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"content": "\u003cp>Leaders can have many different styles — just compare President Donald Trump to \u003ca href=\"https://www.malala.org/malalas-story\" target=\"_blank\" rel=\"noopener\">Malala Yousafzai\u003c/a> to your boss or the coach of your kid's soccer team.\u003c/p>\n\u003cp>But a \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aat0036\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published Thursday suggests that people who end up in leadership roles of various sorts all share one key trait: Leaders make decisions for a group in the same way that they make decisions for themselves. They don't change their decision-making behavior, even when other people's welfare is at stake.\u003c/p>\n\u003cp>That may come as a bit of surprise, given that most lists of key leadership qualities focus on things like charisma and communication skills.\u003c/p>\n\u003cp>\"Previous research has mostly focused on these kinds of either personality characteristics of a leader, or situations where individuals are likely to lead,\" says \u003ca href=\"https://www.econ.uzh.ch/en/people/researchers/edelson.html\" target=\"_blank\" rel=\"noopener\">Micah Edelson\u003c/a>, a neuroscientist at the University of Zurich in Switzerland. \"But we don't know much about the cognitive or neurobiological process that is happening when you are choosing to lead or follow — when you're faced with this choice to lead or follow.\"\u003c/p>\n\u003cp>He notes that the decisions of leaders can affect the lives of many others. \"It's not always that easy to make such a choice, and it's something that could be even a little bit aversive to you, to make a choice that impacts other people,\" says Edelson. \"And there are some people that seem to be able to do it; some people don't. So we were interested in looking at that.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He and his colleagues had volunteers come to the lab, and gave them questionnaires that are widely used to predict whether someone is likely to be in a position of leadership. They also collected information about people's real-world leadership experience, such as what rank they'd achieved in the military (which is compulsory for men in Switzerland) or in the popular Swiss Scouts organization.\u003c/p>\n\u003cp>Then they put the participants into small groups and had them play a series of games in which individuals had to make choices about whether to take a risky action to get a reward.\u003c/p>\n\u003cp>\"These are choices about uncertain gambles that have some probability of success and potential gains and losses,\" Edelson explains.\u003c/p>\n\u003cp>The player could choose to either make the choice alone, or defer the decision to a majority vote.\u003c/p>\n\u003cp>The games were played under two conditions: Sometimes the decision affected only the individual player's winnings and other times the decision affected what the entire group received.\u003c/p>\n\u003cp>What the researchers found is that people in general tended to avoid taking responsibility for what happens to others; deferral rates were the highest when decisions affected other people's pocketbooks.\u003c/p>\n\u003cp>But the people who changed their decision-making behavior the least were the ones who generally served as leaders in the real-world and scored high on leadership questionnaires. Unlike others, they did not require more certainty before being ready to personally make a decision that would affect the whole group.\u003c/p>\n\u003cp>\"On average, people tend to increase the certainty threshold when the choices affect the entire group. But higher-scoring leaders just keep their thresholds almost constant,\" says Edelson, who says preliminary work using MRI brain scanning supports the idea that leaders and followers differ in how their brains process information about gains, losses, and risk in the context of thinking about others.\u003c/p>\n\u003cp>Other neuroscientists say the work, published in the journal \u003cem>Science\u003c/em>, is fascinating.\u003c/p>\n\u003cp>\"It seems a very reasonable finding,\" says \u003ca href=\"http://affectivebrain.com/?page_id=161\" target=\"_blank\" rel=\"noopener\">Tali Sharot\u003c/a>, a cognitive neuroscientist at University College London. \"It works with our intuition, but in the same way it's not something that you'd necessarily think about that distinguishes leadership.\"\u003c/p>\n\u003cp>Sharot cautions that it's not clear whether this decision-making behavior is what led people to their leadership position, or if they've developed it as a result of real-world leadership experience.\u003c/p>\n\u003cp>And this study doesn't say anything about who ends up being a \"good\" leader, either.\u003c/p>\n\u003cp>But Sharot says the researchers have identified something about leadership that can hold true regardless of a leader's style.\u003c/p>\n\u003cp>\"You can have authoritarian leaders who like to have the ultimate control,\" she says. \"You can have democratic leaders who want to lead according to the will of the people. You have leaders who are risk-takers, leaders who are risk-adverse and conservative and so on.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But what's really interesting about this work, she says, is that these different types of leaders' decision-making behavior stays the same regardless of whether the outcome affects only themselves or other people. \"What this paper shows is that all these types of individuals, all these types of leaders, have something in common.\"\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=What+Makes+A+Leader%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Leaders can have many different styles — just compare President Donald Trump to \u003ca href=\"https://www.malala.org/malalas-story\" target=\"_blank\" rel=\"noopener\">Malala Yousafzai\u003c/a> to your boss or the coach of your kid's soccer team.\u003c/p>\n\u003cp>But a \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aat0036\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published Thursday suggests that people who end up in leadership roles of various sorts all share one key trait: Leaders make decisions for a group in the same way that they make decisions for themselves. They don't change their decision-making behavior, even when other people's welfare is at stake.\u003c/p>\n\u003cp>That may come as a bit of surprise, given that most lists of key leadership qualities focus on things like charisma and communication skills.\u003c/p>\n\u003cp>\"Previous research has mostly focused on these kinds of either personality characteristics of a leader, or situations where individuals are likely to lead,\" says \u003ca href=\"https://www.econ.uzh.ch/en/people/researchers/edelson.html\" target=\"_blank\" rel=\"noopener\">Micah Edelson\u003c/a>, a neuroscientist at the University of Zurich in Switzerland. \"But we don't know much about the cognitive or neurobiological process that is happening when you are choosing to lead or follow — when you're faced with this choice to lead or follow.\"\u003c/p>\n\u003cp>He notes that the decisions of leaders can affect the lives of many others. \"It's not always that easy to make such a choice, and it's something that could be even a little bit aversive to you, to make a choice that impacts other people,\" says Edelson. \"And there are some people that seem to be able to do it; some people don't. So we were interested in looking at that.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He and his colleagues had volunteers come to the lab, and gave them questionnaires that are widely used to predict whether someone is likely to be in a position of leadership. They also collected information about people's real-world leadership experience, such as what rank they'd achieved in the military (which is compulsory for men in Switzerland) or in the popular Swiss Scouts organization.\u003c/p>\n\u003cp>Then they put the participants into small groups and had them play a series of games in which individuals had to make choices about whether to take a risky action to get a reward.\u003c/p>\n\u003cp>\"These are choices about uncertain gambles that have some probability of success and potential gains and losses,\" Edelson explains.\u003c/p>\n\u003cp>The player could choose to either make the choice alone, or defer the decision to a majority vote.\u003c/p>\n\u003cp>The games were played under two conditions: Sometimes the decision affected only the individual player's winnings and other times the decision affected what the entire group received.\u003c/p>\n\u003cp>What the researchers found is that people in general tended to avoid taking responsibility for what happens to others; deferral rates were the highest when decisions affected other people's pocketbooks.\u003c/p>\n\u003cp>But the people who changed their decision-making behavior the least were the ones who generally served as leaders in the real-world and scored high on leadership questionnaires. Unlike others, they did not require more certainty before being ready to personally make a decision that would affect the whole group.\u003c/p>\n\u003cp>\"On average, people tend to increase the certainty threshold when the choices affect the entire group. But higher-scoring leaders just keep their thresholds almost constant,\" says Edelson, who says preliminary work using MRI brain scanning supports the idea that leaders and followers differ in how their brains process information about gains, losses, and risk in the context of thinking about others.\u003c/p>\n\u003cp>Other neuroscientists say the work, published in the journal \u003cem>Science\u003c/em>, is fascinating.\u003c/p>\n\u003cp>\"It seems a very reasonable finding,\" says \u003ca href=\"http://affectivebrain.com/?page_id=161\" target=\"_blank\" rel=\"noopener\">Tali Sharot\u003c/a>, a cognitive neuroscientist at University College London. \"It works with our intuition, but in the same way it's not something that you'd necessarily think about that distinguishes leadership.\"\u003c/p>\n\u003cp>Sharot cautions that it's not clear whether this decision-making behavior is what led people to their leadership position, or if they've developed it as a result of real-world leadership experience.\u003c/p>\n\u003cp>And this study doesn't say anything about who ends up being a \"good\" leader, either.\u003c/p>\n\u003cp>But Sharot says the researchers have identified something about leadership that can hold true regardless of a leader's style.\u003c/p>\n\u003cp>\"You can have authoritarian leaders who like to have the ultimate control,\" she says. \"You can have democratic leaders who want to lead according to the will of the people. You have leaders who are risk-takers, leaders who are risk-adverse and conservative and so on.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But what's really interesting about this work, she says, is that these different types of leaders' decision-making behavior stays the same regardless of whether the outcome affects only themselves or other people. \"What this paper shows is that all these types of individuals, all these types of leaders, have something in common.\"\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=What+Makes+A+Leader%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Mom, Desperate to Help Her Son, Drove the First Cannabis Pharmaceutical to Market",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">The first prescription medication extracted from the marijuana plant is poised to land on pharmacists' shelves this fall. Epidiolex, made from purified cannabidiol, or CBD, a compound found in the cannabis plant,\u003c/span>\u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/25/623236189/fda-green-lights-marijuana-based-pharmaceutical-drug\">\u003cspan style=\"font-weight: 400\"> is approved for two rare types of epilepsy.\u003c/span>\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Its journey to market was driven forward by one family's quest to find a treatment for their son's epilepsy.\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'\"I thought, 'My son needs access to that. \"'\u003c/aside>\n\u003cp>Scientific and public interest in CBD had been percolating for several years before the Food and Drug Administration finally approved Epidiolex in June. But researching CBD — which doesn't cause the mind-altering high that comes from THC, the primary psychoactive component of marijuana — is hard, because of tight restrictions on using cannabis in research.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam Vogelstein's family and his doctors found ways to work around those restrictions in their fight to control his seizures.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam’s seizures started in 2005 when he was four years old. It's a moment his mother, Evelyn Nussenbaum, will never forget. The family was saying goodbye to a dinner guest when Sam's face suddenly slackened and he fell forward at the waist.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"He did something that looked like a judo bow after a match,\" says Nussenbaum.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Two months passed before Sam had another seizure, but then he started having them every week. Eventually he was suffering through 100 seizures a day.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"When they were bad, they were once every three minutes,\" Nussenbaum says.\u003c/span>\u003c/p>\n\u003cp>\u003cb>A Roller-Coaster Ride\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam was diagnosed with \u003c/span>\u003ca href=\"https://www.epilepsy.com/learn/types-epilepsy-syndromes/epilepsy-myoclonic-absences\">\u003cspan style=\"font-weight: 400\">epilepsy with myoclonic-absences\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which is characterized by an abrupt unresponsiveness and then sudden body jerks. The episodes were quick, but dangerous.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_443389\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-443389 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/07/IMG_5817-e1531785628384.jpg\" alt=\"\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">Dr. Roberta Cilio, neurologist at UCSF, proudly tells her patient Sam Vogelstein he is cleared to drive a car. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">The electricity in Sam's brain would misfire for about five to 20 seconds, enough time to fall down stairs, plunge face first into a dinner plate, or crack his head on a window.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"I don't remember a lot of it really,\" says Sam.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He does remember the barrage of medications his doctors put him on. Some helped briefly. Others triggered hallucinations, full body rashes and uncontrolled anger.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"Sam is a pretty gentle person,\" his mother says. \"We put him on one medication and it made him angry, and he started punching kids. And it was like, 'Oh my God, this is not my kid.' \"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">More than 3.4 million Americans have epilepsy, according to the \u003c/span>\u003ca href=\"https://www.cdc.gov/epilepsy/about/fast-facts.htm\">\u003cspan style=\"font-weight: 400\">Centers for Disease Control and Prevention,\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> but treating the disease is often a riddle doctors find difficult to solve.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam struggled to read, to write, to solve math problems, and Nussenbaum watched her son fall further and further behind in school.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Life for Sam was like a bad cell phone connection: Every few moments the signal dropped out.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"It was scary,\" Nussenbaum says.\u003c/span> \u003cspan style=\"font-weight: 400\">\"I would often cry in my shower or I would drive up to the top of Grizzly Peak [in Berkeley] and sit in my car and scream.”\u003c/span>\u003c/p>\n\u003cp>\u003cb>Joining the Underground\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In 2011, Nussenbaum came across an article in a British medical journal about a small seizure study on rats. The researchers successfully treated the rodents with CBD.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"I thought, 'My son needs access to that,' \" says Nussenbaum.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But seven years ago, pure CBD was not easy to get. Many states have since legalized medical marijuana and CBD is widely available at dispensaries and on the internet, but it is still classified as a \u003c/span>\u003ca href=\"https://www.dea.gov/druginfo/ds.shtml\">\u003cspan style=\"font-weight: 400\">Schedule 1 \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">drug by the U.S. Drug Enforcement Administration, which means it's illegal under federal law.\u003c/span>\u003c/p>\n\u003cp>Nussembaum joined an underground epilepsy collective. The group worked with an herbalist to cook up their own CBD. Sam responded well to the first recipe, but his seizures returned while he was medicating with the second batch.\u003c/p>\n\u003cp>\"When we had it tested, there was no CBD,\" says Nussembaum.\u003c/p>\n\u003cp>Next, Sam's family and another member of the collective tried to make their own CBD. The process produced a rank odor that wafted out into the neighborhood.\u003c/p>\n\u003cp>\"We talked about what would happen if we get arrested\u003cdel>,\u003c/del>\" said Nussembaum. \"And I thought, you know what, arrest me.\"\u003c/p>\n\u003cp>\u003cstrong>Pushing for Access\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Finally, Nussenbaum learned about a British pharmaceutical company, \u003c/span>\u003ca href=\"https://www.gwpharm.com/about-us\">\u003cspan style=\"font-weight: 400\">GW Pharmaceuticals, \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">that was making a medicine derived from highly concentrated CBD to treat multiple sclerosis patients. After months of phone calls and emails from Sam’s parents, the company agreed to let Sam try the drug, in the U.K. and under a doctor's supervision for two weeks. The family flew to London shortly after.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"After one day his seizures were down to 30,\" says Nussenbaum. \"After two days they were down to 10. After three days he had one seizure.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam didn't suffer any side effects.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Back in the U.S., Sam’s parents needed to find a way to keep getting the drug. They collaborated with \u003c/span>\u003ca href=\"https://pediatrics.ucsf.edu/faculty/roberta-cilio\">\u003cspan style=\"font-weight: 400\">Dr. Roberta Cilio\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a neurologist at UC San Francisco. They petitioned the FDA to allow Sam to use the drug under a \u003c/span>\u003ca href=\"https://www.fda.gov/NewsEvents/PublicHealthFocus/ExpandedAccessCompassionateUse/default.htm\">\u003cspan style=\"font-weight: 400\">compassionate use\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> program. \u003c/span>\u003cspan style=\"font-weight: 400\">Four months and hundreds of pages of documents later, the FDA allowed Sam to enroll in his own one-person trial at UCSF. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The DEA was a little more cautious. One day two agents knocked on Cilio's office door. After hours of questioning, the two men requested she store the medication in a giant safe weighing close to 1,000 pounds.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">According to GW Pharmaceuticals, Sam was the first patient in the world to receive Epidiolex, the brand name of the purified CBD strain.\u003c/span>\u003c/p>\n\u003cp>\u003cb>An Expanded Trial and Varying Results\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Inspired by Sam’s success, Cilio, and other clinicians, started trying Epidiolex on other patients. In 2015, she and several co-authors published a study \u003c/span>\u003ca href=\"https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(15)00379-8/abstract\">\u003cspan style=\"font-weight: 400\">in \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">Lancet Neurology\u003c/span>\u003c/i>\u003c/a>\u003cspan style=\"font-weight: 400\"> that included 214 patients with treatment-resistant epilepsy, all children and young adults\u003c/span>\u003cb>. \u003c/b>\u003cspan style=\"font-weight: 400\">(The trial was partly funded by GW Pharmaceuticals.) \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_443390\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-443390\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/07/DSC-7492-800x1253.jpg\" alt=\"\" width=\"800\" height=\"1253\">\u003cfigcaption class=\"wp-caption-text\">Sam Vogelstein at fencing lessons in Berkeley, CA. \u003ccite>(Fred Vogelstein)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">For most patients the results were not as dramatic as they had been for Sam. Seizures dropped in 36.5 percent of patients, which is about the same success rate as other seizure medications, Cilio says. