rel=\"noopener\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Ambitious+%27Human+Cell+Atlas%27+Aims+To+Catalog+Every+Type+Of+Cell+In+The+Body&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Mounting Calls For EPA to Regulate Contaminated Water Across the Country",
"title": "Mounting Calls For EPA to Regulate Contaminated Water Across the Country",
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"content": "\u003cp>Lauren Woeher wonders if her 16-month-old daughter has been harmed by tap water contaminated with toxic industrial compounds used in products like nonstick cookware, carpets and fast-food wrappers. Henry Betz, at 76, rattles around his house alone at night, thinking about the water his family unknowingly drank for years that was tainted by the same contaminants, and the pancreatic cancers that killed wife Betty Jean and two others in his household.[contextly_sidebar id=\"9NIwMAIiqs6rEwIhTconMwoE0dxPnLXq\"]\u003c/p>\n\u003cp>Tim Hagey, manager of a local water utility, recalls how he used to assure people that the local public water was safe. That was before testing showed it had some of the highest levels of the toxic compounds of any public water system in the U.S.\u003c/p>\n\u003cp>“You all made me out to be a liar,” Hagey, general water and sewer manager in the eastern Pennsylvania town of Warminster, told Environmental Protection Agency officials last month.\u003c/p>\n\u003cp>At “community engagement sessions” like the one in Horsham, residents and state, local and military officials are demanding that the EPA act quickly — and decisively — to clean up local water systems testing positive for dangerous levels of the chemicals, perfluoroalkyl and polyfluoroalkyl substances, or PFAS.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘You all made me out to be a liar.’\u003ccite>Tim Hagey, manager at a Pennsylvania water utility\u003c/cite>\u003c/aside>\n\u003cp>The EPA is being urged to regulate a group of chemicals that are contaminating the public water supply in dozens of states. The group of chemicals known as PFAS were used in everything from nonstick cookware to firefighting foam. (Aug. 13)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Trump administration called the contamination “a potential public relations nightmare” earlier this year after federal toxicology studies found that some of the compounds are more hazardous than previously acknowledged.\u003c/p>\n\u003cp>PFAS have been in production since the 1940s, and there are about 3,500 different types. Dumped into water, the air or soil, some forms of the compounds are expected to remain intact for thousands of years; one public-health expert dubbed them “forever chemicals.”\u003c/p>\n\u003cp>EPA testing from 2013 to 2015 found significant amounts of PFAS in public water supplies in 33 U.S. states. The finding helped move PFAS up as a national priority.\u003c/p>\n\u003cp>\u003cstrong>Health Risks\u003c/strong>\u003c/p>\n\u003cp>So did scientific studies that firmed up the health risks. One, looking at a kind of PFAS once used in making Teflon, found a probable link with kidney and testicular cancer, ulcerative colitis, thyroid disease, hypertension in pregnant women and high cholesterol. Other recent studies point to immune problems in children, among other things.[contextly_sidebar id=\"huKONbhmEHy7kYoS4ySN0SNE56qwgBNB\"]\u003c/p>\n\u003cp>\u003cstrong>A Lack of Enforcement\u003c/strong>\u003c/p>\n\u003cp>In 2016, the EPA set advisory limits — without any direct enforcement — for two kinds of PFAS that had recently been phased out of production in the United States. But manufacturers are still producing, and releasing into the air and water, newer versions of the compounds.\u003c/p>\n\u003cp>Earlier this year, federal toxicologists decided that even the EPA’s 2016 advisory levels for the two phased-out versions of the compound were several times too high for safety.\u003c/p>\n\u003cp>EPA says it will prepare a national management plan for the compounds by the end of the year. But Peter Grevatt, director of the agency’s Office of Ground Water and Drinking Water, told The Associated Press that there’s no deadline for a decision on possible regulatory actions.\u003c/p>\n\u003cp>Reviews of the data, and studies to gather more, are ongoing.\u003c/p>\n\u003cp>Even as the Trump administration says it advocates for clean air and water, it is ceding more regulation to the states and putting a hold on some regulations seen as burdensome to business.\u003c/p>\n\u003cp>In Horsham and surrounding towns in eastern Pennsylvania, and at other sites around the United States, the foams once used routinely in firefighting training at military bases contained PFAS.\u003c/p>\n\u003cp>“I know that you can’t bring back three people that I lost,” Betz, a retired airman, told the federal officials at the Horsham meeting. “But they’re gone.”\u003c/p>\n\u003cp>State lawmakers complained of “a lack of urgency and incompetency” on the part of EPA.[contextly_sidebar id=\"PGPYtG1rl6zSWqpXtYjoruRWaAdQh7WO\"]\u003c/p>\n\u003cp>“It absolutely disgusts me that the federal government would put PR concerns ahead of public health concerns,” Republican state Rep. Todd Stephens declared.\u003c/p>\n\u003cp>After the meeting, Woeher questioned why it took so long to tell the public about the dangers of the compounds.\u003c/p>\n\u003cp>“They knew they had seeped into the water, and they didn’t tell anybody about it until it was revealed and they had to,” she said.\u003c/p>\n\u003cp>Speaking at her home with her toddler nearby, she asked, “Is this something that, you know, I have to worry? It’s in her.”\u003c/p>\n\u003cp>While contamination of drinking water around military bases and factories gets most of the attention, the EPA says 80 percent of human exposure comes from consumer products in the home.\u003c/p>\n\u003cp>The chemical industry says it believes the versions of the nonstick, stain-resistant compounds in use now are safe, in part because they don’t stay in the body as long as older versions.\u003c/p>\n\u003cp>“As an industry today ... we’re very forthcoming meeting any kind of regulatory requirement to disclose any kind of adverse data,” said Jessica Bowman, a senior director at the American Chemistry Council trade group.\u003c/p>\n\u003cp>Independent academics and government regulators say they don’t fully share the industry’s expressed confidence about the safety of PFAS versions now in use.\u003c/p>\n\u003cp>While EPA considers its next step, states are taking action to tackle PFAS contamination on their own.\u003c/p>\n\u003cp>In Delaware, National Guard troops handed out water after high levels of PFAS were found in a town’s water supply. Michigan last month ordered residents of two towns to stop drinking or cooking with their water, after PFAS was found at 20 times the EPA’s 2016 advisory level. In New Jersey, officials urged fishermen to eat some kinds of fish no more than once a year because of PFAS [contextly_sidebar id=\"7nHj1AJqYzx56nUaIoVCUx97LsdUJtGl\"]contamination.\u003c/p>\n\u003cp>Washington became the first state to ban any firefighting foam with the compound.\u003c/p>\n\u003cp>Given the findings on the compounds, alarm bells “should be ringing four out of five” at the EPA, Kerrigan Clough, a former deputy regional EPA administrator, said in an interview with the AP as he waited for a test for PFAS in the water at his Michigan lake home, which is near a military base that used firefighting foam.\u003c/p>\n\u003cp>“If the risk appears to be high, and you’ve got it every place, then you’ve got a different level” of danger and urgency, Clough said. “It’s a serious problem.”\u003c/p>\n\u003cp>Problems with PFAS surfaced partly as a result of a 1999 lawsuit by a farmer who filmed his cattle staggering, frothing and dying in a field near a DuPont disposal site in Parkersburg, West Virginia, for PFAS then used in Teflon.\u003c/p>\n\u003cp>In 2005, under President George W. Bush, the EPA and DuPont settled an EPA complaint that the chemical company knew at least by the mid-1980s that the early PFAS compound posed a substantial risk to human health.\u003c/p>\n\u003cp>The EPA in the past “didn’t have much of a hammer to come down on a bad existing chemical,” said Lynn Goldman, the agency’s assistant administrator over toxic substances in the 1990s, now dean of the Milken Institute School of Public Health at George Washington University.\u003c/p>\n\u003cp>But Congress has boosted the agency’s authority to regulate problematic chemicals since then. That includes toughening up the federal Toxic Substances Control Act and regulatory mandates for the EPA itself in 2016.\u003c/p>\n\u003cp>For PFAS, that should include addressing the new versions of the compounds coming into production, not just tackling old forms that companies already agreed to take offline, Goldman said.\u003c/p>\n\u003cp>“Otherwise it’s the game of whack-a-mole,” she said. “That’s not what you want to do when you’re protecting the public health.”\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Online: EPA site on PFAS: \u003ca href=\"https://www.epa.gov/pfas\" target=\"_blank\" rel=\"noopener\">https://www.epa.gov/pfas\u003c/a>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lauren Woeher wonders if her 16-month-old daughter has been harmed by tap water contaminated with toxic industrial compounds used in products like nonstick cookware, carpets and fast-food wrappers. Henry Betz, at 76, rattles around his house alone at night, thinking about the water his family unknowingly drank for years that was tainted by the same contaminants, and the pancreatic cancers that killed wife Betty Jean and two others in his household.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Tim Hagey, manager of a local water utility, recalls how he used to assure people that the local public water was safe. That was before testing showed it had some of the highest levels of the toxic compounds of any public water system in the U.S.\u003c/p>\n\u003cp>“You all made me out to be a liar,” Hagey, general water and sewer manager in the eastern Pennsylvania town of Warminster, told Environmental Protection Agency officials last month.\u003c/p>\n\u003cp>At “community engagement sessions” like the one in Horsham, residents and state, local and military officials are demanding that the EPA act quickly — and decisively — to clean up local water systems testing positive for dangerous levels of the chemicals, perfluoroalkyl and polyfluoroalkyl substances, or PFAS.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘You all made me out to be a liar.’\u003ccite>Tim Hagey, manager at a Pennsylvania water utility\u003c/cite>\u003c/aside>\n\u003cp>The EPA is being urged to regulate a group of chemicals that are contaminating the public water supply in dozens of states. The group of chemicals known as PFAS were used in everything from nonstick cookware to firefighting foam. (Aug. 13)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Trump administration called the contamination “a potential public relations nightmare” earlier this year after federal toxicology studies found that some of the compounds are more hazardous than previously acknowledged.\u003c/p>\n\u003cp>PFAS have been in production since the 1940s, and there are about 3,500 different types. Dumped into water, the air or soil, some forms of the compounds are expected to remain intact for thousands of years; one public-health expert dubbed them “forever chemicals.”\u003c/p>\n\u003cp>EPA testing from 2013 to 2015 found significant amounts of PFAS in public water supplies in 33 U.S. states. The finding helped move PFAS up as a national priority.\u003c/p>\n\u003cp>\u003cstrong>Health Risks\u003c/strong>\u003c/p>\n\u003cp>So did scientific studies that firmed up the health risks. One, looking at a kind of PFAS once used in making Teflon, found a probable link with kidney and testicular cancer, ulcerative colitis, thyroid disease, hypertension in pregnant women and high cholesterol. Other recent studies point to immune problems in children, among other things.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>A Lack of Enforcement\u003c/strong>\u003c/p>\n\u003cp>In 2016, the EPA set advisory limits — without any direct enforcement — for two kinds of PFAS that had recently been phased out of production in the United States. But manufacturers are still producing, and releasing into the air and water, newer versions of the compounds.\u003c/p>\n\u003cp>Earlier this year, federal toxicologists decided that even the EPA’s 2016 advisory levels for the two phased-out versions of the compound were several times too high for safety.\u003c/p>\n\u003cp>EPA says it will prepare a national management plan for the compounds by the end of the year. But Peter Grevatt, director of the agency’s Office of Ground Water and Drinking Water, told The Associated Press that there’s no deadline for a decision on possible regulatory actions.\u003c/p>\n\u003cp>Reviews of the data, and studies to gather more, are ongoing.\u003c/p>\n\u003cp>Even as the Trump administration says it advocates for clean air and water, it is ceding more regulation to the states and putting a hold on some regulations seen as burdensome to business.\u003c/p>\n\u003cp>In Horsham and surrounding towns in eastern Pennsylvania, and at other sites around the United States, the foams once used routinely in firefighting training at military bases contained PFAS.\u003c/p>\n\u003cp>“I know that you can’t bring back three people that I lost,” Betz, a retired airman, told the federal officials at the Horsham meeting. “But they’re gone.”\u003c/p>\n\u003cp>State lawmakers complained of “a lack of urgency and incompetency” on the part of EPA.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“It absolutely disgusts me that the federal government would put PR concerns ahead of public health concerns,” Republican state Rep. Todd Stephens declared.\u003c/p>\n\u003cp>After the meeting, Woeher questioned why it took so long to tell the public about the dangers of the compounds.\u003c/p>\n\u003cp>“They knew they had seeped into the water, and they didn’t tell anybody about it until it was revealed and they had to,” she said.\u003c/p>\n\u003cp>Speaking at her home with her toddler nearby, she asked, “Is this something that, you know, I have to worry? It’s in her.”\u003c/p>\n\u003cp>While contamination of drinking water around military bases and factories gets most of the attention, the EPA says 80 percent of human exposure comes from consumer products in the home.\u003c/p>\n\u003cp>The chemical industry says it believes the versions of the nonstick, stain-resistant compounds in use now are safe, in part because they don’t stay in the body as long as older versions.\u003c/p>\n\u003cp>“As an industry today ... we’re very forthcoming meeting any kind of regulatory requirement to disclose any kind of adverse data,” said Jessica Bowman, a senior director at the American Chemistry Council trade group.\u003c/p>\n\u003cp>Independent academics and government regulators say they don’t fully share the industry’s expressed confidence about the safety of PFAS versions now in use.\u003c/p>\n\u003cp>While EPA considers its next step, states are taking action to tackle PFAS contamination on their own.\u003c/p>\n\u003cp>In Delaware, National Guard troops handed out water after high levels of PFAS were found in a town’s water supply. Michigan last month ordered residents of two towns to stop drinking or cooking with their water, after PFAS was found at 20 times the EPA’s 2016 advisory level. In New Jersey, officials urged fishermen to eat some kinds of fish no more than once a year because of PFAS \u003c/p>\u003cp>\u003c/p>\u003cp>contamination.\u003c/p>\n\u003cp>Washington became the first state to ban any firefighting foam with the compound.\u003c/p>\n\u003cp>Given the findings on the compounds, alarm bells “should be ringing four out of five” at the EPA, Kerrigan Clough, a former deputy regional EPA administrator, said in an interview with the AP as he waited for a test for PFAS in the water at his Michigan lake home, which is near a military base that used firefighting foam.\u003c/p>\n\u003cp>“If the risk appears to be high, and you’ve got it every place, then you’ve got a different level” of danger and urgency, Clough said. “It’s a serious problem.”\u003c/p>\n\u003cp>Problems with PFAS surfaced partly as a result of a 1999 lawsuit by a farmer who filmed his cattle staggering, frothing and dying in a field near a DuPont disposal site in Parkersburg, West Virginia, for PFAS then used in Teflon.\u003c/p>\n\u003cp>In 2005, under President George W. Bush, the EPA and DuPont settled an EPA complaint that the chemical company knew at least by the mid-1980s that the early PFAS compound posed a substantial risk to human health.\u003c/p>\n\u003cp>The EPA in the past “didn’t have much of a hammer to come down on a bad existing chemical,” said Lynn Goldman, the agency’s assistant administrator over toxic substances in the 1990s, now dean of the Milken Institute School of Public Health at George Washington University.\u003c/p>\n\u003cp>But Congress has boosted the agency’s authority to regulate problematic chemicals since then. That includes toughening up the federal Toxic Substances Control Act and regulatory mandates for the EPA itself in 2016.\u003c/p>\n\u003cp>For PFAS, that should include addressing the new versions of the compounds coming into production, not just tackling old forms that companies already agreed to take offline, Goldman said.\u003c/p>\n\u003cp>“Otherwise it’s the game of whack-a-mole,” she said. “That’s not what you want to do when you’re protecting the public health.”\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Online: EPA site on PFAS: \u003ca href=\"https://www.epa.gov/pfas\" target=\"_blank\" rel=\"noopener\">https://www.epa.gov/pfas\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Families Choose Empathy Over 'Tough Love' To Rescue Loved Ones From Opioids",
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"content": "\u003cp>It was Bea Duncan who answered the phone at 2 a.m. on a January morning. Her son Jeff had been caught using drugs in a New Hampshire sober home and was being kicked out.[contextly_sidebar id=\"0ueKts5XFYp7vq9GJWLyDaZMcqJC2m7p\"]\u003c/p>\n\u003cp>Bea and her husband, Doug Duncan, drove north that night nine years ago to pick Jeff up. On the ride back home, to Natick, Mass., the parents delivered an ultimatum: Their son had to go back to rehab, or leave home.\u003c/p>\n\u003cp>Jeff chose the latter, Bea says. She remembers a lot of yelling, cursing and tears as they stopped the car, in the dead of night, a few miles from the house.\u003c/p>\n\u003cp>\"It was really, really difficult to actually just drop him off in a parking lot on our way home and say, 'you made the decision — no rehab — so we made the decision, no home,' \" Bea says. \"It was exquisitely difficult.\"\u003c/p>\n\u003cp>Doug Duncan says many parents had told him to expect this moment. He remembers them saying, your son will have to \"hit rock bottom; you're going to have to kick him out of the house.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Two torturous days later, Jeff Duncan came home. Although he returned to rehab, the Duncans decided their approach wasn't working. They sought help, eventually \u003ca href=\"http://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement.aspx\" target=\"_blank\" rel=\"noopener\">connecting with a program\u003c/a> that, instead of tough love, stresses empathy: CRAFT or Community Reinforcement and Family Training.\u003c/p>\n\u003cp>\"There was more compassion and, 'Wow, this is really difficult for you;' more open questions to him instead of dictating what he should and should not behave like,\" says Bea.\u003c/p>\n\u003cp>Many drug users say, in hindsight, they've appreciated being forced into treatment. But studies show that a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394369/\" target=\"_blank\" rel=\"noopener\">compassionate approach\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752879/\">voluntary treatment\u003c/a> are the more effective ways to engage drug users in recovery and keep them alive. That's a critical consideration for families \u003ca href=\"https://www.npr.org/sections/health-shots/2018/03/29/597717402/fentanyl-laced-cocaine-becoming-a-deadly-problem-among-drug-users\" target=\"_blank\" rel=\"noopener\">in this era of fentanyl\u003c/a>, a powerful opioid that can shut down breathing in seconds.[contextly_sidebar id=\"fB1AY6AFnWUf8d4yEfB8hxxzkt7SQlns\"]\u003c/p>\n\u003cp>\"The concept of letting their children hit bottom is not the best strategy,\" says Nora Volkow, director of the National Institute on Drug Abuse. \"Because in hitting bottom they may die.\"\u003c/p>\n\u003cp>After they went through CRAFT training, the Duncans say things started to shift from chaos to calm.\u003c/p>\n\u003cp>\"I started to feel an immense sense of relief,\" Bea says. \"I stopped feeling like I had to be a private investigator and controlling mom. I could kind of walk side-by-side with him on this journey, instead of feeling like I had to take charge of it.\"\u003c/p>\n\u003cp>For the Duncans, the approach meant they could switch from enforcing family consequences, like kicking Jeff out of the house, to supporting him as he faced other challenges, like losing a job because of his drug use.\u003c/p>\n\u003cp>It worked well: Bea and Doug helped Jeff stick to his recovery. He's 28 now and has been sober for nine years.\u003c/p>\n\u003cp>But desperate parents often don't know how to avoid \"hitting bottom\" with their children, as the Duncans did on that dark and frigid January morning.\u003c/p>\n\u003cp>The Duncans have found ways to help others: Doug is a \u003ca href=\"https://drugfree.org/article/parent-coaches/\" target=\"_blank\" rel=\"noopener\">parent coach\u003c/a> through the Partnership for Drug-Free Kids, which is now collaborating with the \u003ca href=\"https://graykenaddictionsupport.org/\" target=\"_blank\" rel=\"noopener\">Grayken Center for Addiction\u003c/a> at Boston Medical Center.\u003c/p>\n\u003cp>The collaboration will close a gap in services for families caught up in the opioid epidemic, says Grayken Center's director, Michael Botticelli, who served as drug czar in the Obama administration.\u003c/p>\n\u003cp>\"They don't call this a family disease for no good reason,\" Botticelli says. \"The whole design of these services [is] to promote tools and information for families, so they know how to approach a situation and can heal.\"\u003c/p>\n\u003cp>There is no uniform path to healing for the drug user or parents, and no widespread agreement on the best approach for families.\u003c/p>\n\u003cp>Joanne Peterson, who founded the parent support network \u003ca href=\"https://www.learn2cope.org/\" target=\"_blank\" rel=\"noopener\">Learn to Cope\u003c/a>, says there are reasons why some parents ask older children to leave the house — if there are younger children at home or if the parents don't feel safe.\u003c/p>\n\u003cp>\"So it depends on what 'tough love' means; it can mean many different things,\" Peterson says.\u003c/p>\n\u003cp>She applauds the Grayken Center for expanding access to parent coaches, but \"we also need more professional help.\" Peterson says she routinely hears from parents who can't find counselors and doctors who understand their daily traumas.\u003c/p>\n\u003cp>Some critics suggest the CRAFT model is too soft, that it enables drug use.\u003c/p>\n\u003cp>\"That's a misconception,\" says \u003ca href=\"https://drugfree.org/newsroom/news-item/fred-muench-named-president-and-ceo-of-partnership-for-drug-free-kids/\" target=\"_blank\" rel=\"noopener\">Fred Muench\u003c/a>, president of the Partnership for Drug-Free Kids. \"CRAFT is authoritative parenting, creating a sense of responsibility in the child, and at the same time saying, 'I am here for you; I love you; I'm going to help you; but I can't help you avoid negative consequences if you're not looking to do that on your own.' \"\u003c/p>\n\u003cp>The parent coaching extends beyond periods of crisis.\u003c/p>\n\u003cp>On a recent afternoon, Doug Duncan was on the phone with Doreen, a mom whose daughter is in recovery. (We're using only Doreen's first name to protect her daughter's privacy.) Doreen was upset about an angry text from her daughter that sounded like the messages the young woman sent when she was using drugs.\u003c/p>\n\u003cp>\"It brings me back there. In two seconds, I am back on that scene thinking she's on the heroin, she's not going to live,\" Doreen told Duncan, expressing a very common fear of a loved one's relapse.\u003c/p>\n\u003cp>In a panic — her daughter had overdosed twice and been rescued — Doreen wanted to ask if she was using heroin again. But she ran it by Duncan first. He encouraged her to talk it through.\u003c/p>\n\u003cp>Doreen paused, then said she could ask her daughter about work — whether it's been stressful — or about her grief after a friend's recent death. There are many reasons, Doreen realized, that her daughter might be angry. Her tone didn't have to signal a relapse.\u003c/p>\n\u003cp>\"You talk yourself off the cliff,\" Duncan told her.\u003c/p>\n\u003cp>\"Oh yes, I know all about that cliff, I've visited a few times before,\" Doreen said, and laughed. \"You know, that ties in with what you said before about focusing less on what your feelings are, and the terror or fear that you're going through, and more on what they're feeling and what they're going through — turn the tables a bit. That's an excellent point.\"\u003c/p>\n\u003cp>\"That's true compassion,\" Duncan told her, \"and oddly enough it's very therapeutic for you, too.\"\u003c/p>\n\u003cp>More compassion in the home fits the shift away from criminalizing addiction — toward accepting and treating it as a chronic medical condition.\u003c/p>\n\u003cp>If a child had cancer, parents \"wouldn't disengage with them or be angry with them,\" says Botticelli. \"So I do think it aligns our scientific understanding that addiction is a disease and not a moral failure.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's partnership with \u003c/em>\u003ca href=\"https://ww2.kqed.org/futureofyou/2018/08/08/can-an-app-warning-to-avoid-risky-friends-prevent-opioid-relapses/\" target=\"_blank\" rel=\"noopener\">\u003cem>NPR\u003c/em>\u003c/a>\u003cem> and Kaiser Health News.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Families+Choose+Empathy+Over+%27Tough+Love%27+To+Rescue+Loved+Ones+From+Opioids&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It was Bea Duncan who answered the phone at 2 a.m. on a January morning. Her son Jeff had been caught using drugs in a New Hampshire sober home and was being kicked out.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Bea and her husband, Doug Duncan, drove north that night nine years ago to pick Jeff up. On the ride back home, to Natick, Mass., the parents delivered an ultimatum: Their son had to go back to rehab, or leave home.\u003c/p>\n\u003cp>Jeff chose the latter, Bea says. She remembers a lot of yelling, cursing and tears as they stopped the car, in the dead of night, a few miles from the house.\u003c/p>\n\u003cp>\"It was really, really difficult to actually just drop him off in a parking lot on our way home and say, 'you made the decision — no rehab — so we made the decision, no home,' \" Bea says. \"It was exquisitely difficult.\"\u003c/p>\n\u003cp>Doug Duncan says many parents had told him to expect this moment. He remembers them saying, your son will have to \"hit rock bottom; you're going to have to kick him out of the house.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Two torturous days later, Jeff Duncan came home. Although he returned to rehab, the Duncans decided their approach wasn't working. They sought help, eventually \u003ca href=\"http://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement.aspx\" target=\"_blank\" rel=\"noopener\">connecting with a program\u003c/a> that, instead of tough love, stresses empathy: CRAFT or Community Reinforcement and Family Training.\u003c/p>\n\u003cp>\"There was more compassion and, 'Wow, this is really difficult for you;' more open questions to him instead of dictating what he should and should not behave like,\" says Bea.\u003c/p>\n\u003cp>Many drug users say, in hindsight, they've appreciated being forced into treatment. But studies show that a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394369/\" target=\"_blank\" rel=\"noopener\">compassionate approach\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752879/\">voluntary treatment\u003c/a> are the more effective ways to engage drug users in recovery and keep them alive. That's a critical consideration for families \u003ca href=\"https://www.npr.org/sections/health-shots/2018/03/29/597717402/fentanyl-laced-cocaine-becoming-a-deadly-problem-among-drug-users\" target=\"_blank\" rel=\"noopener\">in this era of fentanyl\u003c/a>, a powerful opioid that can shut down breathing in seconds.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The concept of letting their children hit bottom is not the best strategy,\" says Nora Volkow, director of the National Institute on Drug Abuse. \"Because in hitting bottom they may die.\"\u003c/p>\n\u003cp>After they went through CRAFT training, the Duncans say things started to shift from chaos to calm.\u003c/p>\n\u003cp>\"I started to feel an immense sense of relief,\" Bea says. \"I stopped feeling like I had to be a private investigator and controlling mom. I could kind of walk side-by-side with him on this journey, instead of feeling like I had to take charge of it.\"\u003c/p>\n\u003cp>For the Duncans, the approach meant they could switch from enforcing family consequences, like kicking Jeff out of the house, to supporting him as he faced other challenges, like losing a job because of his drug use.\u003c/p>\n\u003cp>It worked well: Bea and Doug helped Jeff stick to his recovery. He's 28 now and has been sober for nine years.\u003c/p>\n\u003cp>But desperate parents often don't know how to avoid \"hitting bottom\" with their children, as the Duncans did on that dark and frigid January morning.\u003c/p>\n\u003cp>The Duncans have found ways to help others: Doug is a \u003ca href=\"https://drugfree.org/article/parent-coaches/\" target=\"_blank\" rel=\"noopener\">parent coach\u003c/a> through the Partnership for Drug-Free Kids, which is now collaborating with the \u003ca href=\"https://graykenaddictionsupport.org/\" target=\"_blank\" rel=\"noopener\">Grayken Center for Addiction\u003c/a> at Boston Medical Center.\u003c/p>\n\u003cp>The collaboration will close a gap in services for families caught up in the opioid epidemic, says Grayken Center's director, Michael Botticelli, who served as drug czar in the Obama administration.\u003c/p>\n\u003cp>\"They don't call this a family disease for no good reason,\" Botticelli says. \"The whole design of these services [is] to promote tools and information for families, so they know how to approach a situation and can heal.\"\u003c/p>\n\u003cp>There is no uniform path to healing for the drug user or parents, and no widespread agreement on the best approach for families.\u003c/p>\n\u003cp>Joanne Peterson, who founded the parent support network \u003ca href=\"https://www.learn2cope.org/\" target=\"_blank\" rel=\"noopener\">Learn to Cope\u003c/a>, says there are reasons why some parents ask older children to leave the house — if there are younger children at home or if the parents don't feel safe.\u003c/p>\n\u003cp>\"So it depends on what 'tough love' means; it can mean many different things,\" Peterson says.\u003c/p>\n\u003cp>She applauds the Grayken Center for expanding access to parent coaches, but \"we also need more professional help.\" Peterson says she routinely hears from parents who can't find counselors and doctors who understand their daily traumas.\u003c/p>\n\u003cp>Some critics suggest the CRAFT model is too soft, that it enables drug use.\u003c/p>\n\u003cp>\"That's a misconception,\" says \u003ca href=\"https://drugfree.org/newsroom/news-item/fred-muench-named-president-and-ceo-of-partnership-for-drug-free-kids/\" target=\"_blank\" rel=\"noopener\">Fred Muench\u003c/a>, president of the Partnership for Drug-Free Kids. \"CRAFT is authoritative parenting, creating a sense of responsibility in the child, and at the same time saying, 'I am here for you; I love you; I'm going to help you; but I can't help you avoid negative consequences if you're not looking to do that on your own.' \"\u003c/p>\n\u003cp>The parent coaching extends beyond periods of crisis.\u003c/p>\n\u003cp>On a recent afternoon, Doug Duncan was on the phone with Doreen, a mom whose daughter is in recovery. (We're using only Doreen's first name to protect her daughter's privacy.) Doreen was upset about an angry text from her daughter that sounded like the messages the young woman sent when she was using drugs.\u003c/p>\n\u003cp>\"It brings me back there. In two seconds, I am back on that scene thinking she's on the heroin, she's not going to live,\" Doreen told Duncan, expressing a very common fear of a loved one's relapse.\u003c/p>\n\u003cp>In a panic — her daughter had overdosed twice and been rescued — Doreen wanted to ask if she was using heroin again. But she ran it by Duncan first. He encouraged her to talk it through.\u003c/p>\n\u003cp>Doreen paused, then said she could ask her daughter about work — whether it's been stressful — or about her grief after a friend's recent death. There are many reasons, Doreen realized, that her daughter might be angry. Her tone didn't have to signal a relapse.\u003c/p>\n\u003cp>\"You talk yourself off the cliff,\" Duncan told her.\u003c/p>\n\u003cp>\"Oh yes, I know all about that cliff, I've visited a few times before,\" Doreen said, and laughed. \"You know, that ties in with what you said before about focusing less on what your feelings are, and the terror or fear that you're going through, and more on what they're feeling and what they're going through — turn the tables a bit. That's an excellent point.\"\u003c/p>\n\u003cp>\"That's true compassion,\" Duncan told her, \"and oddly enough it's very therapeutic for you, too.\"\u003c/p>\n\u003cp>More compassion in the home fits the shift away from criminalizing addiction — toward accepting and treating it as a chronic medical condition.\u003c/p>\n\u003cp>If a child had cancer, parents \"wouldn't disengage with them or be angry with them,\" says Botticelli. \"So I do think it aligns our scientific understanding that addiction is a disease and not a moral failure.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's partnership with \u003c/em>\u003ca href=\"https://ww2.kqed.org/futureofyou/2018/08/08/can-an-app-warning-to-avoid-risky-friends-prevent-opioid-relapses/\" target=\"_blank\" rel=\"noopener\">\u003cem>NPR\u003c/em>\u003c/a>\u003cem> and Kaiser Health News.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Families+Choose+Empathy+Over+%27Tough+Love%27+To+Rescue+Loved+Ones+From+Opioids&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Group Says Psychologists Who Help Tech Firms Addict Kids Are Unethical",