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">And some patients experienced side effects like fatigue, diarrhea and convulsions. Cilio doesn't know why CBD transforms some lives and other patients don't respond at all.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"The studies that are out are mostly short term,\" says Cilio. \"We need to learn who the best responders are. Of course, we know this is not a miracle drug.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">There have been \u003c/span>\u003ca href=\"https://www.npr.org/sections/health-shots/2015/12/07/458818829/marijuana-extract-may-help-some-children-with-epilepsy-study-finds\">\u003cspan style=\"font-weight: 400\">other trials of CBD oil\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> for intractable epilepsy, which have shown that the substance is helpful for a portion of patients, and several states have legalized \u003c/span>\u003ca href=\"http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx\">\u003cspan style=\"font-weight: 400\">CBD oil\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> specifically for the treatment of intractable epilepsy or seizure disorders. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">CBD has gained popularity with consumers as a remedy for a variety of other ailments. But the products that are available over the counter or in medical cannabis dispensaries aren't regulated the way pharmaceutical drugs are, so the consistency and dose can vary widely.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The FDA's decision to approve Epidiolex means that epilepsy patients will have access to a pharmaceutical-grade drug, which delivers a high-quality, consistent dose of CBD, \u003c/span>\u003ca href=\"https://medschool.vanderbilt.edu/brain-institute/person/robert-carson-md-phd\">\u003cspan style=\"font-weight: 400\">says Robert Carson\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> a pediatric neurologist at Vanderbilt University who treats patients with epilepsy.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Unanswered Questions\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Epidiolex still has to get over one regulatory hurdle. The DEA needs to reclassify CBD so it is no longer considered a\u003c/span>\u003ca href=\"https://www.dea.gov/druginfo/ds.shtml\">\u003cspan style=\"font-weight: 400\"> Schedule 1 \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">substance. Drugs in this category are considered to have no medical use and a high potential for abuse. The FDA's approval of Epidiolex means CBD no longer fits that category, and the reclassification is expected sometime in the fall.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Patients will need a prescription to get the drug. \u003c/span>\u003ca href=\"https://www.epilepsy.com/learn/types-epilepsy-syndromes/epilepsy-myoclonic-absences\">\u003cspan style=\"font-weight: 400\">GW Pharmaceuticals\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> has not released a price yet. And Sam's mom, Evelyn Nussenbaum, worries that some insurance companies might not cover it.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In the meantime, Sam still gets his drugs from the investigational pharmacy at UCSF. One day he hopes he'll be prescribing the medication to patients like him.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"I want to be an epilepsy doctor,\" Sam says.\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">First he's working on his driving license. Dr. Cilio just cleared Sam to get behind the wheel. He's 17 now and hasn't had a seizure in more than two years.\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">The first prescription medication extracted from the marijuana plant is poised to land on pharmacists' shelves this fall. Epidiolex, made from purified cannabidiol, or CBD, a compound found in the cannabis plant,\u003c/span>\u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/25/623236189/fda-green-lights-marijuana-based-pharmaceutical-drug\">\u003cspan style=\"font-weight: 400\"> is approved for two rare types of epilepsy.\u003c/span>\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Its journey to market was driven forward by one family's quest to find a treatment for their son's epilepsy.\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'\"I thought, 'My son needs access to that. \"'\u003c/aside>\n\u003cp>Scientific and public interest in CBD had been percolating for several years before the Food and Drug Administration finally approved Epidiolex in June. But researching CBD — which doesn't cause the mind-altering high that comes from THC, the primary psychoactive component of marijuana — is hard, because of tight restrictions on using cannabis in research.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam Vogelstein's family and his doctors found ways to work around those restrictions in their fight to control his seizures.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam’s seizures started in 2005 when he was four years old. It's a moment his mother, Evelyn Nussenbaum, will never forget. The family was saying goodbye to a dinner guest when Sam's face suddenly slackened and he fell forward at the waist.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"He did something that looked like a judo bow after a match,\" says Nussenbaum.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Two months passed before Sam had another seizure, but then he started having them every week. Eventually he was suffering through 100 seizures a day.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"When they were bad, they were once every three minutes,\" Nussenbaum says.\u003c/span>\u003c/p>\n\u003cp>\u003cb>A Roller-Coaster Ride\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam was diagnosed with \u003c/span>\u003ca href=\"https://www.epilepsy.com/learn/types-epilepsy-syndromes/epilepsy-myoclonic-absences\">\u003cspan style=\"font-weight: 400\">epilepsy with myoclonic-absences\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, which is characterized by an abrupt unresponsiveness and then sudden body jerks. The episodes were quick, but dangerous.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_443389\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-443389 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/07/IMG_5817-e1531785628384.jpg\" alt=\"\" width=\"1920\" height=\"1440\">\u003cfigcaption class=\"wp-caption-text\">Dr. Roberta Cilio, neurologist at UCSF, proudly tells her patient Sam Vogelstein he is cleared to drive a car. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">The electricity in Sam's brain would misfire for about five to 20 seconds, enough time to fall down stairs, plunge face first into a dinner plate, or crack his head on a window.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"I don't remember a lot of it really,\" says Sam.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He does remember the barrage of medications his doctors put him on. Some helped briefly. Others triggered hallucinations, full body rashes and uncontrolled anger.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"Sam is a pretty gentle person,\" his mother says. \"We put him on one medication and it made him angry, and he started punching kids. And it was like, 'Oh my God, this is not my kid.' \"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">More than 3.4 million Americans have epilepsy, according to the \u003c/span>\u003ca href=\"https://www.cdc.gov/epilepsy/about/fast-facts.htm\">\u003cspan style=\"font-weight: 400\">Centers for Disease Control and Prevention,\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> but treating the disease is often a riddle doctors find difficult to solve.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam struggled to read, to write, to solve math problems, and Nussenbaum watched her son fall further and further behind in school.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Life for Sam was like a bad cell phone connection: Every few moments the signal dropped out.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"It was scary,\" Nussenbaum says.\u003c/span> \u003cspan style=\"font-weight: 400\">\"I would often cry in my shower or I would drive up to the top of Grizzly Peak [in Berkeley] and sit in my car and scream.”\u003c/span>\u003c/p>\n\u003cp>\u003cb>Joining the Underground\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In 2011, Nussenbaum came across an article in a British medical journal about a small seizure study on rats. The researchers successfully treated the rodents with CBD.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"I thought, 'My son needs access to that,' \" says Nussenbaum.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">But seven years ago, pure CBD was not easy to get. Many states have since legalized medical marijuana and CBD is widely available at dispensaries and on the internet, but it is still classified as a \u003c/span>\u003ca href=\"https://www.dea.gov/druginfo/ds.shtml\">\u003cspan style=\"font-weight: 400\">Schedule 1 \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">drug by the U.S. Drug Enforcement Administration, which means it's illegal under federal law.\u003c/span>\u003c/p>\n\u003cp>Nussembaum joined an underground epilepsy collective. The group worked with an herbalist to cook up their own CBD. Sam responded well to the first recipe, but his seizures returned while he was medicating with the second batch.\u003c/p>\n\u003cp>\"When we had it tested, there was no CBD,\" says Nussembaum.\u003c/p>\n\u003cp>Next, Sam's family and another member of the collective tried to make their own CBD. The process produced a rank odor that wafted out into the neighborhood.\u003c/p>\n\u003cp>\"We talked about what would happen if we get arrested\u003cdel>,\u003c/del>\" said Nussembaum. \"And I thought, you know what, arrest me.\"\u003c/p>\n\u003cp>\u003cstrong>Pushing for Access\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Finally, Nussenbaum learned about a British pharmaceutical company, \u003c/span>\u003ca href=\"https://www.gwpharm.com/about-us\">\u003cspan style=\"font-weight: 400\">GW Pharmaceuticals, \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">that was making a medicine derived from highly concentrated CBD to treat multiple sclerosis patients. After months of phone calls and emails from Sam’s parents, the company agreed to let Sam try the drug, in the U.K. and under a doctor's supervision for two weeks. The family flew to London shortly after.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"After one day his seizures were down to 30,\" says Nussenbaum. \"After two days they were down to 10. After three days he had one seizure.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Sam didn't suffer any side effects.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Back in the U.S., Sam’s parents needed to find a way to keep getting the drug. They collaborated with \u003c/span>\u003ca href=\"https://pediatrics.ucsf.edu/faculty/roberta-cilio\">\u003cspan style=\"font-weight: 400\">Dr. Roberta Cilio\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, a neurologist at UC San Francisco. They petitioned the FDA to allow Sam to use the drug under a \u003c/span>\u003ca href=\"https://www.fda.gov/NewsEvents/PublicHealthFocus/ExpandedAccessCompassionateUse/default.htm\">\u003cspan style=\"font-weight: 400\">compassionate use\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> program. \u003c/span>\u003cspan style=\"font-weight: 400\">Four months and hundreds of pages of documents later, the FDA allowed Sam to enroll in his own one-person trial at UCSF. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The DEA was a little more cautious. One day two agents knocked on Cilio's office door. After hours of questioning, the two men requested she store the medication in a giant safe weighing close to 1,000 pounds.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">According to GW Pharmaceuticals, Sam was the first patient in the world to receive Epidiolex, the brand name of the purified CBD strain.\u003c/span>\u003c/p>\n\u003cp>\u003cb>An Expanded Trial and Varying Results\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Inspired by Sam’s success, Cilio, and other clinicians, started trying Epidiolex on other patients. In 2015, she and several co-authors published a study \u003c/span>\u003ca href=\"https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(15)00379-8/abstract\">\u003cspan style=\"font-weight: 400\">in \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">Lancet Neurology\u003c/span>\u003c/i>\u003c/a>\u003cspan style=\"font-weight: 400\"> that included 214 patients with treatment-resistant epilepsy, all children and young adults\u003c/span>\u003cb>. \u003c/b>\u003cspan style=\"font-weight: 400\">(The trial was partly funded by GW Pharmaceuticals.) \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_443390\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-443390\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/07/DSC-7492-800x1253.jpg\" alt=\"\" width=\"800\" height=\"1253\">\u003cfigcaption class=\"wp-caption-text\">Sam Vogelstein at fencing lessons in Berkeley, CA. \u003ccite>(Fred Vogelstein)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">For most patients the results were not as dramatic as they had been for Sam. Seizures dropped in 36.5 percent of patients, which is about the same success rate as other seizure medications, Cilio says. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">And some patients experienced side effects like fatigue, diarrhea and convulsions. Cilio doesn't know why CBD transforms some lives and other patients don't respond at all.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"The studies that are out are mostly short term,\" says Cilio. \"We need to learn who the best responders are. Of course, we know this is not a miracle drug.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">There have been \u003c/span>\u003ca href=\"https://www.npr.org/sections/health-shots/2015/12/07/458818829/marijuana-extract-may-help-some-children-with-epilepsy-study-finds\">\u003cspan style=\"font-weight: 400\">other trials of CBD oil\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> for intractable epilepsy, which have shown that the substance is helpful for a portion of patients, and several states have legalized \u003c/span>\u003ca href=\"http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx\">\u003cspan style=\"font-weight: 400\">CBD oil\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> specifically for the treatment of intractable epilepsy or seizure disorders. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">CBD has gained popularity with consumers as a remedy for a variety of other ailments. But the products that are available over the counter or in medical cannabis dispensaries aren't regulated the way pharmaceutical drugs are, so the consistency and dose can vary widely.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The FDA's decision to approve Epidiolex means that epilepsy patients will have access to a pharmaceutical-grade drug, which delivers a high-quality, consistent dose of CBD, \u003c/span>\u003ca href=\"https://medschool.vanderbilt.edu/brain-institute/person/robert-carson-md-phd\">\u003cspan style=\"font-weight: 400\">says Robert Carson\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> a pediatric neurologist at Vanderbilt University who treats patients with epilepsy.\u003c/span>\u003c/p>\n\u003cp>\u003cb>Unanswered Questions\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Epidiolex still has to get over one regulatory hurdle. The DEA needs to reclassify CBD so it is no longer considered a\u003c/span>\u003ca href=\"https://www.dea.gov/druginfo/ds.shtml\">\u003cspan style=\"font-weight: 400\"> Schedule 1 \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">substance. Drugs in this category are considered to have no medical use and a high potential for abuse. The FDA's approval of Epidiolex means CBD no longer fits that category, and the reclassification is expected sometime in the fall.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Patients will need a prescription to get the drug. \u003c/span>\u003ca href=\"https://www.epilepsy.com/learn/types-epilepsy-syndromes/epilepsy-myoclonic-absences\">\u003cspan style=\"font-weight: 400\">GW Pharmaceuticals\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> has not released a price yet. And Sam's mom, Evelyn Nussenbaum, worries that some insurance companies might not cover it.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">In the meantime, Sam still gets his drugs from the investigational pharmacy at UCSF. One day he hopes he'll be prescribing the medication to patients like him.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"I want to be an epilepsy doctor,\" Sam says.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://content.jwplatform.com/players/FN1FYn4y-jEuQjxp9.html\" width=\"640\" height=\"360\" frameborder=\"0\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>What we see often determines how we act: We hit the brakes if a car is stopped ahead of us. We duck to avoid a low-hanging tree branch. We bend down to tie our shoe when the laces come undone.We rarely give these actions a second thought. But Mriganka Sur, a professor at the Massachusetts Institute of Technology’s Picower Institute for Learning and Memory, is obsessed with them.“How is vision, which we do effortlessly, transformed into action, which requires volition, which requires attention and engagement?” Sur asked. “How this transformation takes place is a fundamental question that is at the heart of brain function and behavior.”\u003c/p>\n\u003cp>In a recent \u003ca href=\"https://www.nature.com/articles/s41467-018-05012-y\" target=\"_blank\" rel=\"noopener\">mouse study\u003c/a> published in Nature Communications, Sur and his team took a step toward answering that question\u003cem>.\u003c/em> Their experimental data suggest that the posterior parietal cortex, or PPC, may help us make decisions based on what we see.\u003c/p>\n\u003cp>First author Gerald Pho, formerly a Ph.D. student in Sur’s lab and now a postdoctoral fellow at Harvard, was exhilarated to see mice’s PPCs light up under a microscope when they made choices based on visual stimuli.\u003c/p>\n\u003cp>“It’s quite magical,” he said. “It’s almost like fireworks.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Pho said he’s excited to see how our understanding of visual decision-making will develop as imaging technology becomes more advanced.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I just think we’re in an exciting time in neuroscience,” he said. “And I think the advance of these technologies can only improve our ability to understand how the brain works in a normal animal, and extending to humans, but also how it goes awry in neurological disease.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://content.jwplatform.com/players/FN1FYn4y-jEuQjxp9.html\" width=\"640\" height=\"360\" frameborder=\"0\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>What we see often determines how we act: We hit the brakes if a car is stopped ahead of us. We duck to avoid a low-hanging tree branch. We bend down to tie our shoe when the laces come undone.We rarely give these actions a second thought. But Mriganka Sur, a professor at the Massachusetts Institute of Technology’s Picower Institute for Learning and Memory, is obsessed with them.“How is vision, which we do effortlessly, transformed into action, which requires volition, which requires attention and engagement?” Sur asked. “How this transformation takes place is a fundamental question that is at the heart of brain function and behavior.”\u003c/p>\n\u003cp>In a recent \u003ca href=\"https://www.nature.com/articles/s41467-018-05012-y\" target=\"_blank\" rel=\"noopener\">mouse study\u003c/a> published in Nature Communications, Sur and his team took a step toward answering that question\u003cem>.\u003c/em> Their experimental data suggest that the posterior parietal cortex, or PPC, may help us make decisions based on what we see.\u003c/p>\n\u003cp>First author Gerald Pho, formerly a Ph.D. student in Sur’s lab and now a postdoctoral fellow at Harvard, was exhilarated to see mice’s PPCs light up under a microscope when they made choices based on visual stimuli.\u003c/p>\n\u003cp>“It’s quite magical,” he said. “It’s almost like fireworks.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The first rule of soccer is pretty obvious: don't use your hands. But soccer's signature move, heading the ball, can cause a detectable impact on players' brains. And according to a study \u003ca href=\"https://pubs.rsna.org/doi/10.1148/radiol.2018180217\" target=\"_blank\" rel=\"noopener\">published Tuesday in Radiology\u003c/a>, female players are more sensitive to the impact than males.