"title": "Group Says Psychologists Who Help Tech Firms Addict Kids Are Unethical",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>In a \u003ca href=\"https://screentimenetwork.org/apa\" target=\"_blank\" rel=\"noopener\">letter\u003c/a> sent to the American Psychological Association Wednesday, children's advocates called on the organization to formally condemn psychologists' role in helping to design technologies that increase children's time spent on digital devices.\u003c/p>\n\u003caside class=\"pullquote alignright\">U.S. psychologists, researchers and children's advocates are calling attention to 'the unethical practice of psychologists using hidden manipulation techniques to hook children on social media and video games. \u003c/aside>\n\u003cp> \u003c/p>\n\u003cp>The letter, timed to coincide with the APA's annual meeting in San Francisco, said it was calling attention to \"the unethical practice of psychologists using hidden manipulation techniques to hook children on social media and video games. These techniques—employed without children’s or their parents’ knowledge or consent—increase kids’ overuse of digital devices, resulting in risks to their health and well-being.\"\u003c/p>\n\u003cp>Skeptics say the research is inconclusive, and they note that psychologists have been involved in other industries' marketing and advertising for decades.\u003c/p>\n\u003cp>The group seeking intervention includes 60 U.S. psychologists, researchers, children's advocates and the Children's Screen Time Action Network, a project of the Boston-based Campaign for a Commercial-Free Childhood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"There are powerful psychology principles and technology that are being used against kids in ways that are not in their best interests,\" said Josh Golin, executive director of the Campaign for a Commercial-Free Childhood.\u003c/p>\n\u003cp>That technology uses computers to help figure out what motivates people and influence their online behavior. It's built on age-old tenets of behavioral psychology that marketers and advertisers have long used to get people to buy their products. The difference is smartphones are ubiquitous and unlike human marketers, they don't get tired, said B.J. Fogg, a behavioral scientist at Stanford University who has been called the technology's pioneer.\u003c/p>\n\u003cp>Fogg said he has aimed to use persuasive tech to enhance people's lives. But he also said he has long warned that it has a \"dark side,\" including potential loss of privacy and the potential for encouraging behavior that isn't in users' best interests.\u003c/p>\n\u003cp>The letter to the psychology association cites a recent \u003ca href=\"http://journals.sagepub.com/doi/abs/10.1177/2167702617723376\" target=\"_blank\" rel=\"noopener\">study\u003c/a> that found that teen girls who spend a lot of time on digital devices, including on social media, are at risk for depression and suicidal behaviors. That study couldn't show whether depressed girls might be more prone to using social media than other teens.\u003c/p>\n\u003cp>The letter also notes evidence that some teen boys overuse video games \"at the expense of obtaining real-world competencies,\" including college educations and jobs.\u003c/p>\n\u003cp>\"Families don't understand why their kids are so strongly attracted and pulled to these devices,\" said Richard Freed, a Walnut Creek, California, psychologist who signed the letter. He said the World Health Organization's decision in June to declare excessive video gaming an addiction shows that the problem is real.\u003c/p>\n\u003cp>Under Fogg's model, technology can change a person's behavior by tapping into hard-wired motivations, simplifying the activity and getting people to perform it with a \"well-timed\" trigger. That could mean an app prompting a person to go running or it could be an alert persuading someone to spend more time on social media based on their innate desire to win acceptance and avoid social rejection.\u003c/p>\n\u003cp>It's not just the big tech firms. BuzzFeed reported Tuesday, based on a confidential company memo, that founders of a startup recently acquired by Facebook boasted of using a \"psychological trick\" — custom social media profiles and mysterious calls to action — to get high schoolers to download a polling app. Facebook later shut down the app.\u003c/p>\n\u003cp>In job postings, big tech companies have sought psychologists and people with psychology training for research into user experiences. Microsoft's Xbox user research division is led by psychologists. Amazon looks for hires who \"geek out over user research, psychology, ethnography.\" Google's preferred qualification for some positions includes a doctorate in experimental psychology.\u003c/p>\n\u003cp>\"We strive to learn and understand our users' needs, behaviors, and emotions to yield insights that inform product strategy and guide the design of the experiences we create,\" says one Google job posting online this week.\u003c/p>\n\u003cp>Facebook and Google didn't return requests for comment Tuesday on whether they use psychological persuasion techniques to build digital products for children. Apple said Wednesday that it doesn't. Microsoft and Amazon declined to comment.\u003c/p>\n\u003cp>This year, those companies have promoted better digital well-being amid rising concerns about kids' digital distractions.\u003c/p>\n\u003cp>The Internet Association, an industry trade group, said its member companies endeavor to create safe and positive online experiences.\u003c/p>\n\u003cp>\"This is an important conversation, and the internet industry remains committed to developing and sharing best practices, partnering and collaborating with experts, and developing resources and programs that will ensure positive online experiences,\" the association's Noah Theran said in the statement.\u003c/p>\n\u003cp>Apple is introducing new tools meant to make its iPhone less addictive after two major shareholders earlier this year called on the company to curb smartphone addiction among children. Facebook, YouTube and Microsoft have introduced similar tools.\u003c/p>\n\u003cp>The American Psychological Association has no policy on using psychological research to develop persuasive digital technology.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But in a statement responding to the advocates' letter, association CEO Arthur Evans Jr. said the group \"is concerned about the increasing amount of time children are spending on digital devices.\"\u003cbr>\nHe said the association is examining psychology's role in technology development, and that an association committee will discuss the letter and whether to recommend any action.\u003c/p>\n\n",
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"excerpt": "Children's advocates want the American Psychological Association to condemn the tech industry's practice of using persuasive psychological techniques to keep kids glued to their screens.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a \u003ca href=\"https://screentimenetwork.org/apa\" target=\"_blank\" rel=\"noopener\">letter\u003c/a> sent to the American Psychological Association Wednesday, children's advocates called on the organization to formally condemn psychologists' role in helping to design technologies that increase children's time spent on digital devices.\u003c/p>\n\u003caside class=\"pullquote alignright\">U.S. psychologists, researchers and children's advocates are calling attention to 'the unethical practice of psychologists using hidden manipulation techniques to hook children on social media and video games. \u003c/aside>\n\u003cp> \u003c/p>\n\u003cp>The letter, timed to coincide with the APA's annual meeting in San Francisco, said it was calling attention to \"the unethical practice of psychologists using hidden manipulation techniques to hook children on social media and video games. These techniques—employed without children’s or their parents’ knowledge or consent—increase kids’ overuse of digital devices, resulting in risks to their health and well-being.\"\u003c/p>\n\u003cp>Skeptics say the research is inconclusive, and they note that psychologists have been involved in other industries' marketing and advertising for decades.\u003c/p>\n\u003cp>The group seeking intervention includes 60 U.S. psychologists, researchers, children's advocates and the Children's Screen Time Action Network, a project of the Boston-based Campaign for a Commercial-Free Childhood.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There are powerful psychology principles and technology that are being used against kids in ways that are not in their best interests,\" said Josh Golin, executive director of the Campaign for a Commercial-Free Childhood.\u003c/p>\n\u003cp>That technology uses computers to help figure out what motivates people and influence their online behavior. It's built on age-old tenets of behavioral psychology that marketers and advertisers have long used to get people to buy their products. The difference is smartphones are ubiquitous and unlike human marketers, they don't get tired, said B.J. Fogg, a behavioral scientist at Stanford University who has been called the technology's pioneer.\u003c/p>\n\u003cp>Fogg said he has aimed to use persuasive tech to enhance people's lives. But he also said he has long warned that it has a \"dark side,\" including potential loss of privacy and the potential for encouraging behavior that isn't in users' best interests.\u003c/p>\n\u003cp>The letter to the psychology association cites a recent \u003ca href=\"http://journals.sagepub.com/doi/abs/10.1177/2167702617723376\" target=\"_blank\" rel=\"noopener\">study\u003c/a> that found that teen girls who spend a lot of time on digital devices, including on social media, are at risk for depression and suicidal behaviors. That study couldn't show whether depressed girls might be more prone to using social media than other teens.\u003c/p>\n\u003cp>The letter also notes evidence that some teen boys overuse video games \"at the expense of obtaining real-world competencies,\" including college educations and jobs.\u003c/p>\n\u003cp>\"Families don't understand why their kids are so strongly attracted and pulled to these devices,\" said Richard Freed, a Walnut Creek, California, psychologist who signed the letter. He said the World Health Organization's decision in June to declare excessive video gaming an addiction shows that the problem is real.\u003c/p>\n\u003cp>Under Fogg's model, technology can change a person's behavior by tapping into hard-wired motivations, simplifying the activity and getting people to perform it with a \"well-timed\" trigger. That could mean an app prompting a person to go running or it could be an alert persuading someone to spend more time on social media based on their innate desire to win acceptance and avoid social rejection.\u003c/p>\n\u003cp>It's not just the big tech firms. BuzzFeed reported Tuesday, based on a confidential company memo, that founders of a startup recently acquired by Facebook boasted of using a \"psychological trick\" — custom social media profiles and mysterious calls to action — to get high schoolers to download a polling app. Facebook later shut down the app.\u003c/p>\n\u003cp>In job postings, big tech companies have sought psychologists and people with psychology training for research into user experiences. Microsoft's Xbox user research division is led by psychologists. Amazon looks for hires who \"geek out over user research, psychology, ethnography.\" Google's preferred qualification for some positions includes a doctorate in experimental psychology.\u003c/p>\n\u003cp>\"We strive to learn and understand our users' needs, behaviors, and emotions to yield insights that inform product strategy and guide the design of the experiences we create,\" says one Google job posting online this week.\u003c/p>\n\u003cp>Facebook and Google didn't return requests for comment Tuesday on whether they use psychological persuasion techniques to build digital products for children. Apple said Wednesday that it doesn't. Microsoft and Amazon declined to comment.\u003c/p>\n\u003cp>This year, those companies have promoted better digital well-being amid rising concerns about kids' digital distractions.\u003c/p>\n\u003cp>The Internet Association, an industry trade group, said its member companies endeavor to create safe and positive online experiences.\u003c/p>\n\u003cp>\"This is an important conversation, and the internet industry remains committed to developing and sharing best practices, partnering and collaborating with experts, and developing resources and programs that will ensure positive online experiences,\" the association's Noah Theran said in the statement.\u003c/p>\n\u003cp>Apple is introducing new tools meant to make its iPhone less addictive after two major shareholders earlier this year called on the company to curb smartphone addiction among children. Facebook, YouTube and Microsoft have introduced similar tools.\u003c/p>\n\u003cp>The American Psychological Association has no policy on using psychological research to develop persuasive digital technology.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But in a statement responding to the advocates' letter, association CEO Arthur Evans Jr. said the group \"is concerned about the increasing amount of time children are spending on digital devices.\"\u003cbr>\nHe said the association is examining psychology's role in technology development, and that an association committee will discuss the letter and whether to recommend any action.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Can an App Warning to Avoid Risky Friends Prevent Opioid Relapses?",
"title": "Can an App Warning to Avoid Risky Friends Prevent Opioid Relapses?",
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"content": "\u003cp>You’re in recovery from opioid addiction, and your walk to work takes you down the same streets where you used to buy heroin. The drug’s calling to you, still. Just then, your phone buzzes, with a message that reads like a text from an old friend:\u003c/p>\n\u003cp>“Hey, I know you’re near a risky area. You can do this.”\u003c/p>\n\u003cp>It’s from Hey,Charlie, an app — conceived at a 2016 Massachusetts Institute of Technology health hackathon — that aims to help people avoid environmental triggers that might threaten their recovery from an opioid addiction. The app, now being piloted by several treatment centers in Boston and Framingham, Mass., monitors a user’s contacts and location, and sends pop-up notifications to caution them about risky acquaintances or neighborhoods.[contextly_sidebar id=\"B6m1pmj1KurktxXVtJVATPZuSNjGkhGD\"]\u003c/p>\n\u003cp>“People and places can remind you of using drugs and stress you out,” leading people to relapse, said Emily Lindemer, co-founder of Hey,Charlie.\u003c/p>\n\u003cp>The app chimes in with a different reminder: recovery. “It helps them keep their sobriety at the front of their mind,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There are a sea of addiction apps, many connecting people to treatment or augmenting their outpatient therapy, by counting the number of days in recovery, for example, or recording fluctuations in mood or cravings. Some simply encourage users with inspirational quotes or hypnosis guides. Social apps are increasingly a focus, as well.\u003c/p>\n\u003cp>“Social outlets are critically important,” said Wilson Washington Jr., a senior public health adviser at the federal Substance Abuse and Mental Health Services Administration (SAMHSA). “You need family support, you need community support, you need system support.”\u003c/p>\n\u003cp>One such app, \u003ca href=\"http://www.sobertool.com/about/\" target=\"_blank\" rel=\"noopener\">SoberTool\u003c/a>, offers an anonymous forum for discussion. \u003ca href=\"https://www.sobergrid.com/\" target=\"_blank\" rel=\"noopener\">Sober Grid \u003c/a>is a social network — purported to be the largest for people with a chemical dependency — with a news feed reminiscent of Instagram.\u003c/p>\n\u003cp>But when Lindemer attended the MIT hackathon, she saw a gaping hole among the existing apps — not only could an app foster positive social connections, but it could also help people sever the negative ones.\u003c/p>\n\u003cp>Michael Kidorf, a psychiatrist and associate director of addiction treatment services at Johns Hopkins School of Medicine, told STAT that the social networks of urban drug users tend to include a mix of people who use substances and people who are drug-free.[contextly_sidebar id=\"cwsZEwnwKgEBeLVOmPCSFLGkj8YqHqD4\"]\u003c/p>\n\u003cp>“As you would expect, people who have more network members who use illicit drugs use more drugs [themselves] and engage in more risky behaviors,” he said by email.\u003c/p>\n\u003cp>Opioid users also rely heavily on their contacts to secure heroin and other drugs, Kidorf added. Studies consistently show that regular interaction with other users predicts poorer treatment outcomes.\u003c/p>\n\u003cp>The hard part, he said, is getting people to dismantle and rebuild their social network. “It is relatively easy to tell substance users to ‘change people, places, and things.’ It is much harder to provide a strategy to help them achieve this important goal.”\u003c/p>\n\u003cp>Hey,Charlie is piloting one such strategy.\u003c/p>\n\u003cp>Having watched someone close to her — the namesake for Hey,Charlie — struggle with opioid addiction, Lindemer noticed the obstacles people in recovery face. Even for those who receive \u003ca href=\"https://www.statnews.com/2018/08/06/fda-expands-medication-assisted-treatment/\">medication-assisted treatment\u003c/a>, “you go live your life and in the day-to-day 24/7 doing normal things, you still are in recovery and you still have to battle these constant environmental triggers,” she said.\u003c/p>\n\u003cp>As a then-Ph.D. student in the joint Harvard-MIT Health Sciences and Technology program, Lindemer thought an app could help mediate those urges.\u003c/p>\n\u003cp>Following the hackathon, Lindemer with her co-founder, Vincent Valant, and head developer, Benjamin Pyser, created a company that initially was funded through MIT grants. Now that she has graduated — she has a day job as a scientist at Watson Health in Cambridge, Mass. – the startup is running mostly on funding from the Robert Wood Johnson Foundation and the National Institute on Drug Abuse.\u003c/p>\n\u003cp>Hey,Charlie’s business model is their “Achilles’ heel,” Lindemer said.\u003c/p>\n\u003cp>She wants to ensure that Hey,Charlie is accessible to everybody. “Our goal is that, if we are charging for it, we are not charging the patient. We want it to fit into a treatment program,” which is why the company hopes to eventually demonstrate the app’s clinical efficacy in controlled trials.[contextly_sidebar id=\"dahwcW9QuGAKTVxO8aXeHP8Uk5bpWbni\"]\u003c/p>\n\u003cp>The app is still being refined, but the basics are in place. When sending a text to a “risky” contact, or receiving one, a message from Hey,Charlie will pop up: “Wait a minute, are you sure you want to speak to John Smith right now?” If the user decides against communicating, Hey,Charlie can send an automatic response. The app also shares a handful of affirmative messages with the user throughout the day.\u003c/p>\n\u003cp>For now, Hey,Charlie’s location services simply create a pause (you’re near a risky area). “The idea is that if you are aware of a potentially triggering situation before it arises, you are more mentally primed to handle it effectively,” said Lindemer.\u003c/p>\n\u003cp>But in the future, Lindemer hopes the app can go one step further. She envisions it not only warning people that they’re approaching a risky location, but suggesting an entirely different path as well. Lindemer wants to partner with local businesses so that Hey,Charlie can say, “Hey, there’s a coffee shop with a discount a couple of blocks away if you’re willing to switch up your route!”\u003c/p>\n\u003cp>The app relies on a combination of data actively input by users — a one-time occurrence — and data passively collected as they continue to use their cellphones. The onboarding process asks users a series of questions about their contacts, ranked by frequency of communication, and then calculates the risk each contact poses.\u003c/p>\n\u003cp>Lindemer said that she and her team don’t expect users to be completely upfront and that, especially at the beginning of recovery, relationships can be confusing as they rapidly evolve. Hey,Charlie continues to check in periodically, asking, “Is there anything you want to tell me about this person?”[contextly_sidebar id=\"m4GxEhhH8zjyZ8polANWuf0odOZy5mLJ\"]\u003c/p>\n\u003cp>While the initial version of the app focused on sheltering users from risky contacts, Lindemer and her team are now working to incorporate positive support features as well — letting supportive contacts know when their friend or family member is in a risky place.\u003c/p>\n\u003cp>“One of the things we know really well is that many people in recovery do have somebody — like a really close family member or friend — who wants to help them, and they often just don’t have the tools, and they don’t know when is the right time to reach out, so we’re trying to address that,” Lindemer said.\u003c/p>\n\u003cp>Kidorf stressed the importance of supportive, drug-free contacts. His research focuses on how treatment providers can mobilize drug-free individuals to be active participants in their loved one’s recovery.\u003c/p>\n\u003cp>Hey,Charlie is being piloted at local clinics in and around Boston. Dr. Christopher Shanahan, an internist and professor at Boston University School of Medicine, is leading the effort.\u003c/p>\n\u003cp>Shanahan, who has been studying substance use for nearly 20 years, loved the idea that Hey,Charlie could be there for his patients when he can’t. He said Lindemer pitched it to him and his colleagues during their journal club hour — when researchers typically discuss new papers published in their field.\u003c/p>\n\u003cp>“We have, what, 15 to 20 minutes with a patient in a clinic?” Shanahan said. “We give them some advice, a little bit of coaching, and send them out with some buprenorphine — and then it’s a crapshoot.”\u003c/p>\n\u003cp>The app, he said, is “a very innovative way of addressing the other 23 hours and 15 minutes of the day where doctors aren’t seeing patients.”\u003c/p>\n\u003cp>But he won’t hang his hat on it. An app can help patients cope with triggers and temptations, but it’s far from the perfect solution, he said.\u003c/p>\n\u003cp>Kidorf expressed a similar level-headed optimism, noting that apps can bring users closer to people and organizations that can support their recovery. “Overall, I think it is fair to say that these apps can be helpful for people motivated to use them.”\u003c/p>\n\u003cp>But still, he added, “We have to do better at thinking of opioid use disorder as a severe and often chronic disorder. The best apps in the world will have a hard time competing with it.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/08/07/can-phone-app-prevent-opioid-addiction-relapses/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>You’re in recovery from opioid addiction, and your walk to work takes you down the same streets where you used to buy heroin. The drug’s calling to you, still. Just then, your phone buzzes, with a message that reads like a text from an old friend:\u003c/p>\n\u003cp>“Hey, I know you’re near a risky area. You can do this.”\u003c/p>\n\u003cp>It’s from Hey,Charlie, an app — conceived at a 2016 Massachusetts Institute of Technology health hackathon — that aims to help people avoid environmental triggers that might threaten their recovery from an opioid addiction. The app, now being piloted by several treatment centers in Boston and Framingham, Mass., monitors a user’s contacts and location, and sends pop-up notifications to caution them about risky acquaintances or neighborhoods.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“People and places can remind you of using drugs and stress you out,” leading people to relapse, said Emily Lindemer, co-founder of Hey,Charlie.\u003c/p>\n\u003cp>The app chimes in with a different reminder: recovery. “It helps them keep their sobriety at the front of their mind,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There are a sea of addiction apps, many connecting people to treatment or augmenting their outpatient therapy, by counting the number of days in recovery, for example, or recording fluctuations in mood or cravings. Some simply encourage users with inspirational quotes or hypnosis guides. Social apps are increasingly a focus, as well.\u003c/p>\n\u003cp>“Social outlets are critically important,” said Wilson Washington Jr., a senior public health adviser at the federal Substance Abuse and Mental Health Services Administration (SAMHSA). “You need family support, you need community support, you need system support.”\u003c/p>\n\u003cp>One such app, \u003ca href=\"http://www.sobertool.com/about/\" target=\"_blank\" rel=\"noopener\">SoberTool\u003c/a>, offers an anonymous forum for discussion. \u003ca href=\"https://www.sobergrid.com/\" target=\"_blank\" rel=\"noopener\">Sober Grid \u003c/a>is a social network — purported to be the largest for people with a chemical dependency — with a news feed reminiscent of Instagram.\u003c/p>\n\u003cp>But when Lindemer attended the MIT hackathon, she saw a gaping hole among the existing apps — not only could an app foster positive social connections, but it could also help people sever the negative ones.\u003c/p>\n\u003cp>Michael Kidorf, a psychiatrist and associate director of addiction treatment services at Johns Hopkins School of Medicine, told STAT that the social networks of urban drug users tend to include a mix of people who use substances and people who are drug-free.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“As you would expect, people who have more network members who use illicit drugs use more drugs [themselves] and engage in more risky behaviors,” he said by email.\u003c/p>\n\u003cp>Opioid users also rely heavily on their contacts to secure heroin and other drugs, Kidorf added. Studies consistently show that regular interaction with other users predicts poorer treatment outcomes.\u003c/p>\n\u003cp>The hard part, he said, is getting people to dismantle and rebuild their social network. “It is relatively easy to tell substance users to ‘change people, places, and things.’ It is much harder to provide a strategy to help them achieve this important goal.”\u003c/p>\n\u003cp>Hey,Charlie is piloting one such strategy.\u003c/p>\n\u003cp>Having watched someone close to her — the namesake for Hey,Charlie — struggle with opioid addiction, Lindemer noticed the obstacles people in recovery face. Even for those who receive \u003ca href=\"https://www.statnews.com/2018/08/06/fda-expands-medication-assisted-treatment/\">medication-assisted treatment\u003c/a>, “you go live your life and in the day-to-day 24/7 doing normal things, you still are in recovery and you still have to battle these constant environmental triggers,” she said.\u003c/p>\n\u003cp>As a then-Ph.D. student in the joint Harvard-MIT Health Sciences and Technology program, Lindemer thought an app could help mediate those urges.\u003c/p>\n\u003cp>Following the hackathon, Lindemer with her co-founder, Vincent Valant, and head developer, Benjamin Pyser, created a company that initially was funded through MIT grants. Now that she has graduated — she has a day job as a scientist at Watson Health in Cambridge, Mass. – the startup is running mostly on funding from the Robert Wood Johnson Foundation and the National Institute on Drug Abuse.\u003c/p>\n\u003cp>Hey,Charlie’s business model is their “Achilles’ heel,” Lindemer said.\u003c/p>\n\u003cp>She wants to ensure that Hey,Charlie is accessible to everybody. “Our goal is that, if we are charging for it, we are not charging the patient. We want it to fit into a treatment program,” which is why the company hopes to eventually demonstrate the app’s clinical efficacy in controlled trials.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The app is still being refined, but the basics are in place. When sending a text to a “risky” contact, or receiving one, a message from Hey,Charlie will pop up: “Wait a minute, are you sure you want to speak to John Smith right now?” If the user decides against communicating, Hey,Charlie can send an automatic response. The app also shares a handful of affirmative messages with the user throughout the day.\u003c/p>\n\u003cp>For now, Hey,Charlie’s location services simply create a pause (you’re near a risky area). “The idea is that if you are aware of a potentially triggering situation before it arises, you are more mentally primed to handle it effectively,” said Lindemer.\u003c/p>\n\u003cp>But in the future, Lindemer hopes the app can go one step further. She envisions it not only warning people that they’re approaching a risky location, but suggesting an entirely different path as well. Lindemer wants to partner with local businesses so that Hey,Charlie can say, “Hey, there’s a coffee shop with a discount a couple of blocks away if you’re willing to switch up your route!”\u003c/p>\n\u003cp>The app relies on a combination of data actively input by users — a one-time occurrence — and data passively collected as they continue to use their cellphones. The onboarding process asks users a series of questions about their contacts, ranked by frequency of communication, and then calculates the risk each contact poses.\u003c/p>\n\u003cp>Lindemer said that she and her team don’t expect users to be completely upfront and that, especially at the beginning of recovery, relationships can be confusing as they rapidly evolve. Hey,Charlie continues to check in periodically, asking, “Is there anything you want to tell me about this person?”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>While the initial version of the app focused on sheltering users from risky contacts, Lindemer and her team are now working to incorporate positive support features as well — letting supportive contacts know when their friend or family member is in a risky place.\u003c/p>\n\u003cp>“One of the things we know really well is that many people in recovery do have somebody — like a really close family member or friend — who wants to help them, and they often just don’t have the tools, and they don’t know when is the right time to reach out, so we’re trying to address that,” Lindemer said.\u003c/p>\n\u003cp>Kidorf stressed the importance of supportive, drug-free contacts. His research focuses on how treatment providers can mobilize drug-free individuals to be active participants in their loved one’s recovery.\u003c/p>\n\u003cp>Hey,Charlie is being piloted at local clinics in and around Boston. Dr. Christopher Shanahan, an internist and professor at Boston University School of Medicine, is leading the effort.\u003c/p>\n\u003cp>Shanahan, who has been studying substance use for nearly 20 years, loved the idea that Hey,Charlie could be there for his patients when he can’t. He said Lindemer pitched it to him and his colleagues during their journal club hour — when researchers typically discuss new papers published in their field.\u003c/p>\n\u003cp>“We have, what, 15 to 20 minutes with a patient in a clinic?” Shanahan said. “We give them some advice, a little bit of coaching, and send them out with some buprenorphine — and then it’s a crapshoot.”\u003c/p>\n\u003cp>The app, he said, is “a very innovative way of addressing the other 23 hours and 15 minutes of the day where doctors aren’t seeing patients.”\u003c/p>\n\u003cp>But he won’t hang his hat on it. An app can help patients cope with triggers and temptations, but it’s far from the perfect solution, he said.\u003c/p>\n\u003cp>Kidorf expressed a similar level-headed optimism, noting that apps can bring users closer to people and organizations that can support their recovery. “Overall, I think it is fair to say that these apps can be helpful for people motivated to use them.”\u003c/p>\n\u003cp>But still, he added, “We have to do better at thinking of opioid use disorder as a severe and often chronic disorder. The best apps in the world will have a hard time competing with it.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Babies Who Seem Fine At Birth May Have Zika-Related Problems Later, Study Finds",
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"content": "\u003cp>Since Zika emerged as a threat to babies, it has been a mystery exactly how much of a danger the mosquito-borne virus poses to children.[contextly_sidebar id=\"ty8Keov1NUvlIUGsc2aZa8c364gQOzuA\"]\u003c/p>\n\u003cp>But now, the largest study to follow kids who were exposed to the virus in the womb is providing more answers.\u003c/p>\n\u003cp>The study involved 1,450 babies who had been exposed to the virus, and who were 1-year-old by February 2018. Six percent were born with birth defects, and 14 percent developed problems that could be blamed on the virus by the time they turned 1, the study found.\u003c/p>\n\u003cp>\"We're beginning to see the full spectrum of the impact of Zika,\" says \u003ca href=\"https://www.cdc.gov/media/spokesperson/sme-bio/honein.html\" target=\"_blank\" rel=\"noopener\">Margaret Honein\u003c/a>, director of the Division of Congenital and Developmental Disorders at the Centers for Disease Control and Prevention. The \u003ca href=\"https://www.cdc.gov/vitalsigns/\" target=\"_blank\" rel=\"noopener\">CDC released the study Tuesday\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\"This is really our first look at how these children are doing as they grow and develop, and really emphasizes that the Zika story is not over, particularly for these children,\" Honein says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/zika/index.html\">Zika \u003c/a>triggered an international public health emergency in 2016 when a large outbreak in Brazil revealed that the virus could cause babies to be born with very small heads and severely damaged brains when pregnant women get infected. The condition is called \u003ca href=\"https://www.cdc.gov/ncbddd/birthdefects/microcephaly.html\" target=\"_blank\" rel=\"noopener\">microcephaly\u003c/a>.\u003c/p>\n\u003cp>It slowly has become more apparent that Zika-exposed babies could develop a range of other problems as well, including seizures, damaged vision and developmental disorders.[contextly_sidebar id=\"32OPYd5JdwOY5VRyjI10z7XKAkjzn6RX\"]\u003c/p>\n\u003cp>The \u003ca href=\"https://www.npr.org/sections/health-shots/2017/06/08/532087184/cdc-reveals-sharper-numbers-of-zika-birth-defects-from-u-s-territories\" target=\"_blank\" rel=\"noopener\">CDC reported last year\u003c/a> that about 5 percent of babies exposed in the womb are born with microcephaly and other birth defects. But the extent of the risk as children get older is just now starting to become clear.\u003c/p>\n\u003cp>The new analysis included babies born in U.S. territories such as Puerto Rico and in U.S. freely associated states, such as the Marshall Islands. It found that the risk for birth defects including microcephaly and vision damage is slightly higher — about 6 percent. And 1 in 7 — 14 percent — developed some kind of problem that could have been caused by the virus by their first birthday.\u003c/p>\n\u003cp>For example, 20 babies in the new analysis whose heads were normal at birth had microcephaly by the time they turned 1.\u003c/p>\n\u003cp>\"That happened because their brain was not growing and developing properly,\" Honein says.\u003c/p>\n\u003cp>Babies also developed complications including cognitive problems, difficulties walking, moving and swallowing, and seizures.\u003c/p>\n\u003cp>\"It's really important that parents and doctors work together to make sure children get all the evaluations they need, even if they look healthy when they are born,\" Honein says.\u003c/p>\n\u003cp>For example, only about one-third of the Zika-exposed babies in the study had an eye exam by an eye specialist.[contextly_sidebar id=\"S48dSINArZNQEXA3LRc21c6yj0trOwUT\"]\u003c/p>\n\u003cp>It's also important to continue to follow these children, she says.\u003c/p>\n\u003cp>\"We are still in the early stages of learning about Zika. So we don't yet know what sort of problems might emerge when the children are 2 years old or 3 years old or when they reach school age,\" Honein says.\u003c/p>\n\u003cp>There are no major Zika outbreaks occurring right now. But Honein stresses Zika \u003ca href=\"https://wwwnc.cdc.gov/travel/page/zika-information\" target=\"_blank\" rel=\"noopener\">is still being transmitted in many countries\u003c/a> and outbreaks still could occur.\u003c/p>\n\u003cp>So pregnant women and couples trying to conceive should continue to protect themselves while living or visiting places where Zika is being transmitted. The virus is primarily spread by mosquitoes, but can also be spread sexually.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The CDC on Tuesday also issued new interim guidance for men who were exposed to the virus. The agency \u003ca href=\"https://www.cdc.gov/pregnancy/zika/women-and-their-partners.html\" target=\"_blank\" rel=\"noopener\">is now recommending\u003c/a> these men wait three months after exposure before trying to conceive. The CDC had previously recommended waiting six months. But the latest science suggests the virus doesn't remain infectious in semen as long as previously thought.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Babies+Who+Seem+Fine+At+Birth+May+Have+Zika-Related+Problems+Later%2C+Study+Finds+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Since Zika emerged as a threat to babies, it has been a mystery exactly how much of a danger the mosquito-borne virus poses to children.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But now, the largest study to follow kids who were exposed to the virus in the womb is providing more answers.\u003c/p>\n\u003cp>The study involved 1,450 babies who had been exposed to the virus, and who were 1-year-old by February 2018. Six percent were born with birth defects, and 14 percent developed problems that could be blamed on the virus by the time they turned 1, the study found.