\u003c/p>\n\u003cp>The study authors found that female amateur soccer players who frequently head balls showed more white matter brain alterations than their male counterparts. The study included 49 women and 49 men, ages 18 to 50, and examined MRI imaging of players' brains. Each female player was compared to a male player of a similar age and with other similar characteristics including frequency of heading exposure.\u003c/p>\n\u003cp>Lead author \u003ca href=\"http://www.einstein.yu.edu/faculty/148/michael-lipton/\" target=\"_blank\" rel=\"noopener\">Michael Lipton\u003c/a>, a neuroradiologist and neuroscientist at Albert Einstein College of Medicine, says white matter in the brain can be compared to fiber optic cable, which connects a network of computer. White matter is made up thread-like axon nerve fibers that connect neurons to each other, and their protective covering, myelin.\u003c/p>\n\u003cp>Heading causes these brain tissues to become disorganized, Lipton says. His previous research found that these abnormalities accompany \u003ca href=\"https://www.einstein.yu.edu/docs/labs/michael-lipton/Soccer_heading_is_associated_with_WM.pdf\" target=\"_blank\" rel=\"noopener\">poorer cognitive function\u003c/a> associated with memory or attention issues when associated with heading.\u003c/p>\n\u003cp>\"The most important finding here is that we see that in women's brains, actually looking at brain tissue, there seems to be a greater sensitivity to repetitive, very low-level injury relative to men,\" he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>An important note about this research, Lipton says, is that it isn't about concussions. Instead, it's measuring \"sub-concussive injuries,\" or repeated impacts that don't cause any immediate, acknowledged problem for the player, but could be problematic in the long-term.\u003c/p>\n\u003cp>\"It's actually more important to define what's happening in people that are not yet symptomatic, because that's where there's still an opportunity to head off long-term problems,\" he says.\u003c/p>\n\u003cp>It's already known that female soccer players are at a higher risk of concussion than males. Wellington Hsu, a professor of orthopedic surgery at Northwestern University, \u003ca href=\"http://aaos-annualmeeting-presskit.org/2017/research-news/concussions_hsu/\" target=\"_blank\" rel=\"noopener\">led a decade-long study\u003c/a> of injuries among high school athletes that found this.\u003c/p>\n\u003cp>But the current study gives additional evidence that women are more susceptible to the impact of heading, and shows more areas of women's brains are susceptible to potential injury than men's.\u003c/p>\n\u003cp>Hsu, who was not involved in the current study, says while it's not possible to draw firm conclusions from the study alone, it suggests a path forward for making the sport safer.\u003c/p>\n\u003cp>\"What I think this paper may lead to is further research in the preventative mechanisms of concussions, whether or not it's a brace or a helmet or heading technique or a different way we think about this in men and women,\" Hsu says.\u003c/p>\n\u003cp>Women \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC233178/\" target=\"_blank\" rel=\"noopener\">are more likely to report concussion-related symptoms\u003c/a> than men, but Lipton says there has been debate over whether women actually are more sensitive or just more likely to speak up.\u003c/p>\n\u003cp>This study confirms that there are changes in the tissue of women's brains after these repetitive hits from the soccer ball that are different from men in a similar situation.\u003c/p>\n\u003cp>\"This is the first time anybody has put a definitive piece of information behind what has been a contentious dispute as to whether women's brains are intrinsically more sensitive, or whether it's an artifact of reporting of symptoms,\" Lipton says.\u003c/p>\n\u003cp>It's unclear why women more biologically likely to be affected by repetitive heading. Lipton says it could have to do with sex hormones, or with the fact that women typically having less body and muscle mass than their male counterparts.\u003c/p>\n\u003cp>Thomas Kaminski, a professor of kinesiology and applied physiology at the University of Delaware, who was not involved in the study, says that the differences in these changes in the brain could have to do with neck strength. Women typically have weaker necks and smaller heads than men.\u003c/p>\n\u003cp>Does this research mean women should hang up their cleats forever? Probably not, says Lipton. There are a lot of \u003ca href=\"https://www.npr.org/sections/health-shots/2014/04/02/297910425/run-when-youre-25-for-a-sharper-brain-when-youre-45\" target=\"_blank\" rel=\"noopener\">brain health benefits to getting active\u003c/a>, and women are actually okay to head the ball up to a certain point.\u003c/p>\n\u003cp>\"We're not saying that you head the ball and then you're brain injured,\" Lipton says. \"The data consistently shows that there seems to be some level of exposure to these repeated impacts which is pretty well tolerated by most people. It's really a matter of figuring out how much is too much.\"\u003c/p>\n\u003cp>Lipton says he hopes to find out if there's a safe threshold on heading impact for women. The latest FIFA data shows \u003ca href=\"https://www.fifa.com/mm/document/fifafacts/bcoffsurv/emaga_9384_10704.pdf\" target=\"_blank\" rel=\"noopener\">265 million people play soccer\u003c/a> across the globe, and Lipton says, adverse effects when multiplied by that many people \"potentially [pose] a huge public health concern.\"\u003c/p>\n\u003cp>\"The problem isn't that [soccer is] creating all kinds of vegetative, brain damaged people,\" he says. \"But what's the potential benefit of athletics that's being given up by the effect of this kind of repeated head injury? And is there a way to strike a balance so that people can benefit maximally and not incur the adverse effects?\"\u003c/p>\n\u003cp>Kaminski says it would be interesting to take this research one step forward and explore this problem in youth. In the U.S., youth players can start heading the ball at age 11. He thinks it's worth questioning whether that age cutoff should be older. Parents are faced with the issue of wanting their kids to be active but safe at the same time, he says.\u003c/p>\n\u003cp>\"What happens if [children] head the ball ten times, or a hundred times?\" he says. \"Would you see these changes? Those are the big question marks I have.\"\u003c/p>\n\u003cp>Carla Garcia, a Brooklyn resident and participant in the study, has been playing soccer since she was five. Now 52, she says these results probably won't change the way she plays, but if she were younger, she would consider heading the ball a bit less. She joined the study as a way to give back to the sport she loves — and she even wants to donate her brain to science to help researchers understand brain injuries.\u003c/p>\n\u003cp>\"I think it probably over the long term will have an effect on the way that younger women and younger people play, and I got involved for that reason,\" she says. \"I thought that Dr. Lipton and his colleagues could find the way to make it safer for kids to play.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Sara Kiley Watson is NPR's Science desk intern.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Heading+May+Be+Riskier+For+Female+Soccer+Players+Than+Males&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first rule of soccer is pretty obvious: don't use your hands. But soccer's signature move, heading the ball, can cause a detectable impact on players' brains. And according to a study \u003ca href=\"https://pubs.rsna.org/doi/10.1148/radiol.2018180217\" target=\"_blank\" rel=\"noopener\">published Tuesday in Radiology\u003c/a>, female players are more sensitive to the impact than males.\u003c/p>\n\u003cp>The study authors found that female amateur soccer players who frequently head balls showed more white matter brain alterations than their male counterparts. The study included 49 women and 49 men, ages 18 to 50, and examined MRI imaging of players' brains. Each female player was compared to a male player of a similar age and with other similar characteristics including frequency of heading exposure.\u003c/p>\n\u003cp>Lead author \u003ca href=\"http://www.einstein.yu.edu/faculty/148/michael-lipton/\" target=\"_blank\" rel=\"noopener\">Michael Lipton\u003c/a>, a neuroradiologist and neuroscientist at Albert Einstein College of Medicine, says white matter in the brain can be compared to fiber optic cable, which connects a network of computer. White matter is made up thread-like axon nerve fibers that connect neurons to each other, and their protective covering, myelin.\u003c/p>\n\u003cp>Heading causes these brain tissues to become disorganized, Lipton says. His previous research found that these abnormalities accompany \u003ca href=\"https://www.einstein.yu.edu/docs/labs/michael-lipton/Soccer_heading_is_associated_with_WM.pdf\" target=\"_blank\" rel=\"noopener\">poorer cognitive function\u003c/a> associated with memory or attention issues when associated with heading.\u003c/p>\n\u003cp>\"The most important finding here is that we see that in women's brains, actually looking at brain tissue, there seems to be a greater sensitivity to repetitive, very low-level injury relative to men,\" he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>An important note about this research, Lipton says, is that it isn't about concussions. Instead, it's measuring \"sub-concussive injuries,\" or repeated impacts that don't cause any immediate, acknowledged problem for the player, but could be problematic in the long-term.\u003c/p>\n\u003cp>\"It's actually more important to define what's happening in people that are not yet symptomatic, because that's where there's still an opportunity to head off long-term problems,\" he says.\u003c/p>\n\u003cp>It's already known that female soccer players are at a higher risk of concussion than males. Wellington Hsu, a professor of orthopedic surgery at Northwestern University, \u003ca href=\"http://aaos-annualmeeting-presskit.org/2017/research-news/concussions_hsu/\" target=\"_blank\" rel=\"noopener\">led a decade-long study\u003c/a> of injuries among high school athletes that found this.\u003c/p>\n\u003cp>But the current study gives additional evidence that women are more susceptible to the impact of heading, and shows more areas of women's brains are susceptible to potential injury than men's.\u003c/p>\n\u003cp>Hsu, who was not involved in the current study, says while it's not possible to draw firm conclusions from the study alone, it suggests a path forward for making the sport safer.\u003c/p>\n\u003cp>\"What I think this paper may lead to is further research in the preventative mechanisms of concussions, whether or not it's a brace or a helmet or heading technique or a different way we think about this in men and women,\" Hsu says.\u003c/p>\n\u003cp>Women \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC233178/\" target=\"_blank\" rel=\"noopener\">are more likely to report concussion-related symptoms\u003c/a> than men, but Lipton says there has been debate over whether women actually are more sensitive or just more likely to speak up.\u003c/p>\n\u003cp>This study confirms that there are changes in the tissue of women's brains after these repetitive hits from the soccer ball that are different from men in a similar situation.\u003c/p>\n\u003cp>\"This is the first time anybody has put a definitive piece of information behind what has been a contentious dispute as to whether women's brains are intrinsically more sensitive, or whether it's an artifact of reporting of symptoms,\" Lipton says.\u003c/p>\n\u003cp>It's unclear why women more biologically likely to be affected by repetitive heading. Lipton says it could have to do with sex hormones, or with the fact that women typically having less body and muscle mass than their male counterparts.\u003c/p>\n\u003cp>Thomas Kaminski, a professor of kinesiology and applied physiology at the University of Delaware, who was not involved in the study, says that the differences in these changes in the brain could have to do with neck strength. Women typically have weaker necks and smaller heads than men.\u003c/p>\n\u003cp>Does this research mean women should hang up their cleats forever? Probably not, says Lipton. There are a lot of \u003ca href=\"https://www.npr.org/sections/health-shots/2014/04/02/297910425/run-when-youre-25-for-a-sharper-brain-when-youre-45\" target=\"_blank\" rel=\"noopener\">brain health benefits to getting active\u003c/a>, and women are actually okay to head the ball up to a certain point.\u003c/p>\n\u003cp>\"We're not saying that you head the ball and then you're brain injured,\" Lipton says. \"The data consistently shows that there seems to be some level of exposure to these repeated impacts which is pretty well tolerated by most people. It's really a matter of figuring out how much is too much.\"\u003c/p>\n\u003cp>Lipton says he hopes to find out if there's a safe threshold on heading impact for women. The latest FIFA data shows \u003ca href=\"https://www.fifa.com/mm/document/fifafacts/bcoffsurv/emaga_9384_10704.pdf\" target=\"_blank\" rel=\"noopener\">265 million people play soccer\u003c/a> across the globe, and Lipton says, adverse effects when multiplied by that many people \"potentially [pose] a huge public health concern.\"\u003c/p>\n\u003cp>\"The problem isn't that [soccer is] creating all kinds of vegetative, brain damaged people,\" he says. \"But what's the potential benefit of athletics that's being given up by the effect of this kind of repeated head injury? And is there a way to strike a balance so that people can benefit maximally and not incur the adverse effects?\"\u003c/p>\n\u003cp>Kaminski says it would be interesting to take this research one step forward and explore this problem in youth. In the U.S., youth players can start heading the ball at age 11. He thinks it's worth questioning whether that age cutoff should be older. Parents are faced with the issue of wanting their kids to be active but safe at the same time, he says.\u003c/p>\n\u003cp>\"What happens if [children] head the ball ten times, or a hundred times?\" he says. \"Would you see these changes? Those are the big question marks I have.\"\u003c/p>\n\u003cp>Carla Garcia, a Brooklyn resident and participant in the study, has been playing soccer since she was five. Now 52, she says these results probably won't change the way she plays, but if she were younger, she would consider heading the ball a bit less. She joined the study as a way to give back to the sport she loves — and she even wants to donate her brain to science to help researchers understand brain injuries.\u003c/p>\n\u003cp>\"I think it probably over the long term will have an effect on the way that younger women and younger people play, and I got involved for that reason,\" she says. \"I thought that Dr. Lipton and his colleagues could find the way to make it safer for kids to play.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Sara Kiley Watson is NPR's Science desk intern.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Heading+May+Be+Riskier+For+Female+Soccer+Players+Than+Males&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Alzheimer’s Study Sparks New Debate Over Amyloid Hypothesis",
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"content": "\u003cp>In the long-running debate over just what causes Alzheimer’s disease, one side looks to have scored a victory with \u003ca href=\"https://www.statnews.com/2018/07/25/experimental-alzheimers-drug-biogen-eisai/\" target=\"_blank\" rel=\"noopener\">new results with an in-development drug\u003c/a>. But there’s enough variation in the data to ensure that the squabbling factions of Alzheimer’s will have plenty to fight about.[contextly_sidebar id=\"A04l79ZF49Fepp9ayXq47IfI7cWrtD3j\"]\u003c/p>\n\u003cp>At issue is the so-called amyloid hypothesis, a decades-old theory claiming that Alzheimer’s gradual degradation of the brain is caused by the accumulation of sticky plaques. And the new drug is BAN2401, designed by Biogen and Eisai to prevent those amyloid plaques from clustering and attack the clumps that already have.\u003c/p>\n\u003cp>In data presented last week, one group of patients receiving BAN2401 saw their amyloid levels plummet, a result that was tied to a significant reduction in cognitive decline compared with placebo.\u003c/p>\n\u003cp>To the amyloid-inclined, like Dr. Howard Fillit of the Alzheimer’s Drug Discovery Foundation, that marks a clear affirmation of the linkage between plaques and mental fortitude.\u003c/p>\n\u003cp>“I mean if you asked me five or 10 years ago if we’re going to have a drug that can remove the plaques from the brain, I would have thought this was space technology,” Fillit said. “And there was definitely a signal, in my opinion, on clinical outcomes, which is what we’ve all been looking for.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But to skeptics, the trial was laden with confounding details that make it impossible to draw conclusions.\u003c/p>\n\u003cp>“These results are a mess,” wrote Baird biotech analyst Brian Skorney. “Not so much that they indicate an outright failure of the [amyloid] hypothesis, but they don’t really say anything informative at all.”\u003c/p>\n\u003cp>In the trial, every single tested dose had a significant effect on plaques as measured by a brain scan, and the more BAN2401 patients got, the less amyloid they had after 18 months. But looking at cognition, only the highest tested dose was significantly better than placebo at slowing down mental decline. And some of the patients who received lower doses actually declined faster than those who received no treatment at all.[contextly_sidebar id=\"TAyKNwsnIzWapwgWfQcwbB5f1ZW4XVH2\"]\u003c/p>\n\u003cp>If amyloid really is the driving factor behind Alzheimer’s, why didn’t each incremental reduction in plaques lead to a corresponding improvement in cognition?\u003c/p>\n\u003cp>Dr. Al Sandrock, Biogen’s chief scientific officer, said there is likely a threshold of amyloid reduction that must be reached before patients actually benefit. The low doses, despite their effect on plaques, might not have hit that threshold, Sandrock said, thus accounting for their poor performance on cognitive decline.\u003c/p>\n\u003cp>The divergence in the two curves is what gives Dr. Reisa Sperling, who was overall encouraged by the results, “the most pause.” But Sperling, director Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital, noted that some of the study’s arms had small numbers of patients, making it difficult to draw conclusions. She said while there is a biological argument that could underpin the threshold hypothesis, she wanted to see more data from a larger trial with a more traditional design.\u003c/p>\n\u003cp>Even if Sandrock’s theory holds up, what happened to BAN2401 is not a new phenomenon. This year a drug from Merck, meant to shut off the production of plaques by blocking an enzyme called BACE, was successful in reducing amyloid but fared so dismally on cognitive measures that researchers terminated the trial early. A second BACE drug, from Biogen and Eisai, had similar results in miniature, hitting the mark on plaque reduction in a Phase 2 trial but failing to significantly outperform placebo on cognition.\u003c/p>\n\u003cp>The underlying issue, according Dr. Lon Schneider, director of the California Alzheimer’s Disease Center at the University of Southern California, is that “the plaques are not the target — those are biomarkers.”\u003c/p>\n\u003cp>“A target is something that, as a result of hitting it, there will be change downstream in behavior, cognition, and illness course,” Schneider said. “So, yeah we’re knocking down amyloid, but so far we’re not changing behavior much.”\u003c/p>\n\u003cp>Even BAN2401’s saving grace — that its highest dose appeared to both reduce amyloid and improve patient’s clinical results — has come under scrutiny.\u003c/p>\n\u003cp>In the BAN2401 trial, about 70 percent of patients getting placebo had a genetic mutation that triples the risk of Alzheimer’s. But in the high-dose BAN2401 group, just 30 percent of patients had the mutation, called APOE4.[contextly_sidebar id=\"tcdS8fDReoUFY02DP3vnBwSqYDEV9wHe\"]\u003c/p>\n\u003cp>That could explain why BAN2401 seemed to outperform a saline injection in the high-dose group, skeptics say, as past trials suggest that APOE4 carriers have more rapidly progressing Alzheimer’s than patients without the mutation.\u003c/p>\n\u003cp>And it could mean that the drug’s seeming promise is a mirage.\u003c/p>\n\u003cp>Dr. Paul Aisen, who runs the Alzheimer’s Therapeutic Research Institute at the University of Southern California, said the discrepancy “does create a potential bias.” But in trials where patients are confirmed to have amyloid in their brains at the outset, as was the case with BAN2401, “the impact of [APOE4] on progression is modest,” Aisen wrote in an email. “I don’t think this accounts for the apparent slowing of cognitive decline in the high-dose arm.”\u003c/p>\n\u003cp>Sperling agreed that she did not think the arms’ different populations skewed the data, in part because the group that received the second highest dose of the drug had a larger share of APOE4 carriers and saw results that were similar — though not as substantial — as the high dose group.\u003c/p>\n\u003cp>“It’s a similar pattern,” she said. “For me that partially mitigates that concern.”\u003c/p>\n\u003cp>Biogen and Eisai have promised to dig into the data and parse out the effect APOE4 had on whether patients responded to BAN2401, but those results likely won’t be ready for months.\u003c/p>\n\u003cp>In the meantime, companies are still queueing up to take cracks at amyloid.\u003c/p>\n\u003cp>Eli Lilly, which has spent billions on failed Alzheimer’s drugs in recent years, has designed a trial that will test the amyloid hypothesis “in the most definitive way possible,” said Mark Mintun, the company’s vice president of neurodegeneration.\u003c/p>\n\u003cp>The plan is to take a BACE inhibitor and pair it with an injected treatment that targets amyloid already in the brain. That should address the two major concerns with each approach, Mintun said: BACE inhibitors prevent amyloid but don’t address plaques that already exist, while amyloid-targeting therapies don’t stem the flow of new toxic clumps.\u003c/p>\n\u003cp>“I equate it to going down to your basement and finding three feet of water and there’s been a slow drip for four weeks,” Mintun said. “You can turn off the spigot, but it won’t feel like you’ve made much progress, so you’ve got to pump it out, too.”\u003c/p>\n\u003cp>That study is enrolling 375 patients into three groups, planning to study whether the combination can improve cognition compared with placebo over 18 months.\u003c/p>\n\u003cp>\u003cem>Andrew Joseph contributed reporting.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/07/30/alzheimers-amyloid-hypothesis/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, 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>In the long-running debate over just what causes Alzheimer’s disease, one side looks to have scored a victory with \u003ca href=\"https://www.statnews.com/2018/07/25/experimental-alzheimers-drug-biogen-eisai/\" target=\"_blank\" rel=\"noopener\">new results with an in-development drug\u003c/a>. But there’s enough variation in the data to ensure that the squabbling factions of Alzheimer’s will have plenty to fight about.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At issue is the so-called amyloid hypothesis, a decades-old theory claiming that Alzheimer’s gradual degradation of the brain is caused by the accumulation of sticky plaques. And the new drug is BAN2401, designed by Biogen and Eisai to prevent those amyloid plaques from clustering and attack the clumps that already have.\u003c/p>\n\u003cp>In data presented last week, one group of patients receiving BAN2401 saw their amyloid levels plummet, a result that was tied to a significant reduction in cognitive decline compared with placebo.\u003c/p>\n\u003cp>To the amyloid-inclined, like Dr. Howard Fillit of the Alzheimer’s Drug Discovery Foundation, that marks a clear affirmation of the linkage between plaques and mental fortitude.\u003c/p>\n\u003cp>“I mean if you asked me five or 10 years ago if we’re going to have a drug that can remove the plaques from the brain, I would have thought this was space technology,” Fillit said. “And there was definitely a signal, in my opinion, on clinical outcomes, which is what we’ve all been looking for.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But to skeptics, the trial was laden with confounding details that make it impossible to draw conclusions.\u003c/p>\n\u003cp>“These results are a mess,” wrote Baird biotech analyst Brian Skorney. “Not so much that they indicate an outright failure of the [amyloid] hypothesis, but they don’t really say anything informative at all.”\u003c/p>\n\u003cp>In the trial, every single tested dose had a significant effect on plaques as measured by a brain scan, and the more BAN2401 patients got, the less amyloid they had after 18 months. But looking at cognition, only the highest tested dose was significantly better than placebo at slowing down mental decline. And some of the patients who received lower doses actually declined faster than those who received no treatment at all.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>If amyloid really is the driving factor behind Alzheimer’s, why didn’t each incremental reduction in plaques lead to a corresponding improvement in cognition?\u003c/p>\n\u003cp>Dr. Al Sandrock, Biogen’s chief scientific officer, said there is likely a threshold of amyloid reduction that must be reached before patients actually benefit. The low doses, despite their effect on plaques, might not have hit that threshold, Sandrock said, thus accounting for their poor performance on cognitive decline.\u003c/p>\n\u003cp>The divergence in the two curves is what gives Dr. Reisa Sperling, who was overall encouraged by the results, “the most pause.” But Sperling, director Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital, noted that some of the study’s arms had small numbers of patients, making it difficult to draw conclusions. She said while there is a biological argument that could underpin the threshold hypothesis, she wanted to see more data from a larger trial with a more traditional design.\u003c/p>\n\u003cp>Even if Sandrock’s theory holds up, what happened to BAN2401 is not a new phenomenon. This year a drug from Merck, meant to shut off the production of plaques by blocking an enzyme called BACE, was successful in reducing amyloid but fared so dismally on cognitive measures that researchers terminated the trial early. A second BACE drug, from Biogen and Eisai, had similar results in miniature, hitting the mark on plaque reduction in a Phase 2 trial but failing to significantly outperform placebo on cognition.\u003c/p>\n\u003cp>The underlying issue, according Dr. Lon Schneider, director of the California Alzheimer’s Disease Center at the University of Southern California, is that “the plaques are not the target — those are biomarkers.”\u003c/p>\n\u003cp>“A target is something that, as a result of hitting it, there will be change downstream in behavior, cognition, and illness course,” Schneider said. “So, yeah we’re knocking down amyloid, but so far we’re not changing behavior much.”\u003c/p>\n\u003cp>Even BAN2401’s saving grace — that its highest dose appeared to both reduce amyloid and improve patient’s clinical results — has come under scrutiny.\u003c/p>\n\u003cp>In the BAN2401 trial, about 70 percent of patients getting placebo had a genetic mutation that triples the risk of Alzheimer’s. But in the high-dose BAN2401 group, just 30 percent of patients had the mutation, called APOE4.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That could explain why BAN2401 seemed to outperform a saline injection in the high-dose group, skeptics say, as past trials suggest that APOE4 carriers have more rapidly progressing Alzheimer’s than patients without the mutation.\u003c/p>\n\u003cp>And it could mean that the drug’s seeming promise is a mirage.\u003c/p>\n\u003cp>Dr. Paul Aisen, who runs the Alzheimer’s Therapeutic Research Institute at the University of Southern California, said the discrepancy “does create a potential bias.” But in trials where patients are confirmed to have amyloid in their brains at the outset, as was the case with BAN2401, “the impact of [APOE4] on progression is modest,” Aisen wrote in an email. “I don’t think this accounts for the apparent slowing of cognitive decline in the high-dose arm.”\u003c/p>\n\u003cp>Sperling agreed that she did not think the arms’ different populations skewed the data, in part because the group that received the second highest dose of the drug had a larger share of APOE4 carriers and saw results that were similar — though not as substantial — as the high dose group.\u003c/p>\n\u003cp>“It’s a similar pattern,” she said. “For me that partially mitigates that concern.”\u003c/p>\n\u003cp>Biogen and Eisai have promised to dig into the data and parse out the effect APOE4 had on whether patients responded to BAN2401, but those results likely won’t be ready for months.\u003c/p>\n\u003cp>In the meantime, companies are still queueing up to take cracks at amyloid.\u003c/p>\n\u003cp>Eli Lilly, which has spent billions on failed Alzheimer’s drugs in recent years, has designed a trial that will test the amyloid hypothesis “in the most definitive way possible,” said Mark Mintun, the company’s vice president of neurodegeneration.\u003c/p>\n\u003cp>The plan is to take a BACE inhibitor and pair it with an injected treatment that targets amyloid already in the brain. That should address the two major concerns with each approach, Mintun said: BACE inhibitors prevent amyloid but don’t address plaques that already exist, while amyloid-targeting therapies don’t stem the flow of new toxic clumps.\u003c/p>\n\u003cp>“I equate it to going down to your basement and finding three feet of water and there’s been a slow drip for four weeks,” Mintun said. “You can turn off the spigot, but it won’t feel like you’ve made much progress, so you’ve got to pump it out, too.”\u003c/p>\n\u003cp>That study is enrolling 375 patients into three groups, planning to study whether the combination can improve cognition compared with placebo over 18 months.\u003c/p>\n\u003cp>\u003cem>Andrew Joseph contributed reporting.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/07/30/alzheimers-amyloid-hypothesis/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, 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": "Off Your Mental Game? You Could Be Mildly Dehydrated",
"title": "Off Your Mental Game? You Could Be Mildly Dehydrated",
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"content": "\u003cp>Was it hard to concentrate during that long meeting? Does the crossword seem a little tougher? You could be mildly dehydrated.\u003c/p>\n\u003cp>A growing body of evidence finds that being just a little dehydrated is tied to a range of subtle effects — from mood changes to muddled thinking.\u003c/p>\n\u003cp>\"We find that when people are mildly dehydrated they really don't do as well on tasks that require complex processing or on tasks that require a lot of their attention,\" says \u003ca href=\"http://biosci.gatech.edu/people/mindy-millard-stafford\" target=\"_blank\" rel=\"noopener\">Mindy Millard-Stafford\u003c/a>, director of the Exercise Physiology Laboratory at Georgia Institute of Technology. She \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=dehydration+impairs+cognition+Millard-Stafford\" target=\"_blank\" rel=\"noopener\">published\u003c/a> an analysis of the evidence this month, based on 33 studies.\u003c/p>\n\u003cp>How long does it take to become mildly dehydrated in the summer heat? Not long at all, studies show, especially when you exercise outdoors.\u003c/p>\n\u003cp>\"If I were hiking at moderate intensity for one hour, I could reach about 1.5 percent to 2 percent dehydration,\" says \u003ca href=\"https://ksi.uconn.edu/about/staff/\" target=\"_blank\" rel=\"noopener\">Doug Casa\u003c/a>, a professor of kinesiology at the University of Connecticut, and CEO of the Korey Stringer Institute.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For an average-size person, 2 percent dehydration equates to sweating out about a liter of water.\u003c/p>\n\u003cp>\"Most people don't realize how high their sweat rate is in the heat,\" Casa says. If you're going hard during a run, you can reach that level of dehydration in about 30 minutes.\u003c/p>\n\u003cp>And at this level of dehydration, the feeling of thirst, for many of us, is only just beginning to kick in. \"Most people can't perceive that they're 1.5 percent dehydrated,\" Casa says.\u003c/p>\n\u003cp>But already there are subtle — maybe even imperceptible — effects on our bodies and our mental performance.\u003c/p>\n\u003cp>Take, for example, the findings from a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Water+Intake+Reverses+Dehydration+Executive+Function\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of young, healthy and active women who agreed to take a bunch of cognitive tests and also agreed to restrict their fluid intake to no more than 6 ounces for one day.\u003c/p>\n\u003cp>\"We did manage to dehydrate them by [about] 1 percent just by telling them not to drink for the day,\" says \u003ca href=\"http://jbpierce.org/faculty/nina-stachenfeld-phd/\" target=\"_blank\" rel=\"noopener\">Nina Stachenfeld\u003c/a>, of the Yale School of Medicine and the John B. Pierce Laboratory, who led the research.\u003c/p>\n\u003cp>The women took one test designed to measure cognitive flexibility. It's a card game that requires a lot of attention, since the rules keep changing throughout the game.\u003c/p>\n\u003cp>\"When the women were dehydrated they had about 12 percent more total errors\" in the game, says Stachenfeld.\u003c/p>\n\u003cp>She repeated the tests after the women drank sufficient water, and their performance improved. \"We were able to improve executive function back to normal — in other words, back to the baseline day — when they rehydrated,\" the scientist says.\u003c/p>\n\u003cp>Dehydration didn't hamper performance on all the tests; the women's reaction time, for example, was not impeded. The decline was seen during the complicated tasks.\u003c/p>\n\u003cp>Though the study was small, and funded by PepsiCo, which sells bottled water, Stachenfeld designed the methods and completed the analysis independently. And other scientists say her findings fit with a growing body of independent evidence that points to similar conclusions.\u003c/p>\n\u003cp>\"I absolutely think there could be big implications of having a mild cognitive deficiency with small amounts of dehydration,\" Casa says.\u003c/p>\n\u003cp>If you're a student, for example, a 12 percent increase in errors on a test might matter. And whether you're a pilot, a soldier, a surgeon or a scholar, many daily tasks depend on the ability to be precise and pay attention.\u003c/p>\n\u003cp>For anyone trying to do their best work, the findings raise a number of questions:\u003c/p>\n\u003cp>\u003cstrong>How Much Water Do We Need?\u003c/strong>\u003c/p>\n\u003cp>There are no exact daily requirements, but there are general recommendations.\u003c/p>\n\u003cp>A panel of scholars convened several years ago by the National Academies of Sciences, Engineering and Medicine \u003ca href=\"http://www.nationalacademies.org/hmd/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx\" target=\"_blank\" rel=\"noopener\">concluded\u003c/a> that women should consume, on average, about 91 ounces of total water per day. For men, the suggested level is even higher (125 ounces).\u003c/p>\n\u003cp>Note that this total includes water from all sources, including food and other beverages, such as coffee and tea. Typically, people get about 20 percent of the water they need daily from fruits, vegetables and other food.\u003c/p>\n\u003cp>Also, water needs vary from person to person. For example, body weight and muscle mass matter. Also, physical activity and heat exposure can increase the amount of fluid a person needs.\u003c/p>\n\u003cp>\u003cstrong>How Can You Tell If You're Dehydrated?\u003c/strong>\u003c/p>\n\u003cp>One easy test: The color of your urine is a good guide. As a general rule of thumb, the darker the color, the more likely you are to be dehydrated. Aim for shades that have been described as \"pale lemonade\" or \"straw.\" A \u003ca href=\"http://www.hydrationcheck.com/about.php\" target=\"_blank\" rel=\"noopener\">color chart\u003c/a> developed by physiologist and University of Connecticut professor \u003ca href=\"https://kins.uconn.edu/lawrence-e-armstrong-ph-d/\" target=\"_blank\" rel=\"noopener\">Lawrence Armstrong\u003c/a> can be a helpful guide, researchers say.\u003c/p>\n\u003cp>\u003cstrong>Are Older People More Vulnerable to Dehydration?\u003c/strong>\u003c/p>\n\u003cp>As we age, we're not as good at recognizing thirst. And there's \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=suhr+cognition+and+dehydration\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that older adults are prone to the same dips in mental sharpness as anyone else when mildly dehydrated.\u003c/p>\n\u003cp>Don't wait until you're thirsty. A good rule of thumb is to sip fluids throughout the day. No need to chug huge amounts at one time; there are some \u003ca href=\"https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/water-balance/overhydration\" target=\"_blank\" rel=\"noopener\">risks to overhydrating\u003c/a>, too.\u003c/p>\n\u003cp>\u003cstrong>Can Coffee, Tea and Other Caffeinated Drinks Dehydrate?\u003c/strong>\u003c/p>\n\u003cp>The most recent evidence finds that coffee provides similar hydrating qualities to water. In other words, yes, your morning cup of joe — or whatever caffeinated beverage you fancy, can help to keep you hydrated.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>As we \u003ca href=\"https://www.npr.org/sections/thesalt/2014/01/13/262175623/coffee-myth-busting-cup-of-joe-may-help-hydration-and-memory\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> in 2014, people who routinely drink coffee or tea develop a tolerance to the potential diuretic effects of caffeine.\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=Off+Your+Mental+Game%3F+You+Could+Be+Mildly+Dehydrated&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Was it hard to concentrate during that long meeting? Does the crossword seem a little tougher? You could be mildly dehydrated.\u003c/p>\n\u003cp>A growing body of evidence finds that being just a little dehydrated is tied to a range of subtle effects — from mood changes to muddled thinking.\u003c/p>\n\u003cp>\"We find that when people are mildly dehydrated they really don't do as well on tasks that require complex processing or on tasks that require a lot of their attention,\" says \u003ca href=\"http://biosci.gatech.edu/people/mindy-millard-stafford\" target=\"_blank\" rel=\"noopener\">Mindy Millard-Stafford\u003c/a>, director of the Exercise Physiology Laboratory at Georgia Institute of Technology. She \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=dehydration+impairs+cognition+Millard-Stafford\" target=\"_blank\" rel=\"noopener\">published\u003c/a> an analysis of the evidence this month, based on 33 studies.\u003c/p>\n\u003cp>How long does it take to become mildly dehydrated in the summer heat? Not long at all, studies show, especially when you exercise outdoors.\u003c/p>\n\u003cp>\"If I were hiking at moderate intensity for one hour, I could reach about 1.5 percent to 2 percent dehydration,\" says \u003ca href=\"https://ksi.uconn.edu/about/staff/\" target=\"_blank\" rel=\"noopener\">Doug Casa\u003c/a>, a professor of kinesiology at the University of Connecticut, and CEO of the Korey Stringer Institute.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For an average-size person, 2 percent dehydration equates to sweating out about a liter of water.\u003c/p>\n\u003cp>\"Most people don't realize how high their sweat rate is in the heat,\" Casa says. If you're going hard during a run, you can reach that level of dehydration in about 30 minutes.\u003c/p>\n\u003cp>And at this level of dehydration, the feeling of thirst, for many of us, is only just beginning to kick in. \"Most people can't perceive that they're 1.5 percent dehydrated,\" Casa says.\u003c/p>\n\u003cp>But already there are subtle — maybe even imperceptible — effects on our bodies and our mental performance.\u003c/p>\n\u003cp>Take, for example, the findings from a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=Water+Intake+Reverses+Dehydration+Executive+Function\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of young, healthy and active women who agreed to take a bunch of cognitive tests and also agreed to restrict their fluid intake to no more than 6 ounces for one day.\u003c/p>\n\u003cp>\"We did manage to dehydrate them by [about] 1 percent just by telling them not to drink for the day,\" says \u003ca href=\"http://jbpierce.org/faculty/nina-stachenfeld-phd/\" target=\"_blank\" rel=\"noopener\">Nina Stachenfeld\u003c/a>, of the Yale School of Medicine and the John B. Pierce Laboratory, who led the research.\u003c/p>\n\u003cp>The women took one test designed to measure cognitive flexibility. It's a card game that requires a lot of attention, since the rules keep changing throughout the game.\u003c/p>\n\u003cp>\"When the women were dehydrated they had about 12 percent more total errors\" in the game, says Stachenfeld.\u003c/p>\n\u003cp>She repeated the tests after the women drank sufficient water, and their performance improved. \"We were able to improve executive function back to normal — in other words, back to the baseline day — when they rehydrated,\" the scientist says.\u003c/p>\n\u003cp>Dehydration didn't hamper performance on all the tests; the women's reaction time, for example, was not impeded. The decline was seen during the complicated tasks.