\u003c/p>\n\u003cp>\"We're beginning to see the full spectrum of the impact of Zika,\" says \u003ca href=\"https://www.cdc.gov/media/spokesperson/sme-bio/honein.html\" target=\"_blank\" rel=\"noopener\">Margaret Honein\u003c/a>, director of the Division of Congenital and Developmental Disorders at the Centers for Disease Control and Prevention. The \u003ca href=\"https://www.cdc.gov/vitalsigns/\" target=\"_blank\" rel=\"noopener\">CDC released the study Tuesday\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\"This is really our first look at how these children are doing as they grow and develop, and really emphasizes that the Zika story is not over, particularly for these children,\" Honein says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.cdc.gov/zika/index.html\">Zika \u003c/a>triggered an international public health emergency in 2016 when a large outbreak in Brazil revealed that the virus could cause babies to be born with very small heads and severely damaged brains when pregnant women get infected. The condition is called \u003ca href=\"https://www.cdc.gov/ncbddd/birthdefects/microcephaly.html\" target=\"_blank\" rel=\"noopener\">microcephaly\u003c/a>.\u003c/p>\n\u003cp>It slowly has become more apparent that Zika-exposed babies could develop a range of other problems as well, including seizures, damaged vision and developmental disorders.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"https://www.npr.org/sections/health-shots/2017/06/08/532087184/cdc-reveals-sharper-numbers-of-zika-birth-defects-from-u-s-territories\" target=\"_blank\" rel=\"noopener\">CDC reported last year\u003c/a> that about 5 percent of babies exposed in the womb are born with microcephaly and other birth defects. But the extent of the risk as children get older is just now starting to become clear.\u003c/p>\n\u003cp>The new analysis included babies born in U.S. territories such as Puerto Rico and in U.S. freely associated states, such as the Marshall Islands. It found that the risk for birth defects including microcephaly and vision damage is slightly higher — about 6 percent. And 1 in 7 — 14 percent — developed some kind of problem that could have been caused by the virus by their first birthday.\u003c/p>\n\u003cp>For example, 20 babies in the new analysis whose heads were normal at birth had microcephaly by the time they turned 1.\u003c/p>\n\u003cp>\"That happened because their brain was not growing and developing properly,\" Honein says.\u003c/p>\n\u003cp>Babies also developed complications including cognitive problems, difficulties walking, moving and swallowing, and seizures.\u003c/p>\n\u003cp>\"It's really important that parents and doctors work together to make sure children get all the evaluations they need, even if they look healthy when they are born,\" Honein says.\u003c/p>\n\u003cp>For example, only about one-third of the Zika-exposed babies in the study had an eye exam by an eye specialist.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>It's also important to continue to follow these children, she says.\u003c/p>\n\u003cp>\"We are still in the early stages of learning about Zika. So we don't yet know what sort of problems might emerge when the children are 2 years old or 3 years old or when they reach school age,\" Honein says.\u003c/p>\n\u003cp>There are no major Zika outbreaks occurring right now. But Honein stresses Zika \u003ca href=\"https://wwwnc.cdc.gov/travel/page/zika-information\" target=\"_blank\" rel=\"noopener\">is still being transmitted in many countries\u003c/a> and outbreaks still could occur.\u003c/p>\n\u003cp>So pregnant women and couples trying to conceive should continue to protect themselves while living or visiting places where Zika is being transmitted. The virus is primarily spread by mosquitoes, but can also be spread sexually.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The CDC on Tuesday also issued new interim guidance for men who were exposed to the virus. The agency \u003ca href=\"https://www.cdc.gov/pregnancy/zika/women-and-their-partners.html\" target=\"_blank\" rel=\"noopener\">is now recommending\u003c/a> these men wait three months after exposure before trying to conceive. The CDC had previously recommended waiting six months. But the latest science suggests the virus doesn't remain infectious in semen as long as previously thought.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Babies+Who+Seem+Fine+At+Birth+May+Have+Zika-Related+Problems+Later%2C+Study+Finds+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Genetic Tests Can Hurt Your Chances Of Getting Some Types Of Insurance",
"title": "Genetic Tests Can Hurt Your Chances Of Getting Some Types Of Insurance",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Taking a genetic test in your 20s or 30s could, indeed, affect your ability to get long-term-care insurance later — or at least the price you'll pay. And people who are considering enrolling in Medicare \u003cem>after\u003c/em> age 65 would do well to read the fine print of the sign-up rules. Readers have insurance questions on these topics this month, and we have answers:\u003c/p>\n\u003cp>\u003cstrong>Q: Can getting a genetic test interfere with being able to buy long-term-care insurance in the future? If you do get a plan, can the insurer drop you after you find out the results of a genetic test?\u003c/strong>\u003c/p>\n\u003cp>In general, long-term-care insurers \u003ca href=\"https://www.npr.org/sections/health-shots/2018/07/11/627287642/has-genetic-privacy-been-strained-by-trumps-recent-aca-moves\" target=\"_blank\" rel=\"noopener\">can indeed use genetic test results\u003c/a> when they decide whether to offer you coverage. The federal Genetic Information Nondiscrimination Act does prohibit insurers from asking for or using your genetic information to make decisions about whether to sell you \u003cem>health\u003c/em> insurance or how much to charge you. But those privacy protections don't apply to long-term-care policies, life insurance or disability insurance.[contextly_sidebar id=\"qQSelkzIcg9rHvmpdeoo1Q3hIhLbJVzz\"]\u003c/p>\n\u003cp>When you apply for a long-term-care policy, the insurer is permitted to review your medical records and ask you questions about your health history and that of your family. It's all part of the underwriting process to determine whether to offer you a policy and how much to charge.\u003c/p>\n\u003cp>If the insurer asks you whether you've undergone genetic testing, you generally must disclose it, even if the testing was performed through a direct-to-consumer site like 23andMe, says Catherine Theroux, a spokeswoman for \u003ca href=\"https://www.limra.com/News_Center/\" target=\"_blank\" rel=\"noopener\">LIMRA\u003c/a>, an insurance industry trade group.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"You need to release any medically relevant information,\" she says.\u003c/p>\n\u003cp>Some states provide extra consumer protections related to genetic testing and long-term-care insurance, says \u003ca href=\"https://www.law.gwu.edu/sonia-m-suter\" target=\"_blank\" rel=\"noopener\">Sonia Mateu Suter\u003c/a>, a law professor at George Washington University who specializes in genetics and the law. But most follow federal law.\u003c/p>\n\u003cp>If you get genetic testing after you have a policy, the results can't affect your coverage.\u003c/p>\n\u003cp>\"Once the policy has been underwritten and issued, the insurer doesn't revoke the policy if new medical information comes to light,\" Theroux says.\u003c/p>\n\u003cp>\u003cstrong>Q: Can I switch Medigap insurance companies midway through the year? I found a less expensive policy.\u003c/strong>\u003c/p>\n\u003cp>It depends. Under federal law, when people turn 65 and first enroll in Medicare Part B they have a six-month window to sign up for a \u003ca href=\"https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html\" target=\"_blank\" rel=\"noopener\">Medigap plan\u003c/a> — a commercial policy that picks up some of the out-of-pocket costs for services that Medicare doesn't cover. (\u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-a/what-part-a-covers.html\" target=\"_blank\" rel=\"noopener\">Medicare Part A covers\u003c/a> hospitalization, and \u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html\" target=\"_blank\" rel=\"noopener\">Medicare Part B covers\u003c/a> outpatient services.) During that six-month period, insurers have to accept enrollees, even if they have health problems.[contextly_sidebar id=\"AH3oYgfcAwGcfBrC61gPsQfir4oB7Yc7\"]\u003c/p>\n\u003cp>If you're still within that six-month period now and you want to switch plans, go right ahead.\u003c/p>\n\u003cp>But if you're past the six-month window, under federal law, insurers are required to sell you a plan only in certain circumstances — such as if you lose your retiree coverage or Medicare Advantage plan. If you don't meet the criteria, insurers can decline to cover you or charge you more for preexisting medical conditions.\u003c/p>\n\u003cp>Many states have provided more robust protections, however. Three states — Connecticut, Massachusetts and New York — have year-round open enrollment and require insurers to offer coverage. And Maine requires a one-month \"guaranteed issue\" open-enrollment period every year.\u003c/p>\n\u003cp>Some states guarantee current policyholders a chance to switch Medigap plans at certain points during the year. Other states have \u003ca href=\"https://www.kff.org/medicare/issue-brief/medigap-enrollment-and-consumer-protections-vary-across-states/\" target=\"_blank\" rel=\"noopener\">additional qualifying events\u003c/a> that allow people to switch Medigap plans, according to data from the Kaiser Family Foundation.\u003c/p>\n\u003cp>\"The first thing the person should do is check with her state insurance department to find out her rights related to buying a Medigap plan,\" says \u003ca href=\"https://www.ncoa.org/centerforbenefits/about-the-center/\" target=\"_blank\" rel=\"noopener\">Brandy Bauer\u003c/a>, associate director at the Center for Benefits Access at the National Council on Aging. If you decide to go ahead and switch, she says, it is wise to sign up for a new plan before terminating your current policy.[contextly_sidebar id=\"t6VA7YIl0My5E1I6mIhIw1XmFGiwNdrT\"]\u003c/p>\n\u003cp>\u003cstrong>Q: I did not enroll in Medicare Part B when I turned 65 because I already have a regular plan that covers everything. I was told that the insurer would keep paying as usual, but now the company says it will pay only part and that I have to buy Medicare Part B. I didn't want to pay for two policies. Is there anything I can do to avoid that?\u003c/strong>\u003c/p>\n\u003cp>From your description, it's hard to know exactly what's going on, but we can make educated guesses. Typically, when people turn 65, it makes sense to sign up for Medicare unless they or their spouse are working and getting health insurance from an employer. For others, at age 65, Medicare typically becomes their primary insurer and any other coverage they have becomes secondary, filling in gaps in Medicare coverage.\u003c/p>\n\u003cp>If you have an individual policy that you bought on the health insurance exchange, and decide to hang on to it instead of signing up for Medicare, your premiums and other costs could be higher than they would be on Medicare, depending on your income.\u003c/p>\n\u003cp>But if you're not receiving employee coverage and you don't enroll in Medicare Part B, you could be subject to a permanent \u003ca href=\"https://www.medicare.gov/your-medicare-costs/part-b-costs/penalty/part-b-late-enrollment-penalty.html\" target=\"_blank\" rel=\"noopener\">late enrollment penalty\u003c/a> of 10 percent of the policy's premium for every 12 months that you could have signed up for Part B but didn't.\u003c/p>\n\u003cp>You could also owe a premium penalty for not signing up for a Part D prescription drug plan. (Most people don't owe any premium for Medicare Part A, so there's no penalty for late sign-up.)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Your best move now may be to call 800-Medicare or visit your local \u003ca href=\"https://www.medicare.gov/contacts/#resources/ships\" target=\"_blank\" rel=\"noopener\">state health insurance assistance program\u003c/a> to help sort out your coverage issues, including whether to drop your current coverage and sign up for Medicare Part B and Part D.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Genetic+Tests+Can+Hurt+Your+Chances+Of+Getting+Some+Types+Of+Insurance&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Federal law keeps insurers from using genetic test results when pricing and issuing health insurance. But the tests might keep you from being able to get life insurance or a long-term-care policy.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Taking a genetic test in your 20s or 30s could, indeed, affect your ability to get long-term-care insurance later — or at least the price you'll pay. And people who are considering enrolling in Medicare \u003cem>after\u003c/em> age 65 would do well to read the fine print of the sign-up rules. Readers have insurance questions on these topics this month, and we have answers:\u003c/p>\n\u003cp>\u003cstrong>Q: Can getting a genetic test interfere with being able to buy long-term-care insurance in the future? If you do get a plan, can the insurer drop you after you find out the results of a genetic test?\u003c/strong>\u003c/p>\n\u003cp>In general, long-term-care insurers \u003ca href=\"https://www.npr.org/sections/health-shots/2018/07/11/627287642/has-genetic-privacy-been-strained-by-trumps-recent-aca-moves\" target=\"_blank\" rel=\"noopener\">can indeed use genetic test results\u003c/a> when they decide whether to offer you coverage. The federal Genetic Information Nondiscrimination Act does prohibit insurers from asking for or using your genetic information to make decisions about whether to sell you \u003cem>health\u003c/em> insurance or how much to charge you. But those privacy protections don't apply to long-term-care policies, life insurance or disability insurance.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>When you apply for a long-term-care policy, the insurer is permitted to review your medical records and ask you questions about your health history and that of your family. It's all part of the underwriting process to determine whether to offer you a policy and how much to charge.\u003c/p>\n\u003cp>If the insurer asks you whether you've undergone genetic testing, you generally must disclose it, even if the testing was performed through a direct-to-consumer site like 23andMe, says Catherine Theroux, a spokeswoman for \u003ca href=\"https://www.limra.com/News_Center/\" target=\"_blank\" rel=\"noopener\">LIMRA\u003c/a>, an insurance industry trade group.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"You need to release any medically relevant information,\" she says.\u003c/p>\n\u003cp>Some states provide extra consumer protections related to genetic testing and long-term-care insurance, says \u003ca href=\"https://www.law.gwu.edu/sonia-m-suter\" target=\"_blank\" rel=\"noopener\">Sonia Mateu Suter\u003c/a>, a law professor at George Washington University who specializes in genetics and the law. But most follow federal law.\u003c/p>\n\u003cp>If you get genetic testing after you have a policy, the results can't affect your coverage.\u003c/p>\n\u003cp>\"Once the policy has been underwritten and issued, the insurer doesn't revoke the policy if new medical information comes to light,\" Theroux says.\u003c/p>\n\u003cp>\u003cstrong>Q: Can I switch Medigap insurance companies midway through the year? I found a less expensive policy.\u003c/strong>\u003c/p>\n\u003cp>It depends. Under federal law, when people turn 65 and first enroll in Medicare Part B they have a six-month window to sign up for a \u003ca href=\"https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html\" target=\"_blank\" rel=\"noopener\">Medigap plan\u003c/a> — a commercial policy that picks up some of the out-of-pocket costs for services that Medicare doesn't cover. (\u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-a/what-part-a-covers.html\" target=\"_blank\" rel=\"noopener\">Medicare Part A covers\u003c/a> hospitalization, and \u003ca href=\"https://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html\" target=\"_blank\" rel=\"noopener\">Medicare Part B covers\u003c/a> outpatient services.) During that six-month period, insurers have to accept enrollees, even if they have health problems.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>If you're still within that six-month period now and you want to switch plans, go right ahead.\u003c/p>\n\u003cp>But if you're past the six-month window, under federal law, insurers are required to sell you a plan only in certain circumstances — such as if you lose your retiree coverage or Medicare Advantage plan. If you don't meet the criteria, insurers can decline to cover you or charge you more for preexisting medical conditions.\u003c/p>\n\u003cp>Many states have provided more robust protections, however. Three states — Connecticut, Massachusetts and New York — have year-round open enrollment and require insurers to offer coverage. And Maine requires a one-month \"guaranteed issue\" open-enrollment period every year.\u003c/p>\n\u003cp>Some states guarantee current policyholders a chance to switch Medigap plans at certain points during the year. Other states have \u003ca href=\"https://www.kff.org/medicare/issue-brief/medigap-enrollment-and-consumer-protections-vary-across-states/\" target=\"_blank\" rel=\"noopener\">additional qualifying events\u003c/a> that allow people to switch Medigap plans, according to data from the Kaiser Family Foundation.\u003c/p>\n\u003cp>\"The first thing the person should do is check with her state insurance department to find out her rights related to buying a Medigap plan,\" says \u003ca href=\"https://www.ncoa.org/centerforbenefits/about-the-center/\" target=\"_blank\" rel=\"noopener\">Brandy Bauer\u003c/a>, associate director at the Center for Benefits Access at the National Council on Aging. If you decide to go ahead and switch, she says, it is wise to sign up for a new plan before terminating your current policy.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Q: I did not enroll in Medicare Part B when I turned 65 because I already have a regular plan that covers everything. I was told that the insurer would keep paying as usual, but now the company says it will pay only part and that I have to buy Medicare Part B. I didn't want to pay for two policies. Is there anything I can do to avoid that?\u003c/strong>\u003c/p>\n\u003cp>From your description, it's hard to know exactly what's going on, but we can make educated guesses. Typically, when people turn 65, it makes sense to sign up for Medicare unless they or their spouse are working and getting health insurance from an employer. For others, at age 65, Medicare typically becomes their primary insurer and any other coverage they have becomes secondary, filling in gaps in Medicare coverage.\u003c/p>\n\u003cp>If you have an individual policy that you bought on the health insurance exchange, and decide to hang on to it instead of signing up for Medicare, your premiums and other costs could be higher than they would be on Medicare, depending on your income.\u003c/p>\n\u003cp>But if you're not receiving employee coverage and you don't enroll in Medicare Part B, you could be subject to a permanent \u003ca href=\"https://www.medicare.gov/your-medicare-costs/part-b-costs/penalty/part-b-late-enrollment-penalty.html\" target=\"_blank\" rel=\"noopener\">late enrollment penalty\u003c/a> of 10 percent of the policy's premium for every 12 months that you could have signed up for Part B but didn't.\u003c/p>\n\u003cp>You could also owe a premium penalty for not signing up for a Part D prescription drug plan. (Most people don't owe any premium for Medicare Part A, so there's no penalty for late sign-up.)\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Your best move now may be to call 800-Medicare or visit your local \u003ca href=\"https://www.medicare.gov/contacts/#resources/ships\" target=\"_blank\" rel=\"noopener\">state health insurance assistance program\u003c/a> to help sort out your coverage issues, including whether to drop your current coverage and sign up for Medicare Part B and Part D.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Genetic+Tests+Can+Hurt+Your+Chances+Of+Getting+Some+Types+Of+Insurance&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Women Survive Heart Attack More Often When Doctor is Female, Study Finds",