\u003c/p>\n\u003cp>Though the study was small, and funded by PepsiCo, which sells bottled water, Stachenfeld designed the methods and completed the analysis independently. And other scientists say her findings fit with a growing body of independent evidence that points to similar conclusions.\u003c/p>\n\u003cp>\"I absolutely think there could be big implications of having a mild cognitive deficiency with small amounts of dehydration,\" Casa says.\u003c/p>\n\u003cp>If you're a student, for example, a 12 percent increase in errors on a test might matter. And whether you're a pilot, a soldier, a surgeon or a scholar, many daily tasks depend on the ability to be precise and pay attention.\u003c/p>\n\u003cp>For anyone trying to do their best work, the findings raise a number of questions:\u003c/p>\n\u003cp>\u003cstrong>How Much Water Do We Need?\u003c/strong>\u003c/p>\n\u003cp>There are no exact daily requirements, but there are general recommendations.\u003c/p>\n\u003cp>A panel of scholars convened several years ago by the National Academies of Sciences, Engineering and Medicine \u003ca href=\"http://www.nationalacademies.org/hmd/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx\" target=\"_blank\" rel=\"noopener\">concluded\u003c/a> that women should consume, on average, about 91 ounces of total water per day. For men, the suggested level is even higher (125 ounces).\u003c/p>\n\u003cp>Note that this total includes water from all sources, including food and other beverages, such as coffee and tea. Typically, people get about 20 percent of the water they need daily from fruits, vegetables and other food.\u003c/p>\n\u003cp>Also, water needs vary from person to person. For example, body weight and muscle mass matter. Also, physical activity and heat exposure can increase the amount of fluid a person needs.\u003c/p>\n\u003cp>\u003cstrong>How Can You Tell If You're Dehydrated?\u003c/strong>\u003c/p>\n\u003cp>One easy test: The color of your urine is a good guide. As a general rule of thumb, the darker the color, the more likely you are to be dehydrated. Aim for shades that have been described as \"pale lemonade\" or \"straw.\" A \u003ca href=\"http://www.hydrationcheck.com/about.php\" target=\"_blank\" rel=\"noopener\">color chart\u003c/a> developed by physiologist and University of Connecticut professor \u003ca href=\"https://kins.uconn.edu/lawrence-e-armstrong-ph-d/\" target=\"_blank\" rel=\"noopener\">Lawrence Armstrong\u003c/a> can be a helpful guide, researchers say.\u003c/p>\n\u003cp>\u003cstrong>Are Older People More Vulnerable to Dehydration?\u003c/strong>\u003c/p>\n\u003cp>As we age, we're not as good at recognizing thirst. And there's \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=suhr+cognition+and+dehydration\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that older adults are prone to the same dips in mental sharpness as anyone else when mildly dehydrated.\u003c/p>\n\u003cp>Don't wait until you're thirsty. A good rule of thumb is to sip fluids throughout the day. No need to chug huge amounts at one time; there are some \u003ca href=\"https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/water-balance/overhydration\" target=\"_blank\" rel=\"noopener\">risks to overhydrating\u003c/a>, too.\u003c/p>\n\u003cp>\u003cstrong>Can Coffee, Tea and Other Caffeinated Drinks Dehydrate?\u003c/strong>\u003c/p>\n\u003cp>The most recent evidence finds that coffee provides similar hydrating qualities to water. In other words, yes, your morning cup of joe — or whatever caffeinated beverage you fancy, can help to keep you hydrated.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>As we \u003ca href=\"https://www.npr.org/sections/thesalt/2014/01/13/262175623/coffee-myth-busting-cup-of-joe-may-help-hydration-and-memory\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> in 2014, people who routinely drink coffee or tea develop a tolerance to the potential diuretic effects of caffeine.\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=Off+Your+Mental+Game%3F+You+Could+Be+Mildly+Dehydrated&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Marines Who Fired Rocket Launchers Now Worry About Their Brains",
"title": "Marines Who Fired Rocket Launchers Now Worry About Their Brains",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Chris Ferrari was just 18 the first time he balanced a rocket launcher on his right shoulder and aimed it at a practice target.\u003c/p>\n\u003cp>\"Your adrenaline's going and you're trying to focus on getting that round to hit, and then you go to squeeze that trigger and, you know.\"\u003c/p>\n\u003cp>Boom!\u003c/p>\n\u003cp>The report is loud enough to burst the eardrums of anyone not wearing military-grade hearing protection. And the blast wave from the weapon is so powerful it feels like a whole-body punch.\u003c/p>\n\u003cp>\"It's exhilarating,\" says Chris's buddy Daniel, a former gunner in the Marine Corps who asked that we not use his last name. \"When you feel a concussive wave, it's an awesome thing. It fills you with awe.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It also may do bad things to your brain.\u003c/p>\n\u003cp>Studies show that troops who repeatedly fire powerful, shoulder-launched weapons can \u003ca href=\"https://academic.oup.com/acn/article/31/6/622/2236746\" target=\"_blank\" rel=\"noopener\">experience short-term problems with memory and thinking\u003c/a>. They may also feel nauseated, fatigued and dizzy. In short, they have symptoms like \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24901327\" target=\"_blank\" rel=\"noopener\">those of a concussion\u003c/a>.\u003c/p>\n\u003cp>It's still not clear whether firing these weapons can lead to long-term brain damage. But Chris and Daniel suspect that, for them, it may have.\u003c/p>\n\u003cp>While in the Marines, Daniel and Chris spent two years in the late 1990s firing a rocket launcher called the shoulder-launched multipurpose assault weapon, or \u003ca href=\"https://www.globalsecurity.org/military/systems/ground/smaw.htm\" target=\"_blank\" rel=\"noopener\">SMAW\u003c/a>.\u003c/p>\n\u003cp>They were a team. Chris loaded the rockets. Daniel pulled the trigger. Then they would switch places.\u003c/p>\n\u003cp>And together, they fired hundreds of rounds in training exercises around the world.\u003c/p>\n\u003cp>\"That's me and Daniel at the base of Mount Fuji, posing for a picture with our SMAW,\" Chris says as he leafs through an album of photographs Daniel put together.\u003c/p>\n\u003cp>The SMAW is one of several modern weapons light enough for one person to carry but powerful enough to blow up a tank.\u003c/p>\n\u003cp>Daniel and Chris say they felt like their brains had been rattled every time they fired the SMAW. And they fired it a lot.\u003c/p>\n\u003cp>\"Chris and I were incredibly good shots,\" Daniel says.\u003c/p>\n\u003cp>\"We never missed,\" Chris adds. \"We were always selected by our sergeant and our leaders to do the firing because they wanted to see the explosion, you know, they wanted to see the target get hit.\"\u003c/p>\n\u003cp>But as the two men fired the SMAW again and again, some of the thrill began to fade.\u003c/p>\n\u003cp>Every shot \"felt like the world was caving in on you,\" Chris says.\u003c/p>\n\u003cp>The U.S. military limits the number of times troops can fire heavy weapons like the SMAW in a single day. But the limits are based on concern about hearing loss, not brain damage.\u003c/p>\n\u003cp>And 20 years ago, safety wasn't taken very seriously, Daniel says.\u003c/p>\n\u003cp>\"I remember they were saying you're only allowed to shoot three of these things a day because it's, like, really bad for you,\" he says. \"And then I would shoot three and then you [Chris] would shoot three. And then the guys 10 feet from us would shoot six and then the other team would shoot six.\"\u003c/p>\n\u003cp>Chris had a lot of headaches, and sometimes couldn't think straight after a day on the range. \"You feel odd and you feel out of place and you feel exhausted and tired,\" he says. \"But, you know, you're a Marine and you learn to put it away.\"\u003c/p>\n\u003cp>Until you can't.\u003c/p>\n\u003cp>For Daniel, that happened during a joint training exercise in Malaysia. Their platoon was still setting up, Chris says, \"and all of sudden out of nowhere: Boom!\"\u003c/p>\n\u003cp>Malaysian troops just a few feet away had fired an antitank weapon called the \u003ca href=\"https://saab.com/land/weapon-systems/support-weapons/at4/\" target=\"_blank\" rel=\"noopener\">AT4\u003c/a>. The blast wave hit Daniel hard.\u003c/p>\n\u003cp>\"I was, like, absolutely dizzy,\" Daniel says. \"I was absolutely disjointed. I felt nauseous, like I really felt like I needed to throw up.\"\u003c/p>\n\u003cp>So Daniel told his sergeant. \"And it was just: 'Shut your face. Are you complaining? Why is everyone else OK and you're not?' \"\u003c/p>\n\u003cp>\u003cstrong>Blast Injuries Overlooked\u003c/strong>\u003c/p>\n\u003cp>Back then, in the 1990s, the military pretty much assumed a fighter's brain was fine unless there was some external sign of injury.\u003c/p>\n\u003cp>That was because, at the time, no one really understood how an invisible blast wave could damage the brain without leaving a mark, says Tracie Lattimore, who directs the Army's traumatic brain injury program.\u003c/p>\n\u003cp>\"The science wasn't up to speed,\" she says. \"It just didn't exist.\"\u003c/p>\n\u003cp>But since 2007, Lattimore says, the Department of Defense has spent about a billion dollars studying traumatic brain injuries, including those caused by blast exposure.\u003c/p>\n\u003cp>At first, the research focused on bomb blasts, especially those from the improvised explosive devices that had become common in Iraq and Afghanistan.\u003c/p>\n\u003cp>But over time, Lattimore says, the military's research has expanded beyond IEDs to include the effects of blasts from weapons like the one Chris and Daniel shot.\u003c/p>\n\u003cp>\"If you talk to us in a year from now, I think we're going to have exponential growth in our knowledge coming out of these current studies and our future studies,\" Lattimore says.\u003c/p>\n\u003cp>Eventually, that could help the hundreds of thousands of veterans who have fired these weapons in the past couple of decades.\u003c/p>\n\u003cp>But right now, people like Daniel and Chris have no way to know whether firing heavy weapons could have affected their brains.\u003c/p>\n\u003cp>Chris wonders whether all those blasts might be the reason he once landed in a military hospital for two weeks.\u003c/p>\n\u003cp>It happened after a weeklong training exercise in the California desert near Twentynine Palms. Thousands of troops took part and Daniel and Chris fired lots and lots of rockets. They also set off lots of explosives.\u003c/p>\n\u003cp>Several days after the exercise ended, Daniel noticed that Chris was awake in the middle of the night.\u003c/p>\n\u003cp>\"He just got up and started walking out of the room in his stinking underwear,\" Daniel says. \"And I was like, 'Hey Chris, what's going on?' And he was just kind of like looking through me.\"\u003c/p>\n\u003cp>\"I don't remember it,\" Chris says. \"But I know that they put me in the hospital and thought I had spinal meningitis or something.\"\u003c/p>\n\u003cp>He didn't. And the doctors never pinpointed another cause. They clearly thought something was wrong with his brain. But at the time, no one would have thought to ask whether the problem was caused by the weapons Chris had fired.\u003c/p>\n\u003cp>Chris's military career ended one morning when his platoon left on a bus and he didn't get on it. Ultimately, he got a bad conduct discharge.\u003c/p>\n\u003cp>It's been nearly two decades since Chris and Daniel fired the SMAW.\u003c/p>\n\u003cp>They've both settled in Northern California, which is where they grew up. And they both have symptoms that could be from a brain injury — or something else.\u003c/p>\n\u003cp>Chris has lots of questions.\u003c/p>\n\u003cp>\"Why does this hurt on my body? Why do I feel lost? Why can't I concentrate on stuff as long [as I used to]?\"\u003c/p>\n\u003cp>Chris also has trouble controlling his emotions, something he says wasn't a problem before his military service.\u003c/p>\n\u003cp>For Daniel, it's his memory that's the problem.\u003c/p>\n\u003cp>\"I used to be photographic. Now I'm forgetful,\" he says. \"I'm 40, that's ... I don't know, man. Maybe I'm getting old.\"\u003c/p>\n\u003cp>Both Chris and Daniel have problems with balance and orientation. For Daniel it can happen when he turns his head quickly or stumbles.\u003c/p>\n\u003cp>\"I lose my spatial orientation,\" he says. \"I don't know where I am. Vision gets blurrier. Even sound is kind of muffled.\"\u003c/p>\n\u003cp>These are common symptoms of damage to the brain's \u003ca href=\"https://vestibular.org/understanding-vestibular-disorder/human-balance-system\" target=\"_blank\" rel=\"noopener\">vestibular system\u003c/a>, something that affects many people who have experienced a traumatic brain injury from a bomb blast or blow to the head.\u003c/p>\n\u003cp>\u003cstrong>Uncertain Coverage \u003c/strong>\u003c/p>\n\u003cp>But Daniel and Chris were never in combat and never were injured in any obvious way during training. That means it's not clear whether they are entitled to care from doctors and hospitals run by the Department of Veterans Affairs.\u003c/p>\n\u003cp>Chris has never tried to get care from the VA. But Daniel has. And he learned that the VA doesn't have an obvious category for people like him.\u003c/p>\n\u003cp>Daniel had never connected his symptoms with his time as a Marine until he heard a \u003ca href=\"https://www.npr.org/sections/health-shots/2016/12/20/506146595/pentagon-shelves-blast-gauges-meant-to-detect-battlefield-brain-injuries\" target=\"_blank\" rel=\"noopener\">radio story\u003c/a> on NPR suggesting that certain military weapons might be powerful enough to give the shooter a traumatic brain injury.\u003c/p>\n\u003cp>\"I went back to the VA and I said I want to be tested for TBI,\" he says. \"And they said great.\"\u003c/p>\n\u003cp>They handed him a questionnaire. The first question asked where he had been in combat. But he hadn't been.\u003c/p>\n\u003cp>The second question asked: \"Were you hit by an IED?\" Daniel says it went on: \"Was it a grenade explosion? Was a bomb dropped too close to you?\" So I couldn't actually answer the questionnaire.\"\u003c/p>\n\u003cp>All he'd done was fire a rocket launcher in training exercises, over and over and over.\u003c/p>\n\u003cp>VA doctors see quite a few veterans like Daniel, says \u003ca href=\"https://www.washingtondc.va.gov/management/index.asp?cx=1&key=15\" target=\"_blank\" rel=\"noopener\">Dr. Joel Scholten\u003c/a>, who's in charge of physical medicine and rehabilitation for the VA. He says the conversation usually goes like this:\u003c/p>\n\u003cp>\"While I was training we fired a certain type of weapon. I felt dizzy or had some ringing in my ears after that.\"\u003c/p>\n\u003cp>Then Scholten asks if the veteran was ever near a bomb blast or took a blow to the head. Many say yes. And for them, VA guidelines call for a full examination for traumatic brain injury.\u003c/p>\n\u003cp>But for veterans like Daniel, coverage is uncertain. That's because there still isn't clear evidence that training with heavy weapons can cause long-term problems with things like memory, thinking and balance.\u003c/p>\n\u003cp>\"These symptoms are what we call nonspecific,\" Scholten says. \"So they're not unique to traumatic brain injury, and in fact there is no symptom that happens only with traumatic brain injury or concussion.\"\u003c/p>\n\u003cp>From a medical perspective, the lack of a box to tick is not a big deal. Treatments usually focus on improving a patient's symptoms, regardless of the cause.\u003c/p>\n\u003cp>\"For instance, someone with cognitive or concentration impairments, we would focus our therapy on how to improve concentration,\" Scholten says.\u003c/p>\n\u003cp>But paying for therapy is another matter. The VA gives priority to veterans whose medical problems can be linked to their service.\u003c/p>\n\u003cp>And since military scientists still aren't sure whether firing a powerful weapon can have long-term effects, Daniel says the VA is sending him the bill. He's being asked to pay out of pocket for high-tech brain scans and other tests.\u003c/p>\n\u003cp>\"I love the VA,\" Daniel says. \"I have nothing bad to say about the VA. The individuals there get it. They really do. But their hands are typically tied by their process.\"\u003c/p>\n\u003cp>\u003ca href=\"https://blastinjuryresearch.amedd.army.mil/index.cfm/sos/neurological_effects_of_repeated_exposure\" target=\"_blank\" rel=\"noopener\">Studies\u003c/a> now underway should help clear up whether people like Daniel could have been harmed by the weapons they fired, Scholten says. And the results of those studies will be used to update the VA's guidelines on who gets checked out for a traumatic brain injury.\u003c/p>\n\u003cp>\"In the next iteration, will we or should we expand to include training exposures?\" Scholten says. \"Possibly so.\"\u003c/p>\n\u003cp>If they do, it could mean evaluating the brains of tens of thousands of veterans who trained with weapons like the one Daniel shot.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>You can contact Jon Hamilton at \u003c/em>\u003ca href=\"mailto:jhamilton@npr.org\" target=\"_blank\" rel=\"noopener\">\u003cem>jhamilton@npr.org\u003c/em>\u003c/a>.\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=Marines+Who+Fired+Rocket+Launchers+Now+Worry+About+Their+Brains+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The military is trying to figure out whether troops can sustain brain injuries from firing certain powerful weapons. Two Marines who used to shoot these weapons think they already know.",
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"description": "The military is trying to figure out whether troops can sustain brain injuries from firing certain powerful weapons. Two Marines who used to shoot these weapons think they already know.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Chris Ferrari was just 18 the first time he balanced a rocket launcher on his right shoulder and aimed it at a practice target.\u003c/p>\n\u003cp>\"Your adrenaline's going and you're trying to focus on getting that round to hit, and then you go to squeeze that trigger and, you know.\"\u003c/p>\n\u003cp>Boom!\u003c/p>\n\u003cp>The report is loud enough to burst the eardrums of anyone not wearing military-grade hearing protection. And the blast wave from the weapon is so powerful it feels like a whole-body punch.\u003c/p>\n\u003cp>\"It's exhilarating,\" says Chris's buddy Daniel, a former gunner in the Marine Corps who asked that we not use his last name. \"When you feel a concussive wave, it's an awesome thing. It fills you with awe.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It also may do bad things to your brain.\u003c/p>\n\u003cp>Studies show that troops who repeatedly fire powerful, shoulder-launched weapons can \u003ca href=\"https://academic.oup.com/acn/article/31/6/622/2236746\" target=\"_blank\" rel=\"noopener\">experience short-term problems with memory and thinking\u003c/a>. They may also feel nauseated, fatigued and dizzy. In short, they have symptoms like \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24901327\" target=\"_blank\" rel=\"noopener\">those of a concussion\u003c/a>.\u003c/p>\n\u003cp>It's still not clear whether firing these weapons can lead to long-term brain damage. But Chris and Daniel suspect that, for them, it may have.\u003c/p>\n\u003cp>While in the Marines, Daniel and Chris spent two years in the late 1990s firing a rocket launcher called the shoulder-launched multipurpose assault weapon, or \u003ca href=\"https://www.globalsecurity.org/military/systems/ground/smaw.htm\" target=\"_blank\" rel=\"noopener\">SMAW\u003c/a>.\u003c/p>\n\u003cp>They were a team. Chris loaded the rockets. Daniel pulled the trigger. Then they would switch places.\u003c/p>\n\u003cp>And together, they fired hundreds of rounds in training exercises around the world.\u003c/p>\n\u003cp>\"That's me and Daniel at the base of Mount Fuji, posing for a picture with our SMAW,\" Chris says as he leafs through an album of photographs Daniel put together.\u003c/p>\n\u003cp>The SMAW is one of several modern weapons light enough for one person to carry but powerful enough to blow up a tank.\u003c/p>\n\u003cp>Daniel and Chris say they felt like their brains had been rattled every time they fired the SMAW. And they fired it a lot.\u003c/p>\n\u003cp>\"Chris and I were incredibly good shots,\" Daniel says.\u003c/p>\n\u003cp>\"We never missed,\" Chris adds. \"We were always selected by our sergeant and our leaders to do the firing because they wanted to see the explosion, you know, they wanted to see the target get hit.\"\u003c/p>\n\u003cp>But as the two men fired the SMAW again and again, some of the thrill began to fade.