"title": "Women Survive Heart Attack More Often When Doctor is Female, Study Finds",
"headTitle": "Women’s Health | KQED Future of You | KQED Science",
"content": "\u003cp>Much like shoes or skinny jeans, heart attacks can fit women a little differently than men. Their symptoms don’t always look the same, and for a meshwork of reasons, physicians all too often fail to diagnose heart attacks in women with enough time to intervene.\u003c/p>\n\u003cp>The consequence: Women are more likely to die from heart attacks than men are. But, according to a new study, not if they’re treated by female doctors.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.pnas.org/cgi/doi/10.1073/pnas.1800097115\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, published Monday in Proceedings of the National Academy of Sciences, found that female patients are two to three times more likely to survive a heart attack when the doctor overseeing their care is also a woman. But the difference diminished when male doctors worked in emergency rooms with a higher percentage of female physicians.\u003c/p>\n\u003cp>In fact, both men and women suffering heart attacks fared better when treated by female doctors or when treated by men working alongside more female clinicians, the authors reported.\u003c/p>\n\u003cp>These findings raise an unavoidable question: Are women better doctors? And, does rubbing elbows with women physicians help men become better clinicians? The answers are more convoluted than the questions.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Previous research has found better outcomes among hospitalized Medicare patients treated by women, but the underlying reasons remain murky at best.\u003c/p>\n\u003cp>“It’s important to not get caught up in the idea that women are better doctors,” said Dr. Klea Bertakis, a physician and researcher at the University of California, Davis, who studies gender dynamics in health care. “It’s not a men-against-women kind of thing, it’s what are the best practice styles and how can we teach them.”\u003c/p>\n\u003cp>Bertakis pointed to specific practice behaviors – female physicians tend to share more information with patients and to focus more on partnership and patient participation. Male physicians, on the other hand, tend to stick to “the facts,” emphasizing the patient history and physical exam, she said.\u003c/p>\n\u003cp>Dr. Sharonne Hayes, a cardiologist at the Mayo Women’s Heart Clinic, broke down one common explanation for the differences in outcomes for male and female heart attack patients — the symptoms.\u003c/p>\n\u003cp>During a heart attack, women are less likely to experience chest pain, and are more likely to present with nausea and vomiting. But Hayes pointed out that there are more similarities than differences: 30 percent of both men and women won’t experience chest pain, and men can have nausea, too. The symptom hypothesis doesn’t fully explain the different rates of diagnosis and survival.\u003c/p>\n\u003cp>Hayes suggested that part of the problem is that physicians and people in general are “still stuck with some confirmation bias about who gets a heart attack.”\u003c/p>\n\u003cp>The new study, conducted by three business school professors at the University of Minnesota, Washington University in St. Louis, and Harvard, started by looking at whether gender concordance between patients and the attending physicians in the emergency department influenced survival.\u003c/p>\n\u003cp>“There’s relatively deep streams of literature in economics, political science, and sociology that suggest when advocates differ from the people they advocate for, there are often penalties,” said lead author Brad Greenwood of Minnesota’s Carlson School of Management.\u003c/p>\n\u003cp>“Penalties” are business-speak that, when applied in an emergency room, refer to mortality. And “advocacy,” in this case, translates to physician care.\u003c/p>\n\u003cp>Using a census of heart attack patients admitted to Florida hospitals between 1991 and 2010, Greenwood and his colleagues found that when the gender of the patient matched the gender of the physician, both male and female patients were more likely to survive.\u003c/p>\n\u003cp>Looking more closely at the data revealed that female patients treated by male physicians were the least likely to survive a heart attack.\u003c/p>\n\u003cp>The magnitude of the difference impressed Greenwood, but he was not surprised by its existence.\u003c/p>\n\u003cp>Greenwood and his co-authors took their research one step further, studying not only the physicians’ gender, but their environment. They found that patients were more likely to survive heart attacks when treated in emergency departments with higher percentages of female physicians.\u003c/p>\n\u003cp>Greenwood and co-author Seth Carnahan, of Washington University, were both hesitant to speculate about the reasons underlying their observations. Carnahan — who compared the patient-physician relationship to an employee-customer one — acknowledged that, as business professors, he and his colleagues lack the perspective of clinicians.\u003c/p>\n\u003cp>“We have expertise in analyzing data like this and thinking about organizational problems, but we don’t have the firsthand experience and knowledge that doctors have,” he said.\u003c/p>\n\u003cp>Hayes said their statistical analysis went beyond what most doctors could even “conceptualize,” but she and Bertakis expressed some concern over the study’s methods and conclusions. The data, now eight years old, might miss the impact of recent efforts to educate physicians and the public about gender differences in cardiovascular disease.\u003c/p>\n\u003cp>Both physicians also noted that the attending doctor used in the data analysis was likely the physician that discharged the patient — or signed their death certificate — which might not be the same doctor who treated the patient in the emergency room.\u003c/p>\n\u003cp>Bertakis took issue with the the study’s recommendation that one way to improve outcomes would be to increase the number of female physicians in the emergency department.\u003c/p>\n\u003cp>“These approaches are not likely to be feasible,” she said. Instead, she would focus on continuing to improve the curriculum in medical schools and in residency programs to teach physicians about gender differences — both at the patient and physician level — in cardiovascular care.\u003c/p>\n\u003cp>Hayes would like future research to focus on understanding why male physicians who work among more female doctors have better patient survival rates. “Where’s the education coming from? Is it in the hallways and at the watercooler?” she asked. “Or are there policy changes and practice changes?”\u003c/p>\n\u003cp>The new study is a launchpad to address these questions, she said: “Understanding differences in how we need to care for men and women — particularly with heart disease, but for many other conditions — is something we should all be teaching our medical students, and learning, and incorporating in our daily practice.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/08/06/heart-attacks-women-female-doctors/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Much like shoes or skinny jeans, heart attacks can fit women a little differently than men. Their symptoms don’t always look the same, and for a meshwork of reasons, physicians all too often fail to diagnose heart attacks in women with enough time to intervene.\u003c/p>\n\u003cp>The consequence: Women are more likely to die from heart attacks than men are. But, according to a new study, not if they’re treated by female doctors.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.pnas.org/cgi/doi/10.1073/pnas.1800097115\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, published Monday in Proceedings of the National Academy of Sciences, found that female patients are two to three times more likely to survive a heart attack when the doctor overseeing their care is also a woman. But the difference diminished when male doctors worked in emergency rooms with a higher percentage of female physicians.\u003c/p>\n\u003cp>In fact, both men and women suffering heart attacks fared better when treated by female doctors or when treated by men working alongside more female clinicians, the authors reported.\u003c/p>\n\u003cp>These findings raise an unavoidable question: Are women better doctors? And, does rubbing elbows with women physicians help men become better clinicians? The answers are more convoluted than the questions.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Previous research has found better outcomes among hospitalized Medicare patients treated by women, but the underlying reasons remain murky at best.\u003c/p>\n\u003cp>“It’s important to not get caught up in the idea that women are better doctors,” said Dr. Klea Bertakis, a physician and researcher at the University of California, Davis, who studies gender dynamics in health care. “It’s not a men-against-women kind of thing, it’s what are the best practice styles and how can we teach them.”\u003c/p>\n\u003cp>Bertakis pointed to specific practice behaviors – female physicians tend to share more information with patients and to focus more on partnership and patient participation. Male physicians, on the other hand, tend to stick to “the facts,” emphasizing the patient history and physical exam, she said.\u003c/p>\n\u003cp>Dr. Sharonne Hayes, a cardiologist at the Mayo Women’s Heart Clinic, broke down one common explanation for the differences in outcomes for male and female heart attack patients — the symptoms.\u003c/p>\n\u003cp>During a heart attack, women are less likely to experience chest pain, and are more likely to present with nausea and vomiting. But Hayes pointed out that there are more similarities than differences: 30 percent of both men and women won’t experience chest pain, and men can have nausea, too. The symptom hypothesis doesn’t fully explain the different rates of diagnosis and survival.\u003c/p>\n\u003cp>Hayes suggested that part of the problem is that physicians and people in general are “still stuck with some confirmation bias about who gets a heart attack.”\u003c/p>\n\u003cp>The new study, conducted by three business school professors at the University of Minnesota, Washington University in St. Louis, and Harvard, started by looking at whether gender concordance between patients and the attending physicians in the emergency department influenced survival.\u003c/p>\n\u003cp>“There’s relatively deep streams of literature in economics, political science, and sociology that suggest when advocates differ from the people they advocate for, there are often penalties,” said lead author Brad Greenwood of Minnesota’s Carlson School of Management.\u003c/p>\n\u003cp>“Penalties” are business-speak that, when applied in an emergency room, refer to mortality. And “advocacy,” in this case, translates to physician care.\u003c/p>\n\u003cp>Using a census of heart attack patients admitted to Florida hospitals between 1991 and 2010, Greenwood and his colleagues found that when the gender of the patient matched the gender of the physician, both male and female patients were more likely to survive.\u003c/p>\n\u003cp>Looking more closely at the data revealed that female patients treated by male physicians were the least likely to survive a heart attack.\u003c/p>\n\u003cp>The magnitude of the difference impressed Greenwood, but he was not surprised by its existence.\u003c/p>\n\u003cp>Greenwood and his co-authors took their research one step further, studying not only the physicians’ gender, but their environment. They found that patients were more likely to survive heart attacks when treated in emergency departments with higher percentages of female physicians.\u003c/p>\n\u003cp>Greenwood and co-author Seth Carnahan, of Washington University, were both hesitant to speculate about the reasons underlying their observations. Carnahan — who compared the patient-physician relationship to an employee-customer one — acknowledged that, as business professors, he and his colleagues lack the perspective of clinicians.\u003c/p>\n\u003cp>“We have expertise in analyzing data like this and thinking about organizational problems, but we don’t have the firsthand experience and knowledge that doctors have,” he said.\u003c/p>\n\u003cp>Hayes said their statistical analysis went beyond what most doctors could even “conceptualize,” but she and Bertakis expressed some concern over the study’s methods and conclusions. The data, now eight years old, might miss the impact of recent efforts to educate physicians and the public about gender differences in cardiovascular disease.\u003c/p>\n\u003cp>Both physicians also noted that the attending doctor used in the data analysis was likely the physician that discharged the patient — or signed their death certificate — which might not be the same doctor who treated the patient in the emergency room.\u003c/p>\n\u003cp>Bertakis took issue with the the study’s recommendation that one way to improve outcomes would be to increase the number of female physicians in the emergency department.\u003c/p>\n\u003cp>“These approaches are not likely to be feasible,” she said. Instead, she would focus on continuing to improve the curriculum in medical schools and in residency programs to teach physicians about gender differences — both at the patient and physician level — in cardiovascular care.\u003c/p>\n\u003cp>Hayes would like future research to focus on understanding why male physicians who work among more female doctors have better patient survival rates. “Where’s the education coming from? Is it in the hallways and at the watercooler?” she asked. “Or are there policy changes and practice changes?”\u003c/p>\n\u003cp>The new study is a launchpad to address these questions, she said: “Understanding differences in how we need to care for men and women — particularly with heart disease, but for many other conditions — is something we should all be teaching our medical students, and learning, and incorporating in our daily practice.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/08/06/heart-attacks-women-female-doctors/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Calls to Suicide Prevention Lifeline Surge Amid Under-Resourced Centers",
"title": "Calls to Suicide Prevention Lifeline Surge Amid Under-Resourced Centers",