\u003c/p>\n\u003cp>Every shot \"felt like the world was caving in on you,\" Chris says.\u003c/p>\n\u003cp>The U.S. military limits the number of times troops can fire heavy weapons like the SMAW in a single day. But the limits are based on concern about hearing loss, not brain damage.\u003c/p>\n\u003cp>And 20 years ago, safety wasn't taken very seriously, Daniel says.\u003c/p>\n\u003cp>\"I remember they were saying you're only allowed to shoot three of these things a day because it's, like, really bad for you,\" he says. \"And then I would shoot three and then you [Chris] would shoot three. And then the guys 10 feet from us would shoot six and then the other team would shoot six.\"\u003c/p>\n\u003cp>Chris had a lot of headaches, and sometimes couldn't think straight after a day on the range. \"You feel odd and you feel out of place and you feel exhausted and tired,\" he says. \"But, you know, you're a Marine and you learn to put it away.\"\u003c/p>\n\u003cp>Until you can't.\u003c/p>\n\u003cp>For Daniel, that happened during a joint training exercise in Malaysia. Their platoon was still setting up, Chris says, \"and all of sudden out of nowhere: Boom!\"\u003c/p>\n\u003cp>Malaysian troops just a few feet away had fired an antitank weapon called the \u003ca href=\"https://saab.com/land/weapon-systems/support-weapons/at4/\" target=\"_blank\" rel=\"noopener\">AT4\u003c/a>. The blast wave hit Daniel hard.\u003c/p>\n\u003cp>\"I was, like, absolutely dizzy,\" Daniel says. \"I was absolutely disjointed. I felt nauseous, like I really felt like I needed to throw up.\"\u003c/p>\n\u003cp>So Daniel told his sergeant. \"And it was just: 'Shut your face. Are you complaining? Why is everyone else OK and you're not?' \"\u003c/p>\n\u003cp>\u003cstrong>Blast Injuries Overlooked\u003c/strong>\u003c/p>\n\u003cp>Back then, in the 1990s, the military pretty much assumed a fighter's brain was fine unless there was some external sign of injury.\u003c/p>\n\u003cp>That was because, at the time, no one really understood how an invisible blast wave could damage the brain without leaving a mark, says Tracie Lattimore, who directs the Army's traumatic brain injury program.\u003c/p>\n\u003cp>\"The science wasn't up to speed,\" she says. \"It just didn't exist.\"\u003c/p>\n\u003cp>But since 2007, Lattimore says, the Department of Defense has spent about a billion dollars studying traumatic brain injuries, including those caused by blast exposure.\u003c/p>\n\u003cp>At first, the research focused on bomb blasts, especially those from the improvised explosive devices that had become common in Iraq and Afghanistan.\u003c/p>\n\u003cp>But over time, Lattimore says, the military's research has expanded beyond IEDs to include the effects of blasts from weapons like the one Chris and Daniel shot.\u003c/p>\n\u003cp>\"If you talk to us in a year from now, I think we're going to have exponential growth in our knowledge coming out of these current studies and our future studies,\" Lattimore says.\u003c/p>\n\u003cp>Eventually, that could help the hundreds of thousands of veterans who have fired these weapons in the past couple of decades.\u003c/p>\n\u003cp>But right now, people like Daniel and Chris have no way to know whether firing heavy weapons could have affected their brains.\u003c/p>\n\u003cp>Chris wonders whether all those blasts might be the reason he once landed in a military hospital for two weeks.\u003c/p>\n\u003cp>It happened after a weeklong training exercise in the California desert near Twentynine Palms. Thousands of troops took part and Daniel and Chris fired lots and lots of rockets. They also set off lots of explosives.\u003c/p>\n\u003cp>Several days after the exercise ended, Daniel noticed that Chris was awake in the middle of the night.\u003c/p>\n\u003cp>\"He just got up and started walking out of the room in his stinking underwear,\" Daniel says. \"And I was like, 'Hey Chris, what's going on?' And he was just kind of like looking through me.\"\u003c/p>\n\u003cp>\"I don't remember it,\" Chris says. \"But I know that they put me in the hospital and thought I had spinal meningitis or something.\"\u003c/p>\n\u003cp>He didn't. And the doctors never pinpointed another cause. They clearly thought something was wrong with his brain. But at the time, no one would have thought to ask whether the problem was caused by the weapons Chris had fired.\u003c/p>\n\u003cp>Chris's military career ended one morning when his platoon left on a bus and he didn't get on it. Ultimately, he got a bad conduct discharge.\u003c/p>\n\u003cp>It's been nearly two decades since Chris and Daniel fired the SMAW.\u003c/p>\n\u003cp>They've both settled in Northern California, which is where they grew up. And they both have symptoms that could be from a brain injury — or something else.\u003c/p>\n\u003cp>Chris has lots of questions.\u003c/p>\n\u003cp>\"Why does this hurt on my body? Why do I feel lost? Why can't I concentrate on stuff as long [as I used to]?\"\u003c/p>\n\u003cp>Chris also has trouble controlling his emotions, something he says wasn't a problem before his military service.\u003c/p>\n\u003cp>For Daniel, it's his memory that's the problem.\u003c/p>\n\u003cp>\"I used to be photographic. Now I'm forgetful,\" he says. \"I'm 40, that's ... I don't know, man. Maybe I'm getting old.\"\u003c/p>\n\u003cp>Both Chris and Daniel have problems with balance and orientation. For Daniel it can happen when he turns his head quickly or stumbles.\u003c/p>\n\u003cp>\"I lose my spatial orientation,\" he says. \"I don't know where I am. Vision gets blurrier. Even sound is kind of muffled.\"\u003c/p>\n\u003cp>These are common symptoms of damage to the brain's \u003ca href=\"https://vestibular.org/understanding-vestibular-disorder/human-balance-system\" target=\"_blank\" rel=\"noopener\">vestibular system\u003c/a>, something that affects many people who have experienced a traumatic brain injury from a bomb blast or blow to the head.\u003c/p>\n\u003cp>\u003cstrong>Uncertain Coverage \u003c/strong>\u003c/p>\n\u003cp>But Daniel and Chris were never in combat and never were injured in any obvious way during training. That means it's not clear whether they are entitled to care from doctors and hospitals run by the Department of Veterans Affairs.\u003c/p>\n\u003cp>Chris has never tried to get care from the VA. But Daniel has. And he learned that the VA doesn't have an obvious category for people like him.\u003c/p>\n\u003cp>Daniel had never connected his symptoms with his time as a Marine until he heard a \u003ca href=\"https://www.npr.org/sections/health-shots/2016/12/20/506146595/pentagon-shelves-blast-gauges-meant-to-detect-battlefield-brain-injuries\" target=\"_blank\" rel=\"noopener\">radio story\u003c/a> on NPR suggesting that certain military weapons might be powerful enough to give the shooter a traumatic brain injury.\u003c/p>\n\u003cp>\"I went back to the VA and I said I want to be tested for TBI,\" he says. \"And they said great.\"\u003c/p>\n\u003cp>They handed him a questionnaire. The first question asked where he had been in combat. But he hadn't been.\u003c/p>\n\u003cp>The second question asked: \"Were you hit by an IED?\" Daniel says it went on: \"Was it a grenade explosion? Was a bomb dropped too close to you?\" So I couldn't actually answer the questionnaire.\"\u003c/p>\n\u003cp>All he'd done was fire a rocket launcher in training exercises, over and over and over.\u003c/p>\n\u003cp>VA doctors see quite a few veterans like Daniel, says \u003ca href=\"https://www.washingtondc.va.gov/management/index.asp?cx=1&key=15\" target=\"_blank\" rel=\"noopener\">Dr. Joel Scholten\u003c/a>, who's in charge of physical medicine and rehabilitation for the VA. He says the conversation usually goes like this:\u003c/p>\n\u003cp>\"While I was training we fired a certain type of weapon. I felt dizzy or had some ringing in my ears after that.\"\u003c/p>\n\u003cp>Then Scholten asks if the veteran was ever near a bomb blast or took a blow to the head. Many say yes. And for them, VA guidelines call for a full examination for traumatic brain injury.\u003c/p>\n\u003cp>But for veterans like Daniel, coverage is uncertain. That's because there still isn't clear evidence that training with heavy weapons can cause long-term problems with things like memory, thinking and balance.\u003c/p>\n\u003cp>\"These symptoms are what we call nonspecific,\" Scholten says. \"So they're not unique to traumatic brain injury, and in fact there is no symptom that happens only with traumatic brain injury or concussion.\"\u003c/p>\n\u003cp>From a medical perspective, the lack of a box to tick is not a big deal. Treatments usually focus on improving a patient's symptoms, regardless of the cause.\u003c/p>\n\u003cp>\"For instance, someone with cognitive or concentration impairments, we would focus our therapy on how to improve concentration,\" Scholten says.\u003c/p>\n\u003cp>But paying for therapy is another matter. The VA gives priority to veterans whose medical problems can be linked to their service.\u003c/p>\n\u003cp>And since military scientists still aren't sure whether firing a powerful weapon can have long-term effects, Daniel says the VA is sending him the bill. He's being asked to pay out of pocket for high-tech brain scans and other tests.\u003c/p>\n\u003cp>\"I love the VA,\" Daniel says. \"I have nothing bad to say about the VA. The individuals there get it. They really do. But their hands are typically tied by their process.\"\u003c/p>\n\u003cp>\u003ca href=\"https://blastinjuryresearch.amedd.army.mil/index.cfm/sos/neurological_effects_of_repeated_exposure\" target=\"_blank\" rel=\"noopener\">Studies\u003c/a> now underway should help clear up whether people like Daniel could have been harmed by the weapons they fired, Scholten says. And the results of those studies will be used to update the VA's guidelines on who gets checked out for a traumatic brain injury.\u003c/p>\n\u003cp>\"In the next iteration, will we or should we expand to include training exposures?\" Scholten says. \"Possibly so.\"\u003c/p>\n\u003cp>If they do, it could mean evaluating the brains of tens of thousands of veterans who trained with weapons like the one Daniel shot.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>You can contact Jon Hamilton at \u003c/em>\u003ca href=\"mailto:jhamilton@npr.org\" target=\"_blank\" rel=\"noopener\">\u003cem>jhamilton@npr.org\u003c/em>\u003c/a>.\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=Marines+Who+Fired+Rocket+Launchers+Now+Worry+About+Their+Brains+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Most People Think Pot's Totally Safe. But We Don't Actually Know",
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"content": "\u003cp>When it comes to pot, many Americans seem to think it is a magic cure-all despite the lack of scientific data to corroborate that view.[contextly_sidebar id=\"qbIMJ6HAj7B7PdjXyzZ3WGlgtNv4dD58\"]\u003c/p>\n\u003cp>Those are the findings of a new survey, published this week in the journal \u003ca href=\"http://annals.org/aim/article/doi/10.7326/M18-0810\">\u003cem>Annals of Internal Medicine\u003c/em>. \u003c/a>The online survey, conducted by researchers at UC San Francisco, found that many Americans believe marijuana has significant health benefits, despite a lack of scientific data to support that view.\u003c/p>\n\u003cp>That data lack is largely due to marijuana's restricted legal status in the U.S., which makes it difficult for scientists to study the drug's impact on human health, according to Timothy Fong, a professor of addiction psychiatry at UC Los Angeles.\u003c/p>\n\u003cp>[contextly_sidebar id=\"1hOtotjglJ20ftdvAgNx5fpFHerDNbOZ\"]Without actual data to go on, people fall back on personal or anecdotal evidence.\u003c/p>\n\u003cp>\"We want to do more studies, but we can’t do a darn thing if the federal government handcuffs us,” Fong told \u003ca href=\"https://www.reuters.com/article/us-health-marijuana/americans-view-of-marijuana-is-rosy-and-unscientific-idUSKBN1KD2IR\" target=\"_blank\" rel=\"noopener\">Reuters.\u003c/a> “This is the kind of study that I think elevates the discussion. And it shows we have a long way to go.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Researchers surveyed 16,280 people in the U.S. and found that 81 percent of respondents believe that smoking marijuana has at least one health benefit, with pain management being the most commonly cited one.\u003c/p>\n\u003cp>Yet a separate study \u003ca href=\"https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30110-5/fulltext?code=lancet-site\" target=\"_blank\" rel=\"noopener\">spanning four years\u003c/a> found no evidence that marijuana use improves the symptoms of chronic pain.\u003c/p>\n\u003cp>The survey also found that 91 percent of respondents believe that marijuana has at least one risk, but the most commonly cited risk — legal trouble — wasn't health related, a finding researchers found troubling because it indicates that many people are downplaying potential harm, according to \u003ca href=\"http://chime.ucsf.edu/people/salomeh-keyhani-md\" target=\"_blank\" rel=\"noopener\">Dr. Salomeh Keyhani,\u003c/a> a professor of medicine at UC San Francisco.\u003c/p>\n\u003cp>“The American public has a much more favorable point of view than is warranted by the evidence,” Dr. Keyhani told \u003ca href=\"https://www.reuters.com/article/us-health-marijuana/americans-view-of-marijuana-is-rosy-and-unscientific-idUSKBN1KD2IR\" target=\"_blank\" rel=\"noopener\">Reuters.\u003c/a> “Perhaps most concerning is that they think that it prevents health problems.”\u003c/p>\n\u003cp>The survey found that 18 percent of respondents believe that smoking marijuana is somewhat or completely safe for adults.\u003c/p>\n\u003cp>In addition, nearly half of those surveyed believe that marijuana can alleviate insomnia, anxiety and depression, none of which are scientifically established, says Dr. Keyhani.[contextly_sidebar id=\"llwIT8YXMfGYSqJGFFEv4ackgmMz0K5Q\"]\u003c/p>\n\u003cp>\"The bottom line is that there's no evidence for the vast majority of this,\" Dr. Keyhani told \u003ca href=\"https://www.livescience.com/63141-marijuana-assumed-beneficial.html\" target=\"_blank\" rel=\"noopener\">Livescience\u003c/a>. \"There's limited data on harm, and people think that means it's OK.\"\u003c/p>\n\u003cp>Researchers created the survey to examine the impact of marketing on the public's perception of marijuana. From \u003ca href=\"https://www.theguardian.com/society/2018/jul/23/cannabis-health-benefits-american-attitudes-study\" target=\"_blank\" rel=\"noopener\">the Guardian\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Mixed signals regarding marijuana’s potential dangers and benefits have enabled the commercial marijuana industry to promote a maximalist view of marijuana’s possible benefits. Since direct unproven claims of marijuana’s medical benefits, and assertions such as that a product cures cancer, can lead to unwanted attention from the FDA regulators, cannabis companies have learned to be much more subtle.\u003c/p>\u003c/blockquote>\n\u003cp>Despite the federal ban on marijuana, the Food and Drug Administration \u003ca href=\"https://www.kqed.org/futureofyou/443383/meet-sam-the-berkeley-kid-who-inspired-first-marijuana-based-drug\" target=\"_blank\" rel=\"noopener\">recently approved Epidiolex, an epilepsy drug\u003c/a> derived from marijuana. Medical marijuana is also legal in 31 states, a fact that only contributes to its rosy reputation.\u003c/p>\n\u003cp>Still, Keyhani says more research needs to be done. Until that happens, most of the health claims touted by the industry remain unproven.\u003c/p>\n\u003cp>“We need better data,” Keyhani told the Guardian. “We need any data.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When it comes to pot, many Americans seem to think it is a magic cure-all despite the lack of scientific data to corroborate that view.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Those are the findings of a new survey, published this week in the journal \u003ca href=\"http://annals.org/aim/article/doi/10.7326/M18-0810\">\u003cem>Annals of Internal Medicine\u003c/em>. \u003c/a>The online survey, conducted by researchers at UC San Francisco, found that many Americans believe marijuana has significant health benefits, despite a lack of scientific data to support that view.\u003c/p>\n\u003cp>That data lack is largely due to marijuana's restricted legal status in the U.S., which makes it difficult for scientists to study the drug's impact on human health, according to Timothy Fong, a professor of addiction psychiatry at UC Los Angeles.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Without actual data to go on, people fall back on personal or anecdotal evidence.\u003c/p>\n\u003cp>\"We want to do more studies, but we can’t do a darn thing if the federal government handcuffs us,” Fong told \u003ca href=\"https://www.reuters.com/article/us-health-marijuana/americans-view-of-marijuana-is-rosy-and-unscientific-idUSKBN1KD2IR\" target=\"_blank\" rel=\"noopener\">Reuters.\u003c/a> “This is the kind of study that I think elevates the discussion. And it shows we have a long way to go.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Researchers surveyed 16,280 people in the U.S. and found that 81 percent of respondents believe that smoking marijuana has at least one health benefit, with pain management being the most commonly cited one.\u003c/p>\n\u003cp>Yet a separate study \u003ca href=\"https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30110-5/fulltext?code=lancet-site\" target=\"_blank\" rel=\"noopener\">spanning four years\u003c/a> found no evidence that marijuana use improves the symptoms of chronic pain.\u003c/p>\n\u003cp>The survey also found that 91 percent of respondents believe that marijuana has at least one risk, but the most commonly cited risk — legal trouble — wasn't health related, a finding researchers found troubling because it indicates that many people are downplaying potential harm, according to \u003ca href=\"http://chime.ucsf.edu/people/salomeh-keyhani-md\" target=\"_blank\" rel=\"noopener\">Dr. Salomeh Keyhani,\u003c/a> a professor of medicine at UC San Francisco.\u003c/p>\n\u003cp>“The American public has a much more favorable point of view than is warranted by the evidence,” Dr. Keyhani told \u003ca href=\"https://www.reuters.com/article/us-health-marijuana/americans-view-of-marijuana-is-rosy-and-unscientific-idUSKBN1KD2IR\" target=\"_blank\" rel=\"noopener\">Reuters.\u003c/a> “Perhaps most concerning is that they think that it prevents health problems.”\u003c/p>\n\u003cp>The survey found that 18 percent of respondents believe that smoking marijuana is somewhat or completely safe for adults.\u003c/p>\n\u003cp>In addition, nearly half of those surveyed believe that marijuana can alleviate insomnia, anxiety and depression, none of which are scientifically established, says Dr. Keyhani.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The bottom line is that there's no evidence for the vast majority of this,\" Dr. Keyhani told \u003ca href=\"https://www.livescience.com/63141-marijuana-assumed-beneficial.html\" target=\"_blank\" rel=\"noopener\">Livescience\u003c/a>. \"There's limited data on harm, and people think that means it's OK.\"\u003c/p>\n\u003cp>Researchers created the survey to examine the impact of marketing on the public's perception of marijuana. From \u003ca href=\"https://www.theguardian.com/society/2018/jul/23/cannabis-health-benefits-american-attitudes-study\" target=\"_blank\" rel=\"noopener\">the Guardian\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Mixed signals regarding marijuana’s potential dangers and benefits have enabled the commercial marijuana industry to promote a maximalist view of marijuana’s possible benefits. Since direct unproven claims of marijuana’s medical benefits, and assertions such as that a product cures cancer, can lead to unwanted attention from the FDA regulators, cannabis companies have learned to be much more subtle.\u003c/p>\u003c/blockquote>\n\u003cp>Despite the federal ban on marijuana, the Food and Drug Administration \u003ca href=\"https://www.kqed.org/futureofyou/443383/meet-sam-the-berkeley-kid-who-inspired-first-marijuana-based-drug\" target=\"_blank\" rel=\"noopener\">recently approved Epidiolex, an epilepsy drug\u003c/a> derived from marijuana. Medical marijuana is also legal in 31 states, a fact that only contributes to its rosy reputation.\u003c/p>\n\u003cp>Still, Keyhani says more research needs to be done. Until that happens, most of the health claims touted by the industry remain unproven.\u003c/p>\n\u003cp>“We need better data,” Keyhani told the Guardian. “We need any data.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Ticks And Lyme Disease: 3 Factors Determine Risk Of Infection",