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"content": "\u003cp>On the day of Anthony Bourdain’s death by suicide, calls to Community Crisis Services, Inc. (CCSI), a crisis center that answers calls to the National Suicide Prevention Lifeline, went up 500 percent. Across the country, counselors scrambled to field the spike in calls. Tim Jansen, the center’s executive director, brought in extra staff and answered calls himself. It wasn’t enough.\u003c/p>\n\u003cp>In the half hour it took Jansen to drive home, he heard the Lifeline number announced seven times on the radio. He checked his phone, watching as calls at the center queued up, knowing that after a long day, he “wasn’t in the mental place to be able to dial in and help them.”\u003c/p>\n\u003cp>On July 23, the House passed the National Suicide Hotline Improvement Act, which seeks to evaluate the effectiveness of the Lifeline and the feasibility of implementing a 3-digit dialing code like 911, a number that could be easier to remember than the current 10-digit number. But some local crisis center directors that field Lifeline calls and advocates say this could place more pressure on an overwhelmed and underfunded network.\u003c/p>\n\u003cp>Now, the bill sits on President Donald Trump’s desk, awaiting action.\u003c/p>\n\u003cp>Already, calls to the Lifeline are on the rise. Over the next four years, the Lifeline expects 12 million calls, the same number of calls it previously received for the 12-year period between 2005 and 2017.\u003c/p>\n\u003cfigure id=\"attachment_1928764\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928764\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/20180802_175639-1-1200x900-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Community Crisis Services, Inc. in Hyattsville, Maryland, is a backup center for the National Suicide Prevention Lifeline.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Local Crisis Centers on the Front Lines\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>CCSI is housed in an unassuming, one-story orange brick and glass building. Tucked behind slightly overgrown, dark green shrubbery at the end of a peaceful residential block in Hyattsville, Maryland, CCSI acts as one of more than 150 local crisis centers across the country that answers calls from the Lifeline.\u003c/p>\n\u003cp>The building’s quiet exterior belies the activity inside. In the main “bullpen,” as Jansen calls it, overlapping conversations from counselors fill the room as they type rapidly, and with a quiet urgency, into call reports on their dual-monitor desktop computers. Occasionally, a single voice rises above the others, punctuating the regulated hum and rhythm of the room.\u003c/p>\n\u003cp>“You know, somebody who’s never been in that position, somebody who’s never struggled with their mental health might not be able to understand when you say ‘I’m frustrated and I know I’m taking it out on you, but it’s not your fault,’” a counselor says.\u003c/p>\n\u003cfigure id=\"attachment_1928763\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928763\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/20180802_162115-1-1200x900-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Counselors answer calls at Community Crisis Services, Inc. in Hyattsville, Maryland.\u003c/figcaption>\u003c/figure>\n\u003cp>Colorful cork boards refer to homeless shelters and bear prominently displayed phone numbers for social services. A plastic Mickey Mouse phone and an early 20th century rotary wall phone decorate a window that looks out onto the side of the tidy, gray stone house next to the center.\u003c/p>\n\u003cp>A counselor sits at her desk, recommending to a caller ways to cope in moments of crisis: snapping a rubber band, drawing on your legs, listening to music. She shares her own struggles with anxiety. “If I’m out in a public space, and I just get overwhelmed, I just kind of find somewhere I can sit down and write.”\u003c/p>\n\u003cp>Sometimes ripping up that writing and throwing it away can serve as “another release of ‘this is me throwing away my anxieties’ or those inspirational things you hear all the time,” she tells the caller with a chuckle.\u003c/p>\n\u003cp>Another counselor starting her shift places her Frappuccino on her desk, puts on a bright pink headset, and begins talking to a caller. “It’s okay to struggle, you’re human,” she says.\u003c/p>\n\u003cp>Counselors at CCSI normally answer around 40-50 calls per shift. Most shifts are eight hours.\u003c/p>\n\u003cp>The camaraderie of the room is palpable. Jansen, who has trained people in crisis intervention for 20 years, circles his staff at work, chatting with one counselor about her upcoming trip to Las Vegas and listening to calls. “It’s so awesome to hear my training words come out of people’s mouths,” he says.\u003c/p>\n\u003cfigure id=\"attachment_1928762\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928762\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/IMG_9433-2-1200x783-800x522.jpg\" alt=\"\" width=\"800\" height=\"522\">\u003cfigcaption class=\"wp-caption-text\">Counselors at Community Crisis Services, Inc. take calls.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Current Funding and Lifeline calls\u003c/strong>\u003c/p>\n\u003cp>Some centers, like CCSI, are “national backup centers,” which are meant to handle their local volume of calls along with overflow calls from other centers across the country.\u003c/p>\n\u003cp>The Lifeline receives around $5.3 million a year in an infrastructure grant from the Substance Abuse and Mental Health Services Association (SAMHSA). From that, crisis centers receive an annual stipend of $1,500, and an extra $1,000 if they collect data on veteran calls to their center. Backup centers receive $17,500 quarterly plus $10 for every call over 3,000 they answer through the backup routing system.\u003c/p>\n\u003cp>According to James Wright, the Lifeline project officer for SAMHSA, this amount is mainly meant to offset the costs of accreditation, a process required for operation within the Lifeline network. It assesses if the center is achieving base level practices and standards in their services.\u003c/p>\n\u003cp>The stipend is “more of a gesture,” said Wright. It’s not intended to serve as direct support for centers’ work. “I’ve never heard a single crisis center report back to me and say that $1,500 a month supported the calls being answered,” said Wright.\u003c/p>\n\u003cfigure id=\"attachment_1928761\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928761\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/IMG_9397-1-1200x674-800x449.jpg\" alt=\"\" width=\"800\" height=\"449\">\u003cfigcaption class=\"wp-caption-text\">Suicide prevention information appears on the fridge at Community Crisis Services, Inc.\u003c/figcaption>\u003c/figure>\n\u003cp>To accommodate the rising call volume, Dr. Draper, the director of the Lifeline, says local crisis centers need more resources–and that a lack of resources contributes to centers leaving the network or shutting down. From 2008-2012, nine centers dropped out of the network and from 2013-2017, 23 centers dropped out. Just this year, three centers shut down.\u003c/p>\n\u003cp>Remaining centers do what they can to stay functioning. This often means taking on extra contracts, like running local crisis lines, to support their suicide prevention work.\u003c/p>\n\u003cp>Crisis Call Center, a Lifeline backup center in Nevada, operates a sexual assault support service program and a substance abuse hotline. They also provide child protective service reports and take elder protective service reports after hours. Rachelle Pellissier, its executive director, says they have to “cobble together” these different funding streams to offset the costs of the suicide prevention calls they take.\u003c/p>\n\u003cp>“We really need about $1.1 million to run this organization,” said Pellissier.\u003c/p>\n\u003cp>Centers like Provident in Missouri rely on their local United Way. The money they receive from the Lifeline, even as a backup center with more support, “pays for maybe two salaries of my 15 person team,” said Jane Smith, the director of life crisis services for Provident. “We’re a money-losing entity at Provident.”\u003c/p>\n\u003cp>If backup centers are unable to take a call, that call is routed from one backup center to the next, until a counselor can talk. “All the calls can be answered. The only question is, how long do people wait?” Draper said.\u003c/p>\n\u003cfigure id=\"attachment_1928760\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928760\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/20180802_161929-1-1200x949-800x633.jpg\" alt=\"\" width=\"800\" height=\"633\">\u003cfigcaption class=\"wp-caption-text\">Office supplies sit in an empty room, which will soon become additional space for counselors, at Community Crisis Services, Inc. in Hyattsville, Maryland.\u003c/figcaption>\u003c/figure>\n\u003cp>For January to March of 2018, the average wait time for a caller after the Lifeline’s automated greeting was 36 seconds at a local center and 88 seconds at a backup center. “It’s simply a supply and demand challenge,” Draper said.\u003c/p>\n\u003cp>\u003cstrong>Distance, Low Pay, and Pressure\u003c/strong>\u003c/p>\n\u003cp>Answering calls from all across the nation at backup centers can create barriers to getting help. With no local centers serving Minnesota, for example, all callers in the state are routed to an out-of-state backup center. It’s a solution that both increases the call volume pressure on backup centers and makes it difficult for centers to connect callers to resources in their area.\u003c/p>\n\u003cp>At CCSI, a counselor asks, “Do you have any community centers in your area or anything like that?”\u003c/p>\n\u003cp>In an emergency, it’s often more difficult to initiate an “active rescue” for someone who may be at imminent risk of attempted suicide because of the lack of an established relationship between the center and the out-of-state law enforcement.\u003c/p>\n\u003cp>Sometimes, counselors get this response from police: “‘Well, if they’re going to do it they’re going to need to do it. We’ll hear about it on the news,’” said Jansen. He says those responses typically occur a couple of times a week.\u003c/p>\n\u003cp>The stress of the job and the pay can drive high turnover rates for counselors in some centers. Even taking a day off can make answering calls more difficult for other staff. Counselors often “feel concerned for their fellow staff members” when they’re out of the office because “they know the impact that them not being there is going to cause,” said Victoria Graham, chief program officer at Action in Community Through Service in Dumfries, Virginia.\u003c/p>\n\u003cp>Gene Dobrzynski, the assistant call center director at CCC, sees a direct link between lack of funding and staff turnover. He says with more funding, the center could hire more staff and counselors’ mentality of “I gotta be at my desk because there’s going to be another call coming in” could be eased. “They could get a little bit of relief and be able to walk away,” he said.\u003c/p>\n\u003cp>Low pay for counselors is also a function of funding woes. “Let’s be serious, we’re paying frontline staff $11-12 an hour to do this crisis intervention, this life-and-death work,” said Pellissier.\u003c/p>\n\u003cp>\u003cstrong>In Arizona, Adjusting to Increased Calls\u003c/strong>\u003c/p>\n\u003cp>Not all Lifeline centers feel the same strain: Crisis Response Network in Arizona, for example, receives Medicaid funding and other social service funding from the state.\u003c/p>\n\u003cp>Like other centers, they’ve also seen an increase in calls. In June of 2017, Crisis Response Network and La Frontera Empact, another Arizona-based crisis center, fielded around 2,800 Lifeline calls. This past June, it was more than 4,400 calls. Unlike many other centers, they were able to increase their staffing to adjust to the increase in calls. At the busiest part of its day, Crisis Response Network might have 30 people on the phones.\u003c/p>\n\u003cp>Crisis Response Network also has “compassion rooms” where staff can go “to decompress after a tough call,” said Alex Zavala, its chief experience officer. Ocean noises play in the background and staff are encouraged to take a break or meditate.\u003c/p>\n\u003cp>The difference between Crisis Response Network and Crisis Call Center is stark. At Crisis Call Center, they can’t afford to replace the constantly-used chairs in their office when they wear down or clean their bathrooms as much as they’d like.\u003c/p>\n\u003cp>The numbers reveal Crisis Response Network’s success. Based on numbers collected from June 2017 to June 2018, less than 1 percent of callers hang up or lose their call before a counselor answers them. The center attributes this to its “consistent and stable” funding that allows for effective staffing with changing call volume, said Sarah Schol, the senior director of contact center operations.\u003c/p>\n\u003cfigure id=\"attachment_1928759\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928759\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/IMG_9315-1-1200x800-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\">\u003cfigcaption class=\"wp-caption-text\">An award sits on a display case at Community Crisis Services, Inc. in Hyattsville, Maryland.\u003c/figcaption>\u003c/figure>\n\u003cp>Seeking to solve unknowns in suicide prevention\u003cbr>\nThe circumstances of each call center are wide-ranging, and so are reactions to the National Suicide Hotline Improvement Act.\u003c/p>\n\u003cp>The leadership of several centers told the NewsHour Weekend that a 3-digit number for the Lifeline would probably allow people to more easily access the help that they need. But the accessibility is a double-edged sword for centers like Crisis Call Center–they want more callers to have access to the Lifeline, but “do not have enough capacity to take the increase in calls,” said Pellissier.\u003c/p>\n\u003cp>Draper says “it’s a fair presumption that [a 3-digit number] would increase calls, we just don’t know by how much.” But not everyone agrees that a 3-digit number would mean a greater volume of calls. Graham says that she couldn’t predict that, while Crisis Response Network believes an increase in call volume is possible, it doesn’t see a change to a 3-digit number impacting their day-to-day operations.\u003c/p>\n\u003cp>The bill’s lead House sponsor, Rep. Chris Stewart (R-UT), told the NewsHour Weekend that the legislation seeks to “increase awareness of resources and save lives,” and co-sponsor Rep. Eddie Bernice Johnson (D-TX) added that “ease” in access is critical. Sen. Joe Donnelly (D-IN), who co-sponsored the bill in the Senate, believes the legislation will examine if there’s a “simpler way” to “help in moments of crisis,” according to his office. Sen. Orrin Hatch (R-UT) did not respond to request for comment via email.\u003c/p>\n\u003cp>John Madigan, the Senior Vice President of Public Policy for the American Foundation for Suicide Prevention, said he hopes the bill’s study will answer “the million dollar question” of the current suicide prevention network’s reach and “holes” in the system.\u003c/p>\n\u003cfigure id=\"attachment_1928758\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928758\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/IMG_9376-1-1200x765-800x510.jpg\" alt=\"\" width=\"800\" height=\"510\">\u003cfigcaption class=\"wp-caption-text\">Tim Jansen sits at his desk at Community Crisis Services, Inc. in Hyattsville, Maryland.\u003c/figcaption>\u003c/figure>\n\u003cp>Meanwhile, local crisis centers will continue to draw people who feel called to act and those who need to call.\u003c/p>\n\u003cp>Jansen entered the world of suicide prevention when he was 25 years old, after coming out as gay. He felt “fortunate” not to “lose people in [his] life.”\u003c/p>\n\u003cp>“I started thinking, ‘Gosh what happens when folks don’t have somebody?’” he said. Then, he saw an ad for crisis counselors. A few weeks later, he was a volunteer. Now, he’s spent 13 years as executive director at CCSI, which also takes backup calls for the Trevor Project, an organization that helps LGBTQ people in crisis.\u003c/p>\n\u003cp>Sometimes, on those calls, Jansen tells callers what it was like for him to come out–the fear he felt and the unexpected acceptance he found.\u003c/p>\n\u003cp>“I think when somebody needs to hear that you can actually come to the other side of it, hearing that somebody has done that can be powerful,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>If you are having thoughts of suicide, go to SpeakingOfSuicide.com/resources or call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>On the day of Anthony Bourdain’s death by suicide, calls to Community Crisis Services, Inc. (CCSI), a crisis center that answers calls to the National Suicide Prevention Lifeline, went up 500 percent. Across the country, counselors scrambled to field the spike in calls. Tim Jansen, the center’s executive director, brought in extra staff and answered calls himself. It wasn’t enough.\u003c/p>\n\u003cp>In the half hour it took Jansen to drive home, he heard the Lifeline number announced seven times on the radio. He checked his phone, watching as calls at the center queued up, knowing that after a long day, he “wasn’t in the mental place to be able to dial in and help them.”\u003c/p>\n\u003cp>On July 23, the House passed the National Suicide Hotline Improvement Act, which seeks to evaluate the effectiveness of the Lifeline and the feasibility of implementing a 3-digit dialing code like 911, a number that could be easier to remember than the current 10-digit number. But some local crisis center directors that field Lifeline calls and advocates say this could place more pressure on an overwhelmed and underfunded network.\u003c/p>\n\u003cp>Now, the bill sits on President Donald Trump’s desk, awaiting action.\u003c/p>\n\u003cp>Already, calls to the Lifeline are on the rise. Over the next four years, the Lifeline expects 12 million calls, the same number of calls it previously received for the 12-year period between 2005 and 2017.\u003c/p>\n\u003cfigure id=\"attachment_1928764\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928764\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/20180802_175639-1-1200x900-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Community Crisis Services, Inc. in Hyattsville, Maryland, is a backup center for the National Suicide Prevention Lifeline.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Local Crisis Centers on the Front Lines\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>CCSI is housed in an unassuming, one-story orange brick and glass building. Tucked behind slightly overgrown, dark green shrubbery at the end of a peaceful residential block in Hyattsville, Maryland, CCSI acts as one of more than 150 local crisis centers across the country that answers calls from the Lifeline.\u003c/p>\n\u003cp>The building’s quiet exterior belies the activity inside. In the main “bullpen,” as Jansen calls it, overlapping conversations from counselors fill the room as they type rapidly, and with a quiet urgency, into call reports on their dual-monitor desktop computers. Occasionally, a single voice rises above the others, punctuating the regulated hum and rhythm of the room.\u003c/p>\n\u003cp>“You know, somebody who’s never been in that position, somebody who’s never struggled with their mental health might not be able to understand when you say ‘I’m frustrated and I know I’m taking it out on you, but it’s not your fault,’” a counselor says.\u003c/p>\n\u003cfigure id=\"attachment_1928763\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928763\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/20180802_162115-1-1200x900-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">Counselors answer calls at Community Crisis Services, Inc. in Hyattsville, Maryland.\u003c/figcaption>\u003c/figure>\n\u003cp>Colorful cork boards refer to homeless shelters and bear prominently displayed phone numbers for social services. A plastic Mickey Mouse phone and an early 20th century rotary wall phone decorate a window that looks out onto the side of the tidy, gray stone house next to the center.