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"content": "\u003cp>So you've found a tick, and it's sucking your blood.\u003c/p>\n\u003cp>After an initial wave of revulsion, you \u003ca href=\"https://www.npr.org/sections/health-shots/2017/03/06/518065660/if-you-get-bit-by-a-lyme-infested-tick-here-are-5-tips\" target=\"_blank\" rel=\"noopener\">carefully remove it\u003c/a> with a pair of tweezers. Now you're probably wondering: What's the chance I have Lyme disease?[contextly_sidebar id=\"Fl2AHrFLvIBK40QcD3sQvRyHsrfNmCKE\"]\u003c/p>\n\u003cp>Nick Berndt found himself in that exact situation earlier this summer. Berndt, 26, of Lancaster, Pa., felt a tick attached to his scalp three days after disc golfing in a forest near his home.\u003c/p>\n\u003cp>\"Obviously, Lyme disease was my main concern with it,\" Berndt says. \"It's not something I wanted to mess around with.\"\u003c/p>\n\u003cp>Berndt spent his childhood in southeast Pennsylvania but moved to California to study business administration at San Diego State. After graduation, he stayed in Southern California to manage a photography business, but he missed being close to his family and moved back to Lancaster in June.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Berndt had experience with ticks growing up in Pennsylvania, and he knew Lyme was a local threat. But he was unsure whether this particular tick posed a significant risk.\u003c/p>\n\u003cp>\u003cimg class=\"alignnone wp-image-443609 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/07/1-1-800x450.jpg\" alt=\"\" width=\"800\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-1020x574.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-1200x675.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-520x293.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>Berndt's situation isn't unique, says Thomas Mather, a professor of public health entomology at University of Rhode Island and the director of \u003ca href=\"https://tickencounter.org/\" target=\"_blank\" rel=\"noopener\">Tick Encounter\u003c/a>, a free service that connects tick-bite victims with tick experts. Mather estimates that ticks bite millions of Americans each year, but only 30,000 cases of Lyme disease are reported to the Centers for Disease Control and Prevention annually.[contextly_sidebar id=\"xWpMOWOv4LbOKMRPURZUay9sF9cU4yuM\"]\u003c/p>\n\u003cp>How do you know if your particular bite represents a high-risk case?\u003c/p>\n\u003cp>As it turns out, the chance of catching Lyme disease from an individual tick ranges from zero to roughly 50 percent, according to Mather. The exact probability depends on three factors: the tick species, where it came from and how long the tick was feeding.\u003c/p>\n\u003cp>First, Mather says it's important to identify the species of tick.\u003c/p>\n\u003cp>Only \u003ca href=\"https://www.cdc.gov/lyme/transmission/index.html\" target=\"_blank\" rel=\"noopener\">two species of tick\u003c/a> transmit Lyme disease, both from the genus \u003cem>Ixodes\u003c/em>. The blacklegged tick (\u003cem>Ixodes scapularis\u003c/em>), often referred to as the deer tick, is found \u003ca href=\"https://www.cdc.gov/ticks/maps/blacklegged_tick.pdf\" target=\"_blank\" rel=\"noopener\">throughout the U.S.\u003c/a> east of the Rocky Mountains. The Western blacklegged tick (\u003cem>Ixodes pacificus\u003c/em>) \u003ca href=\"https://www.cdc.gov/ticks/maps/western_blacklegged_tick.pdf\" target=\"_blank\" rel=\"noopener\">is found west\u003c/a> of the Rockies.\u003c/p>\n\u003cp>Adults of both species have \u003ca href=\"https://www.cdc.gov/ticks/tickbornediseases/tickID.html\" target=\"_blank\" rel=\"noopener\">reddish-black bodies\u003c/a> and are about the size of a sesame seed — smaller than most other ticks. As juveniles, they're even tinier — roughly the size of a poppy seed.\u003c/p>\n\u003cp>If you've been bitten by something other than a blacklegged tick, you can stop worrying about Lyme. But Mather cautions that you may be at risk for other, less common infections, like Rocky Mountain spotted fever.\u003c/p>\n\u003cp>Even if a blacklegged tick bit you, there's still a good chance you're OK. That's because only a fraction of blacklegged ticks carry the bacteria that cause Lyme disease.\u003c/p>\n\u003cp>Where you live determines how many blacklegged ticks are carrying Lyme. A \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199644\">recent study\u003c/a> found that in the Northeast and Upper Midwest, up to 50 percent of blacklegged ticks are infected. But in the South and West, infection rates are usually less than 10 percent.\u003c/p>\n\u003cp>If you've been bitten by a blacklegged tick carrying Lyme you still might not get sick, says Rick Ostfeld, a disease ecologist at the Cary Institute of Ecosystem Studies in New York.[contextly_sidebar id=\"usiymVdQTBzoDa4pz6hOp1aRAroRm8LD\"]\u003c/p>\n\u003cp>\"The probability that it [Lyme disease] is transmitted to you ... depends on the length of feeding,\" Ostfeld says. \"It looks like something on the order of 24 hours is required before transmission occurs.\"\u003c/p>\n\u003cp>Within a day of discovering the tick, Berndt submitted photographs and information about his case to Tick Encounter. Within 24 hours, a specialist informed Berndt that his case posed a high risk of Lyme disease.\u003c/p>\n\u003cp>Why was Berndt's tick so risky? First, it was a blacklegged tick, a known carrier of Lyme disease bacteria. Second, the tick was in southeast Pennsylvania, where relatively large proportions of ticks are infected (Mather estimates that the Lancaster area has a 20-25 percent infection rate). Finally, the tick had been feeding for three days, much longer than the transmission threshold of 24 hours.\u003c/p>\n\u003cp>As a precaution, Berndt went to a doctor and started an antibiotic regimen. He also paid \u003ca href=\"https://www.tickreport.com/\" target=\"_blank\" rel=\"noopener\">a lab\u003c/a> to have the tick tested.\u003c/p>\n\u003cp>Fortunately, the test came back negative for Lyme disease.\u003c/p>\n\u003cp>\"I think the $50 [for the test] was worth it, just to be able to say 'No, it definitely wasn't carrying it,' \" Berndt says.[contextly_sidebar id=\"yky3i7JtgPc9hWDgGznOtgNIIHKuXkNu\"]\u003c/p>\n\u003cp>Even though Berndt's tick tested negative, Mather says it's still a good idea for people like Berndt to be on the lookout for Lyme symptoms. That's because they could have gotten other tick bites that went unnoticed.\u003c/p>\n\u003cp>But Mather stresses that not everyone who finds a tick on their body needs to worry. Many cases have a low probability of causing disease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"There was one woman, she was nursing a 12-week-old baby and said, 'I just scraped this off my back and I'm scared,' \" Mather says. \"In her case, it was a barely attached American dog tick. We could tell her, 'You're probably fine.' \"\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=Ticks+And+Lyme+Disease%3A+3+Factors+Determine+Risk+Of+Infection&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>So you've found a tick, and it's sucking your blood.\u003c/p>\n\u003cp>After an initial wave of revulsion, you \u003ca href=\"https://www.npr.org/sections/health-shots/2017/03/06/518065660/if-you-get-bit-by-a-lyme-infested-tick-here-are-5-tips\" target=\"_blank\" rel=\"noopener\">carefully remove it\u003c/a> with a pair of tweezers. Now you're probably wondering: What's the chance I have Lyme disease?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Nick Berndt found himself in that exact situation earlier this summer. Berndt, 26, of Lancaster, Pa., felt a tick attached to his scalp three days after disc golfing in a forest near his home.\u003c/p>\n\u003cp>\"Obviously, Lyme disease was my main concern with it,\" Berndt says. \"It's not something I wanted to mess around with.\"\u003c/p>\n\u003cp>Berndt spent his childhood in southeast Pennsylvania but moved to California to study business administration at San Diego State. After graduation, he stayed in Southern California to manage a photography business, but he missed being close to his family and moved back to Lancaster in June.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Berndt had experience with ticks growing up in Pennsylvania, and he knew Lyme was a local threat. But he was unsure whether this particular tick posed a significant risk.\u003c/p>\n\u003cp>\u003cimg class=\"alignnone wp-image-443609 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/07/1-1-800x450.jpg\" alt=\"\" width=\"800\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-1020x574.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-1200x675.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/07/1-1-520x293.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>Berndt's situation isn't unique, says Thomas Mather, a professor of public health entomology at University of Rhode Island and the director of \u003ca href=\"https://tickencounter.org/\" target=\"_blank\" rel=\"noopener\">Tick Encounter\u003c/a>, a free service that connects tick-bite victims with tick experts. Mather estimates that ticks bite millions of Americans each year, but only 30,000 cases of Lyme disease are reported to the Centers for Disease Control and Prevention annually.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>How do you know if your particular bite represents a high-risk case?\u003c/p>\n\u003cp>As it turns out, the chance of catching Lyme disease from an individual tick ranges from zero to roughly 50 percent, according to Mather. The exact probability depends on three factors: the tick species, where it came from and how long the tick was feeding.\u003c/p>\n\u003cp>First, Mather says it's important to identify the species of tick.\u003c/p>\n\u003cp>Only \u003ca href=\"https://www.cdc.gov/lyme/transmission/index.html\" target=\"_blank\" rel=\"noopener\">two species of tick\u003c/a> transmit Lyme disease, both from the genus \u003cem>Ixodes\u003c/em>. The blacklegged tick (\u003cem>Ixodes scapularis\u003c/em>), often referred to as the deer tick, is found \u003ca href=\"https://www.cdc.gov/ticks/maps/blacklegged_tick.pdf\" target=\"_blank\" rel=\"noopener\">throughout the U.S.\u003c/a> east of the Rocky Mountains. The Western blacklegged tick (\u003cem>Ixodes pacificus\u003c/em>) \u003ca href=\"https://www.cdc.gov/ticks/maps/western_blacklegged_tick.pdf\" target=\"_blank\" rel=\"noopener\">is found west\u003c/a> of the Rockies.\u003c/p>\n\u003cp>Adults of both species have \u003ca href=\"https://www.cdc.gov/ticks/tickbornediseases/tickID.html\" target=\"_blank\" rel=\"noopener\">reddish-black bodies\u003c/a> and are about the size of a sesame seed — smaller than most other ticks. As juveniles, they're even tinier — roughly the size of a poppy seed.\u003c/p>\n\u003cp>If you've been bitten by something other than a blacklegged tick, you can stop worrying about Lyme. But Mather cautions that you may be at risk for other, less common infections, like Rocky Mountain spotted fever.\u003c/p>\n\u003cp>Even if a blacklegged tick bit you, there's still a good chance you're OK. That's because only a fraction of blacklegged ticks carry the bacteria that cause Lyme disease.\u003c/p>\n\u003cp>Where you live determines how many blacklegged ticks are carrying Lyme. A \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199644\">recent study\u003c/a> found that in the Northeast and Upper Midwest, up to 50 percent of blacklegged ticks are infected. But in the South and West, infection rates are usually less than 10 percent.\u003c/p>\n\u003cp>If you've been bitten by a blacklegged tick carrying Lyme you still might not get sick, says Rick Ostfeld, a disease ecologist at the Cary Institute of Ecosystem Studies in New York.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The probability that it [Lyme disease] is transmitted to you ... depends on the length of feeding,\" Ostfeld says. \"It looks like something on the order of 24 hours is required before transmission occurs.\"\u003c/p>\n\u003cp>Within a day of discovering the tick, Berndt submitted photographs and information about his case to Tick Encounter. Within 24 hours, a specialist informed Berndt that his case posed a high risk of Lyme disease.\u003c/p>\n\u003cp>Why was Berndt's tick so risky? First, it was a blacklegged tick, a known carrier of Lyme disease bacteria. Second, the tick was in southeast Pennsylvania, where relatively large proportions of ticks are infected (Mather estimates that the Lancaster area has a 20-25 percent infection rate). Finally, the tick had been feeding for three days, much longer than the transmission threshold of 24 hours.\u003c/p>\n\u003cp>As a precaution, Berndt went to a doctor and started an antibiotic regimen. He also paid \u003ca href=\"https://www.tickreport.com/\" target=\"_blank\" rel=\"noopener\">a lab\u003c/a> to have the tick tested.\u003c/p>\n\u003cp>Fortunately, the test came back negative for Lyme disease.\u003c/p>\n\u003cp>\"I think the $50 [for the test] was worth it, just to be able to say 'No, it definitely wasn't carrying it,' \" Berndt says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Even though Berndt's tick tested negative, Mather says it's still a good idea for people like Berndt to be on the lookout for Lyme symptoms. That's because they could have gotten other tick bites that went unnoticed.\u003c/p>\n\u003cp>But Mather stresses that not everyone who finds a tick on their body needs to worry. Many cases have a low probability of causing disease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"There was one woman, she was nursing a 12-week-old baby and said, 'I just scraped this off my back and I'm scared,' \" Mather says. \"In her case, it was a barely attached American dog tick. We could tell her, 'You're probably fine.' \"\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=Ticks+And+Lyme+Disease%3A+3+Factors+Determine+Risk+Of+Infection&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>If you're in the hospital or a doctor's office with a painful problem, you'll likely be asked to rate your pain on a \u003ca href=\"https://paindoctor.com/pain-scales/\" target=\"_blank\" rel=\"noopener\">scale\u003c/a> of 0 to 10 – with 0 meaning no pain at all and 10 indicating the worst pain you can imagine. But many doctors and nurses say this rating system isn't working and they're trying a new approach.[contextly_sidebar id=\"PzT9DEOa22PlTyV4kUDRN8kM4A2CX5Tx\"]\u003c/p>\n\u003cp>The numeric pain scale may just be too simplistic, says \u003ca href=\"https://www.urmc.rochester.edu/people/21192807-john-d-markman\" target=\"_blank\" rel=\"noopener\">Dr. John Markman\u003c/a>, director of the Translational Pain Research Program at the University of Rochester School of Medicine and Dentistry. It can lead doctors to \"treat by numbers,\" he says and as a result, patients may not be getting the most effective treatment for their pain.\u003c/p>\n\u003cp>Take the case of 33-year-old Adam Rosette, who was recently hospitalized for \u003ca href=\"https://orthoinfo.aaos.org/en/diseases--conditions/fibrous-dysplasia/\" target=\"_blank\" rel=\"noopener\">fibrous dysplasia\u003c/a>, a bone disorder that made it nearly impossible for him to chew or even speak. After brain surgery to remove benign tumors related to the disorder, he was definitely in pain. But he was reluctant to label the pain too high.\u003c/p>\n\u003cp>\"I don't think I ever answered higher than a '7' because an '8' would be, in my mind, like I'm missing half of my body or a limb,\" he recalls.\u003c/p>\n\u003cp>On the pain scale a rating of 4 to 7 is considered moderate. Mild pain is rated 1 to 3. Over 7 is considered severe.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today, Rosette has recovered and is pain-free, but he wonders if \"low balling\" his pain level while in the hospital, meant he wasn't given adequate pain medication.[contextly_sidebar id=\"gNyBEO7kaaOOQQPLiTFHH1VcWAsQe2Bq\"]\u003c/p>\n\u003cp>\"You realize you got less medicine and it's been eight hours and they're not allowed to give you more for a while,\" Rosette says.\u003c/p>\n\u003cp>If your doctor gets the wrong idea about your pain, it's not just going to affect your comfort — it can affect your treatment. Markman says that especially after an injury, there's therapeutic value to keeping the pain tamped down, so that you can keep up with physical therapy.\u003c/p>\n\u003cp>For chronic pain, being clear can help clinicians choose the right mix of therapies or medications to allow you to stay as active as possible. And staying active can help manage chronic pain, says \u003ca href=\"https://anesthesiology.duke.edu/?page_id=834374\" target=\"_blank\" rel=\"noopener\">Dr. William Maixner\u003c/a>, with Duke University School of Medicine and current president of the American Pain Society.\u003c/p>\n\u003cp>Exercise, he says, \"causes the release of a number of anti-inflammatory substances from the muscle that can help diminish pain and pain processing and make the individual more resilient.\"\u003c/p>\n\u003cp>To find out more about how the numerical pain scale was affecting treatment, Markman and colleagues at the University of Rochester did a study, which they will present at the World Congress on Pain in Boston in September. The research analyzed data from other studies, which asked chronic pain patients to rate their pain using both numbers and words.\u003c/p>\n\u003cp>Patients were asked to rate their pain on a scale of 0 to 10, and they were also asked the question, \"Is your pain tolerable?\"\u003c/p>\n\u003cp>Surprisingly, three quarters of the patients who rated their pain between 4 and 7 on the numerical scale, a range that typically calls for higher doses of medications, also described their pain as \"tolerable\" — a description that normally means no more pain treatment is needed.[contextly_sidebar id=\"ClUbqCuoEqdLIyjzgS1I1irhMb4fhntn\"]\u003c/p>\n\u003cp>This showed the danger of relying only on a number, Markman says. \"If you were just treating by the numbers you might say, 'Well, someone has a pain that is 6 [out of]10. I feel obligated to do something about that ... to fix that number just like you might fix their blood pressure or their blood glucose,' \" he says.\u003c/p>\n\u003cp>If clinicians just look at a number, Markman says, they may be more likely to over-treat or prescribe more medication, which can be worrisome during an era of concern about opioid abuse and addiction.\u003c/p>\n\u003cp>So if today's pain scale isn't working well for patients and doctors, what's the alternative?\u003c/p>\n\u003cp>Many health care providers are trying to come up with a system that involves words, not numbers.\u003c/p>\n\u003cp>\"I never look at just the pain scale,\" says \u003ca href=\"https://www.uclahealth.org/chrystina-jeter\" target=\"_blank\" rel=\"noopener\">Dr. Chrystina Jeter\u003c/a>, an anesthesiologist and pain management specialist with UCLA Health, who was Rosette's doctor.\u003c/p>\n\u003cp>Using words to describe pain brings greater specificity to the measurement of pain, says Maixner.[contextly_sidebar id=\"jBdk15Gcdb1FQXh8PlzSvMvHZmeTdBu9\"]\u003c/p>\n\u003cp>If patients can describe their pain precisely, he says, their appointment with a health care provider will be much more focused, allowing the physician to \"come to a decision about treatment in a much more rapid and logical way.\"\u003c/p>\n\u003cp>Here's advice for the next time you need to talk to your doctor about your pain.\u003c/p>\n\u003cp>\u003cstrong>Get Descriptive\u003c/strong>\u003c/p>\n\u003cp>You can help doctors understand just how debilitating your pain is by being more descriptive.\u003c/p>\n\u003cp>\"It's perfectly OK to be a little more flowery in the description of pain,\" says Jeter. \"My pain is aching, burning. What does it feel like to you? Where is it? Does it move?\"\u003c/p>\n\u003cp>Jeter typically asks patients to compare their current pain to the worst pain they ever had, such as childbirth or kidney stones. This helps put their pain in context, she says, and may help them realize their pain may not be that bad after all.\u003c/p>\n\u003cp>\u003cstrong>Describe Your Day\u003c/strong>\u003c/p>\n\u003cp>It can be helpful to talk about how your pain waxes and wanes throughout the day, says Jeter. For example, is it mostly when you eat, walk, or do certain activities?\u003c/p>\n\u003cp>\"I look for trends over time and I look at their function,\" she says.\u003c/p>\n\u003cp>\u003cstrong>Talk About Function, Not Feeling\u003c/strong>\u003c/p>\n\u003cp>Be clear about how your pain interferes with daily activities, such as getting out of bed early, getting dressed, feeling fatigued, or no longer enjoying getting out with friends, suggests Maixner.\u003c/p>\n\u003cp>Thinking about function is key, agrees Markman. He says the most accurate measurement of pain may be what it prevents patients from doing. For example, if a patient cannot chew or talk, walk, or exercise that might be more disturbing to them than the pain. Sometimes it's more useful to seek ways to \"work around the pain\" rather than \"making it go away,\" Markman says.\u003c/p>\n\u003cp>\u003cstrong>Share Treatment History\u003c/strong>\u003c/p>\n\u003cp>Describe the history of the pain, the location, how long it's been hurting and what factors seem to aggravate it, or help it get better, suggests Maixner.\u003c/p>\n\u003cp>Share other treatments you've sought, such as acupuncture, massage and certain medications, he says. \"Let the doctor know what you've done and whether it was effective.