\u003c/p>\n\u003cp>A counselor sits at her desk, recommending to a caller ways to cope in moments of crisis: snapping a rubber band, drawing on your legs, listening to music. She shares her own struggles with anxiety. “If I’m out in a public space, and I just get overwhelmed, I just kind of find somewhere I can sit down and write.”\u003c/p>\n\u003cp>Sometimes ripping up that writing and throwing it away can serve as “another release of ‘this is me throwing away my anxieties’ or those inspirational things you hear all the time,” she tells the caller with a chuckle.\u003c/p>\n\u003cp>Another counselor starting her shift places her Frappuccino on her desk, puts on a bright pink headset, and begins talking to a caller. “It’s okay to struggle, you’re human,” she says.\u003c/p>\n\u003cp>Counselors at CCSI normally answer around 40-50 calls per shift. Most shifts are eight hours.\u003c/p>\n\u003cp>The camaraderie of the room is palpable. Jansen, who has trained people in crisis intervention for 20 years, circles his staff at work, chatting with one counselor about her upcoming trip to Las Vegas and listening to calls. “It’s so awesome to hear my training words come out of people’s mouths,” he says.\u003c/p>\n\u003cfigure id=\"attachment_1928762\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928762\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/IMG_9433-2-1200x783-800x522.jpg\" alt=\"\" width=\"800\" height=\"522\">\u003cfigcaption class=\"wp-caption-text\">Counselors at Community Crisis Services, Inc. take calls.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Current Funding and Lifeline calls\u003c/strong>\u003c/p>\n\u003cp>Some centers, like CCSI, are “national backup centers,” which are meant to handle their local volume of calls along with overflow calls from other centers across the country.\u003c/p>\n\u003cp>The Lifeline receives around $5.3 million a year in an infrastructure grant from the Substance Abuse and Mental Health Services Association (SAMHSA). From that, crisis centers receive an annual stipend of $1,500, and an extra $1,000 if they collect data on veteran calls to their center. Backup centers receive $17,500 quarterly plus $10 for every call over 3,000 they answer through the backup routing system.\u003c/p>\n\u003cp>According to James Wright, the Lifeline project officer for SAMHSA, this amount is mainly meant to offset the costs of accreditation, a process required for operation within the Lifeline network. It assesses if the center is achieving base level practices and standards in their services.\u003c/p>\n\u003cp>The stipend is “more of a gesture,” said Wright. It’s not intended to serve as direct support for centers’ work. “I’ve never heard a single crisis center report back to me and say that $1,500 a month supported the calls being answered,” said Wright.\u003c/p>\n\u003cfigure id=\"attachment_1928761\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928761\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/IMG_9397-1-1200x674-800x449.jpg\" alt=\"\" width=\"800\" height=\"449\">\u003cfigcaption class=\"wp-caption-text\">Suicide prevention information appears on the fridge at Community Crisis Services, Inc.\u003c/figcaption>\u003c/figure>\n\u003cp>To accommodate the rising call volume, Dr. Draper, the director of the Lifeline, says local crisis centers need more resources–and that a lack of resources contributes to centers leaving the network or shutting down. From 2008-2012, nine centers dropped out of the network and from 2013-2017, 23 centers dropped out. Just this year, three centers shut down.\u003c/p>\n\u003cp>Remaining centers do what they can to stay functioning. This often means taking on extra contracts, like running local crisis lines, to support their suicide prevention work.\u003c/p>\n\u003cp>Crisis Call Center, a Lifeline backup center in Nevada, operates a sexual assault support service program and a substance abuse hotline. They also provide child protective service reports and take elder protective service reports after hours. Rachelle Pellissier, its executive director, says they have to “cobble together” these different funding streams to offset the costs of the suicide prevention calls they take.\u003c/p>\n\u003cp>“We really need about $1.1 million to run this organization,” said Pellissier.\u003c/p>\n\u003cp>Centers like Provident in Missouri rely on their local United Way. The money they receive from the Lifeline, even as a backup center with more support, “pays for maybe two salaries of my 15 person team,” said Jane Smith, the director of life crisis services for Provident. “We’re a money-losing entity at Provident.”\u003c/p>\n\u003cp>If backup centers are unable to take a call, that call is routed from one backup center to the next, until a counselor can talk. “All the calls can be answered. The only question is, how long do people wait?” Draper said.\u003c/p>\n\u003cfigure id=\"attachment_1928760\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928760\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/20180802_161929-1-1200x949-800x633.jpg\" alt=\"\" width=\"800\" height=\"633\">\u003cfigcaption class=\"wp-caption-text\">Office supplies sit in an empty room, which will soon become additional space for counselors, at Community Crisis Services, Inc. in Hyattsville, Maryland.\u003c/figcaption>\u003c/figure>\n\u003cp>For January to March of 2018, the average wait time for a caller after the Lifeline’s automated greeting was 36 seconds at a local center and 88 seconds at a backup center. “It’s simply a supply and demand challenge,” Draper said.\u003c/p>\n\u003cp>\u003cstrong>Distance, Low Pay, and Pressure\u003c/strong>\u003c/p>\n\u003cp>Answering calls from all across the nation at backup centers can create barriers to getting help. With no local centers serving Minnesota, for example, all callers in the state are routed to an out-of-state backup center. It’s a solution that both increases the call volume pressure on backup centers and makes it difficult for centers to connect callers to resources in their area.\u003c/p>\n\u003cp>At CCSI, a counselor asks, “Do you have any community centers in your area or anything like that?”\u003c/p>\n\u003cp>In an emergency, it’s often more difficult to initiate an “active rescue” for someone who may be at imminent risk of attempted suicide because of the lack of an established relationship between the center and the out-of-state law enforcement.\u003c/p>\n\u003cp>Sometimes, counselors get this response from police: “‘Well, if they’re going to do it they’re going to need to do it. We’ll hear about it on the news,’” said Jansen. He says those responses typically occur a couple of times a week.\u003c/p>\n\u003cp>The stress of the job and the pay can drive high turnover rates for counselors in some centers. Even taking a day off can make answering calls more difficult for other staff. Counselors often “feel concerned for their fellow staff members” when they’re out of the office because “they know the impact that them not being there is going to cause,” said Victoria Graham, chief program officer at Action in Community Through Service in Dumfries, Virginia.\u003c/p>\n\u003cp>Gene Dobrzynski, the assistant call center director at CCC, sees a direct link between lack of funding and staff turnover. He says with more funding, the center could hire more staff and counselors’ mentality of “I gotta be at my desk because there’s going to be another call coming in” could be eased. “They could get a little bit of relief and be able to walk away,” he said.\u003c/p>\n\u003cp>Low pay for counselors is also a function of funding woes. “Let’s be serious, we’re paying frontline staff $11-12 an hour to do this crisis intervention, this life-and-death work,” said Pellissier.\u003c/p>\n\u003cp>\u003cstrong>In Arizona, Adjusting to Increased Calls\u003c/strong>\u003c/p>\n\u003cp>Not all Lifeline centers feel the same strain: Crisis Response Network in Arizona, for example, receives Medicaid funding and other social service funding from the state.\u003c/p>\n\u003cp>Like other centers, they’ve also seen an increase in calls. In June of 2017, Crisis Response Network and La Frontera Empact, another Arizona-based crisis center, fielded around 2,800 Lifeline calls. This past June, it was more than 4,400 calls. Unlike many other centers, they were able to increase their staffing to adjust to the increase in calls. At the busiest part of its day, Crisis Response Network might have 30 people on the phones.\u003c/p>\n\u003cp>Crisis Response Network also has “compassion rooms” where staff can go “to decompress after a tough call,” said Alex Zavala, its chief experience officer. Ocean noises play in the background and staff are encouraged to take a break or meditate.\u003c/p>\n\u003cp>The difference between Crisis Response Network and Crisis Call Center is stark. At Crisis Call Center, they can’t afford to replace the constantly-used chairs in their office when they wear down or clean their bathrooms as much as they’d like.\u003c/p>\n\u003cp>The numbers reveal Crisis Response Network’s success. Based on numbers collected from June 2017 to June 2018, less than 1 percent of callers hang up or lose their call before a counselor answers them. The center attributes this to its “consistent and stable” funding that allows for effective staffing with changing call volume, said Sarah Schol, the senior director of contact center operations.\u003c/p>\n\u003cfigure id=\"attachment_1928759\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928759\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/IMG_9315-1-1200x800-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\">\u003cfigcaption class=\"wp-caption-text\">An award sits on a display case at Community Crisis Services, Inc. in Hyattsville, Maryland.\u003c/figcaption>\u003c/figure>\n\u003cp>Seeking to solve unknowns in suicide prevention\u003cbr>\nThe circumstances of each call center are wide-ranging, and so are reactions to the National Suicide Hotline Improvement Act.\u003c/p>\n\u003cp>The leadership of several centers told the NewsHour Weekend that a 3-digit number for the Lifeline would probably allow people to more easily access the help that they need. But the accessibility is a double-edged sword for centers like Crisis Call Center–they want more callers to have access to the Lifeline, but “do not have enough capacity to take the increase in calls,” said Pellissier.\u003c/p>\n\u003cp>Draper says “it’s a fair presumption that [a 3-digit number] would increase calls, we just don’t know by how much.” But not everyone agrees that a 3-digit number would mean a greater volume of calls. Graham says that she couldn’t predict that, while Crisis Response Network believes an increase in call volume is possible, it doesn’t see a change to a 3-digit number impacting their day-to-day operations.\u003c/p>\n\u003cp>The bill’s lead House sponsor, Rep. Chris Stewart (R-UT), told the NewsHour Weekend that the legislation seeks to “increase awareness of resources and save lives,” and co-sponsor Rep. Eddie Bernice Johnson (D-TX) added that “ease” in access is critical. Sen. Joe Donnelly (D-IN), who co-sponsored the bill in the Senate, believes the legislation will examine if there’s a “simpler way” to “help in moments of crisis,” according to his office. Sen. Orrin Hatch (R-UT) did not respond to request for comment via email.\u003c/p>\n\u003cp>John Madigan, the Senior Vice President of Public Policy for the American Foundation for Suicide Prevention, said he hopes the bill’s study will answer “the million dollar question” of the current suicide prevention network’s reach and “holes” in the system.\u003c/p>\n\u003cfigure id=\"attachment_1928758\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-1928758\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2018/08/IMG_9376-1-1200x765-800x510.jpg\" alt=\"\" width=\"800\" height=\"510\">\u003cfigcaption class=\"wp-caption-text\">Tim Jansen sits at his desk at Community Crisis Services, Inc. in Hyattsville, Maryland.\u003c/figcaption>\u003c/figure>\n\u003cp>Meanwhile, local crisis centers will continue to draw people who feel called to act and those who need to call.\u003c/p>\n\u003cp>Jansen entered the world of suicide prevention when he was 25 years old, after coming out as gay. He felt “fortunate” not to “lose people in [his] life.”\u003c/p>\n\u003cp>“I started thinking, ‘Gosh what happens when folks don’t have somebody?’” he said. Then, he saw an ad for crisis counselors. A few weeks later, he was a volunteer. Now, he’s spent 13 years as executive director at CCSI, which also takes backup calls for the Trevor Project, an organization that helps LGBTQ people in crisis.\u003c/p>\n\u003cp>Sometimes, on those calls, Jansen tells callers what it was like for him to come out–the fear he felt and the unexpected acceptance he found.\u003c/p>\n\u003cp>“I think when somebody needs to hear that you can actually come to the other side of it, hearing that somebody has done that can be powerful,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>If you are having thoughts of suicide, go to SpeakingOfSuicide.com/resources or call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK).\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Video: What It's Like to Go Through the Hiroshima Bombing in Virtual Reality",
"headTitle": "Video: What It’s Like to Go Through the Hiroshima Bombing in Virtual Reality | KQED",
"content": "\u003cp>https://www.youtube.com/watch?v=RfXULE7UtpA\u003c/p>\n\u003cp>It’s a sunny summer morning in the city of Hiroshima, Japan. Cicadas chirp in the trees. A lone plane flies high overhead. Then a flash of light, followed by a loud blast. Buildings are flattened and smoke rises from crackling fires under a darkened sky.\u003c/p>\n\u003cp>Over two years, a group of Japanese high school students has been painstakingly producing a five-minute virtual reality experience that recreates the sights and sounds of Hiroshima before, during and after the U.S. dropped an atomic bomb on the city 73 years ago Monday.\u003c/p>\n\u003cdiv id=\"div-gpt-ad-1470255291270-0\" class=\"ad-placeholder\">\n\u003cp>By transporting users back in time to the moment when a city was turned into a wasteland, the students and their teacher hope to ensure that something similar never happens again.\u003c/p>\n\u003cp>The Aug. 6, 1945, bombing of Hiroshima killed 140,000 people. Three days later, a second U.S. atomic bomb killed 70,000 people in Nagasaki. Japan surrendered six days after that, ending World War II.\u003c/p>\n\u003cp>“Even without language, once you see the images, you understand,” said Mei Okada, one of the students working on the project at a technical high school in Fukuyama, a city about 100 kilometers (60 miles) east of Hiroshima. “That is definitely one of the merits of this VR experience.”\u003c/p>\n\u003cp>Wearing virtual reality headsets, users can take a walk along the Motoyasu River prior to the blast and see the businesses and buildings that once stood. They can enter the post office and the Shima Hospital courtyard, where the skeletal remains of a building now known as the Atomic Bomb Dome stand on the river’s banks, a testament to what happened.\u003c/p>\n\u003cp>The students, who belong to the computation skill research club at Fukuyama Technical High School, were born more than half a century after the bombing. Yuhi Nakagawa, 18, said he initially didn’t have much interest in what happened when the bombs were dropped; if anything, it was a topic he had avoided.\u003c/p>\n\u003cp>“When I was creating the buildings before the atomic bomb fell and after, I saw many photos of buildings that were gone. I really felt how scary atomic bombs can be,” he said. “So while creating this scenery, I felt it was really important to share this with others.”\u003c/p>\n\u003cp>To recreate Hiroshima, the students studied old photographs and postcards and interviewed survivors of the bombing to hear their experiences and get their feedback on the VR footage. They used computer graphics software to add further details such as lighting and the natural wear and tear on building surfaces.\u003c/p>\n\u003carticle id=\"contentArea\" class=\" \">\n\u003cdiv class=\"articleBody\">\n\u003cp>“Those who knew the city very well tell us it’s done very well. They say it’s very nostalgic,” said Katsushi Hasegawa, a computer teacher who supervises the club. “Sometimes they start to reminisce about their memories from that time, and it really makes me glad that we created this.”\u003c/p>\n\u003cp>The students are working through summer vacation in a classroom without air conditioning, as temperatures reach 95 degrees Fahrenheit. With the survivors aging, Hasegawa said, it’s a race against time.\u003c/p>\n\u003c/div>\n\u003c/article>\n\u003cdiv id=\"taboolaContainer\" class=\"taboolaContainer\">\n\u003cdiv id=\"taboola-below-article-text-links\">\u003c/div>\n\u003cdiv id=\"taboola-below-article-thumbnails-2nd\" class=\" trc_related_container trc_spotlight_widget\">\u003c/div>\n\u003cdiv id=\"taboola-below-article-thumbnails\" class=\" trc_related_container trc_spotlight_widget tbl-feed-container tbl-feed-full-width\">\n\u003cdiv class=\"tbl-feed-header\">\n\u003cdiv class=\"trc-widget-footer\">\n\u003cdiv class=\"logoDiv link-adc \">\u003ca class=\"trc_desktop_adc_link trc_attribution_position_bottom\" href=\"https://popup.taboola.com/en/?template=colorbox&utm_source=associatedpress-apnews&utm_medium=referral&utm_content=thumbnails-feed-b-stream:Below%20Article%20Thumbnails%20%7C%20Card%202:\" target=\"_blank\" rel=\"nofollow noopener\">\u003cspan class=\"trc_adc_wrapper\"> \u003c/span>\u003cspan class=\"trc_logos_v_align\"> \u003c/span>\u003c/a>\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"excerpt": "Although it’s impossible to relive a moment in history, a group of the students have recreated the moment an atomic bomb dropped over the city through VR to portray the livelihood of people that was taken away as a result of the bombing. ",
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"description": "Although it’s impossible to relive a moment in history, a group of the students have recreated the moment an atomic bomb dropped over the city through VR to portray the livelihood of people that was taken away as a result of the bombing. ",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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},
"rightnowish": {
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"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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