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Family history is also important, he says, especially when you consider much of an individual's pain sensitivity is inherited. If your parents were highly sensitive to pain, chances are you will be, too, he says.\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=Words+Matter+When+Talking+About+Pain+With+Your+Doctor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you're in the hospital or a doctor's office with a painful problem, you'll likely be asked to rate your pain on a \u003ca href=\"https://paindoctor.com/pain-scales/\" target=\"_blank\" rel=\"noopener\">scale\u003c/a> of 0 to 10 – with 0 meaning no pain at all and 10 indicating the worst pain you can imagine. But many doctors and nurses say this rating system isn't working and they're trying a new approach.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The numeric pain scale may just be too simplistic, says \u003ca href=\"https://www.urmc.rochester.edu/people/21192807-john-d-markman\" target=\"_blank\" rel=\"noopener\">Dr. John Markman\u003c/a>, director of the Translational Pain Research Program at the University of Rochester School of Medicine and Dentistry. It can lead doctors to \"treat by numbers,\" he says and as a result, patients may not be getting the most effective treatment for their pain.\u003c/p>\n\u003cp>Take the case of 33-year-old Adam Rosette, who was recently hospitalized for \u003ca href=\"https://orthoinfo.aaos.org/en/diseases--conditions/fibrous-dysplasia/\" target=\"_blank\" rel=\"noopener\">fibrous dysplasia\u003c/a>, a bone disorder that made it nearly impossible for him to chew or even speak. After brain surgery to remove benign tumors related to the disorder, he was definitely in pain. But he was reluctant to label the pain too high.\u003c/p>\n\u003cp>\"I don't think I ever answered higher than a '7' because an '8' would be, in my mind, like I'm missing half of my body or a limb,\" he recalls.\u003c/p>\n\u003cp>On the pain scale a rating of 4 to 7 is considered moderate. Mild pain is rated 1 to 3. Over 7 is considered severe.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today, Rosette has recovered and is pain-free, but he wonders if \"low balling\" his pain level while in the hospital, meant he wasn't given adequate pain medication.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"You realize you got less medicine and it's been eight hours and they're not allowed to give you more for a while,\" Rosette says.\u003c/p>\n\u003cp>If your doctor gets the wrong idea about your pain, it's not just going to affect your comfort — it can affect your treatment. Markman says that especially after an injury, there's therapeutic value to keeping the pain tamped down, so that you can keep up with physical therapy.\u003c/p>\n\u003cp>For chronic pain, being clear can help clinicians choose the right mix of therapies or medications to allow you to stay as active as possible. And staying active can help manage chronic pain, says \u003ca href=\"https://anesthesiology.duke.edu/?page_id=834374\" target=\"_blank\" rel=\"noopener\">Dr. William Maixner\u003c/a>, with Duke University School of Medicine and current president of the American Pain Society.\u003c/p>\n\u003cp>Exercise, he says, \"causes the release of a number of anti-inflammatory substances from the muscle that can help diminish pain and pain processing and make the individual more resilient.\"\u003c/p>\n\u003cp>To find out more about how the numerical pain scale was affecting treatment, Markman and colleagues at the University of Rochester did a study, which they will present at the World Congress on Pain in Boston in September. The research analyzed data from other studies, which asked chronic pain patients to rate their pain using both numbers and words.\u003c/p>\n\u003cp>Patients were asked to rate their pain on a scale of 0 to 10, and they were also asked the question, \"Is your pain tolerable?\"\u003c/p>\n\u003cp>Surprisingly, three quarters of the patients who rated their pain between 4 and 7 on the numerical scale, a range that typically calls for higher doses of medications, also described their pain as \"tolerable\" — a description that normally means no more pain treatment is needed.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>This showed the danger of relying only on a number, Markman says. \"If you were just treating by the numbers you might say, 'Well, someone has a pain that is 6 [out of]10. I feel obligated to do something about that ... to fix that number just like you might fix their blood pressure or their blood glucose,' \" he says.\u003c/p>\n\u003cp>If clinicians just look at a number, Markman says, they may be more likely to over-treat or prescribe more medication, which can be worrisome during an era of concern about opioid abuse and addiction.\u003c/p>\n\u003cp>So if today's pain scale isn't working well for patients and doctors, what's the alternative?\u003c/p>\n\u003cp>Many health care providers are trying to come up with a system that involves words, not numbers.\u003c/p>\n\u003cp>\"I never look at just the pain scale,\" says \u003ca href=\"https://www.uclahealth.org/chrystina-jeter\" target=\"_blank\" rel=\"noopener\">Dr. Chrystina Jeter\u003c/a>, an anesthesiologist and pain management specialist with UCLA Health, who was Rosette's doctor.\u003c/p>\n\u003cp>Using words to describe pain brings greater specificity to the measurement of pain, says Maixner.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>If patients can describe their pain precisely, he says, their appointment with a health care provider will be much more focused, allowing the physician to \"come to a decision about treatment in a much more rapid and logical way.\"\u003c/p>\n\u003cp>Here's advice for the next time you need to talk to your doctor about your pain.\u003c/p>\n\u003cp>\u003cstrong>Get Descriptive\u003c/strong>\u003c/p>\n\u003cp>You can help doctors understand just how debilitating your pain is by being more descriptive.\u003c/p>\n\u003cp>\"It's perfectly OK to be a little more flowery in the description of pain,\" says Jeter. \"My pain is aching, burning. What does it feel like to you? Where is it? Does it move?\"\u003c/p>\n\u003cp>Jeter typically asks patients to compare their current pain to the worst pain they ever had, such as childbirth or kidney stones. This helps put their pain in context, she says, and may help them realize their pain may not be that bad after all.\u003c/p>\n\u003cp>\u003cstrong>Describe Your Day\u003c/strong>\u003c/p>\n\u003cp>It can be helpful to talk about how your pain waxes and wanes throughout the day, says Jeter. For example, is it mostly when you eat, walk, or do certain activities?\u003c/p>\n\u003cp>\"I look for trends over time and I look at their function,\" she says.\u003c/p>\n\u003cp>\u003cstrong>Talk About Function, Not Feeling\u003c/strong>\u003c/p>\n\u003cp>Be clear about how your pain interferes with daily activities, such as getting out of bed early, getting dressed, feeling fatigued, or no longer enjoying getting out with friends, suggests Maixner.\u003c/p>\n\u003cp>Thinking about function is key, agrees Markman. He says the most accurate measurement of pain may be what it prevents patients from doing. For example, if a patient cannot chew or talk, walk, or exercise that might be more disturbing to them than the pain. Sometimes it's more useful to seek ways to \"work around the pain\" rather than \"making it go away,\" Markman says.\u003c/p>\n\u003cp>\u003cstrong>Share Treatment History\u003c/strong>\u003c/p>\n\u003cp>Describe the history of the pain, the location, how long it's been hurting and what factors seem to aggravate it, or help it get better, suggests Maixner.\u003c/p>\n\u003cp>Share other treatments you've sought, such as acupuncture, massage and certain medications, he says. \"Let the doctor know what you've done and whether it was effective.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Family history is also important, he says, especially when you consider much of an individual's pain sensitivity is inherited. If your parents were highly sensitive to pain, chances are you will be, too, he says.\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=Words+Matter+When+Talking+About+Pain+With+Your+Doctor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The woman arrived at the emergency department at Huntington Hospital on New York's Long Island after she was hit by her boyfriend during an argument. Her situation raised concerns among the medical staff, which had recently been trained to be on the lookout for signs of sex trafficking.\u003c/p>\n\u003cp>An undocumented immigrant from El Salvador, she worked at a local cantina frequented by immigrants. Her job was to get patrons drinks and to dance with them, but many workers in those jobs are expected to offer sex, too. Her boyfriend didn't want her to work there, and that led to the fight, one doctor recalled.\u003c/p>\n\u003cp>As part of the intake process, the emergency staff asked the 36-year-old woman a series of questions about whether she'd ever had sex for money, or whether she had to give someone else part of what she earns, among other things. The screening questions were part of a new program at Northwell Health, a 23-hospital system in the New York metro area that includes Huntington Hospital, to train staff and provide them with \u003ca href=\"https://www.northwell.edu/about/news/press-releases/training-staff-identify-help-human-trafficking-victims\" target=\"_blank\" rel=\"noopener\">tools to identify and support victims of human trafficking\u003c/a>.\u003c/p>\n\u003cp>There are few hard figures for how many people are harmed by human trafficking, the term used when individuals are forced to work or have sex for someone else's commercial benefit. Polaris, a Washington, D.C.-based nonprofit that \u003ca href=\"https://humantraffickinghotline.org/type-trafficking/human-trafficking\" target=\"_blank\" rel=\"noopener\">advocates for these people and runs help lines\u003c/a> for them, says calls and texts to its national hotlines have\u003ca href=\"http://polarisproject.org/sites/default/files/2017NHTHStats%20%281%29.pdf\" target=\"_blank\" rel=\"noopener\"> steadily ticked up in recent years\u003c/a>, increasing the number of cases 13 percent to 8,759 between 2016 and 2017.\u003c/p>\n\u003cp>But health care providers frequently fail to recognize these patients' situation. According to a \u003ca href=\"http://www.globalcenturion.org/wp-content/uploads/2014/08/The-Health-Consequences-of-Sex-Trafficking.pdf\" target=\"_blank\" rel=\"noopener\">2014 survey of about 100 survivors of sex trafficking\u003c/a>, 88 percent said that while they were being trafficked they had contact with a health care provider, typically someone in an emergency department.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"When trafficking victims come through the health care system but we don't identify them, it's a big missed opportunity,\" says Dr. Santhosh Paulus, a family physician who is the site director of the Huntington Hospital's family medicine residency program and who started the program at Northwell.\u003c/p>\n\u003cp>Northwell is one of a growing number of hospitals and health care systems that are putting such programs in place. They want to alert staff to be on the lookout for trafficking, much as they watch for signs of child abuse, domestic violence and elder abuse.\u003c/p>\n\u003cp>Since last spring, nearly 300 staff members at Huntington Hospital and a family clinic have received training in how to spot trafficking victims and how to help them.\u003c/p>\n\u003cp>Training is given not only to doctors and nurses but also to registration and reception staff, social workers and security guards. Restore NYC, an organization that assists people caught up in sex trafficking, provided the initial training to key staff, and a hospital task force trains the others. During the next few years, similar efforts will be rolled out at all of Northwell's 23 hospitals, Paulus says.\u003c/p>\n\u003cp>Identifying victims of trafficking is not unlike identifying victims of other forms of violence, says Dr. Wendy Macias-Konstantopoulos, director of the \u003ca href=\"https://www.massgeneral.org/emergencymedicineglobalhealth/initiatives/Human-Trafficking-Initiative.aspx\" target=\"_blank\" rel=\"noopener\">Human Trafficking Initiative\u003c/a> at Massachusetts General Hospital in Boston.\u003c/p>\n\u003cp>One of the big red flags is when people delay coming in for medical care, such as waiting weeks to come in to get an injured ankle or sexually transmitted infection checked out, Macias-Konstantopoulos says. Or it may be a pattern of injuries that don't make sense. Sometimes people are reluctant to explain their injury, or they come in with someone who seems overbearing.\u003c/p>\n\u003cp>\"Having a high index of suspicion is the first step,\" she says. \"If we're not asking about it, we're just not going to see it.\"\u003c/p>\n\u003cp>Starting in October, health care providers can also start \u003ca href=\"https://www.aha.org/system/files/2018-07/icd-10-code-human-trafficking_0.pdf\" target=\"_blank\" rel=\"noopener\">using new diagnosis codes\u003c/a> in their records to differentiate trafficking from other types of abuse. This will help track the number of victims and provide appropriate treatment.\u003c/p>\n\u003cp>Asking may not be enough, however. Depending on what's going on in their lives, these patients may not be willing or ready to acknowledge that they need help, says \u003ca href=\"https://www.traffickinginstitute.org/holly-austin-gibbs-joins-the-human-trafficking-institute/\" target=\"_blank\" rel=\"noopener\">Holly Gibbs\u003c/a>, human trafficking response program director for Dignity Health, a health care system with nearly 40 hospitals in California, Nevada and Arizona.\u003c/p>\n\u003cp>Gibbs knows the issue well. She was forced briefly into prostitution in Atlantic City, N.J., after meeting a man at a shopping mall as a 14-year-old and running away with him. The man persuaded Gibbs to go with him with promises of a new, glamorous life as a musician or model.\u003c/p>\n\u003cp>At the time, Gibbs says, she thought that what happened to her was her own fault, a result of choices she made. No health care or law enforcement professional connected her to social services that could have helped her understand otherwise. She was reunited with her family by law enforcement personnel, who arrested the man, who was later convicted.\u003c/p>\n\u003cp>Dignity Health has implemented a human trafficking response program in the emergency departments and labor and delivery areas of each of its hospitals. Now it's rolling out the program at clinics and physicians' offices as well.\u003c/p>\n\u003cp>A key priority is to help clinicians know how to talk to patients about any violence they may be facing and to connect the patients with outside sources of help.\u003c/p>\n\u003cp>But in the end, if these patients don't want assistance, \"you respect their wishes,\" Gibbs says. \"They may not be ready to accept help now, but you may plant seeds so they'll be able to accept it later on.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>\u003cem> is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that isn't affiliated with Kaiser Permanente. You can follow Michelle Andrews on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/mandrews110\" target=\"_blank\" rel=\"noopener\">@mandrews110\u003c/a>.\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=Hospitals+Gear+Up+For+New+Diagnosis%3A+Human+Trafficking+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The woman arrived at the emergency department at Huntington Hospital on New York's Long Island after she was hit by her boyfriend during an argument. Her situation raised concerns among the medical staff, which had recently been trained to be on the lookout for signs of sex trafficking.\u003c/p>\n\u003cp>An undocumented immigrant from El Salvador, she worked at a local cantina frequented by immigrants. Her job was to get patrons drinks and to dance with them, but many workers in those jobs are expected to offer sex, too. Her boyfriend didn't want her to work there, and that led to the fight, one doctor recalled.\u003c/p>\n\u003cp>As part of the intake process, the emergency staff asked the 36-year-old woman a series of questions about whether she'd ever had sex for money, or whether she had to give someone else part of what she earns, among other things. The screening questions were part of a new program at Northwell Health, a 23-hospital system in the New York metro area that includes Huntington Hospital, to train staff and provide them with \u003ca href=\"https://www.northwell.edu/about/news/press-releases/training-staff-identify-help-human-trafficking-victims\" target=\"_blank\" rel=\"noopener\">tools to identify and support victims of human trafficking\u003c/a>.\u003c/p>\n\u003cp>There are few hard figures for how many people are harmed by human trafficking, the term used when individuals are forced to work or have sex for someone else's commercial benefit. Polaris, a Washington, D.C.-based nonprofit that \u003ca href=\"https://humantraffickinghotline.org/type-trafficking/human-trafficking\" target=\"_blank\" rel=\"noopener\">advocates for these people and runs help lines\u003c/a> for them, says calls and texts to its national hotlines have\u003ca href=\"http://polarisproject.org/sites/default/files/2017NHTHStats%20%281%29.pdf\" target=\"_blank\" rel=\"noopener\"> steadily ticked up in recent years\u003c/a>, increasing the number of cases 13 percent to 8,759 between 2016 and 2017.\u003c/p>\n\u003cp>But health care providers frequently fail to recognize these patients' situation. According to a \u003ca href=\"http://www.globalcenturion.org/wp-content/uploads/2014/08/The-Health-Consequences-of-Sex-Trafficking.pdf\" target=\"_blank\" rel=\"noopener\">2014 survey of about 100 survivors of sex trafficking\u003c/a>, 88 percent said that while they were being trafficked they had contact with a health care provider, typically someone in an emergency department.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"When trafficking victims come through the health care system but we don't identify them, it's a big missed opportunity,\" says Dr. Santhosh Paulus, a family physician who is the site director of the Huntington Hospital's family medicine residency program and who started the program at Northwell.\u003c/p>\n\u003cp>Northwell is one of a growing number of hospitals and health care systems that are putting such programs in place. They want to alert staff to be on the lookout for trafficking, much as they watch for signs of child abuse, domestic violence and elder abuse.\u003c/p>\n\u003cp>Since last spring, nearly 300 staff members at Huntington Hospital and a family clinic have received training in how to spot trafficking victims and how to help them.\u003c/p>\n\u003cp>Training is given not only to doctors and nurses but also to registration and reception staff, social workers and security guards. Restore NYC, an organization that assists people caught up in sex trafficking, provided the initial training to key staff, and a hospital task force trains the others. During the next few years, similar efforts will be rolled out at all of Northwell's 23 hospitals, Paulus says.\u003c/p>\n\u003cp>Identifying victims of trafficking is not unlike identifying victims of other forms of violence, says Dr. Wendy Macias-Konstantopoulos, director of the \u003ca href=\"https://www.massgeneral.org/emergencymedicineglobalhealth/initiatives/Human-Trafficking-Initiative.aspx\" target=\"_blank\" rel=\"noopener\">Human Trafficking Initiative\u003c/a> at Massachusetts General Hospital in Boston.\u003c/p>\n\u003cp>One of the big red flags is when people delay coming in for medical care, such as waiting weeks to come in to get an injured ankle or sexually transmitted infection checked out, Macias-Konstantopoulos says. Or it may be a pattern of injuries that don't make sense. Sometimes people are reluctant to explain their injury, or they come in with someone who seems overbearing.\u003c/p>\n\u003cp>\"Having a high index of suspicion is the first step,\" she says. \"If we're not asking about it, we're just not going to see it.\"\u003c/p>\n\u003cp>Starting in October, health care providers can also start \u003ca href=\"https://www.aha.org/system/files/2018-07/icd-10-code-human-trafficking_0.pdf\" target=\"_blank\" rel=\"noopener\">using new diagnosis codes\u003c/a> in their records to differentiate trafficking from other types of abuse. This will help track the number of victims and provide appropriate treatment.\u003c/p>\n\u003cp>Asking may not be enough, however. Depending on what's going on in their lives, these patients may not be willing or ready to acknowledge that they need help, says \u003ca href=\"https://www.traffickinginstitute.org/holly-austin-gibbs-joins-the-human-trafficking-institute/\" target=\"_blank\" rel=\"noopener\">Holly Gibbs\u003c/a>, human trafficking response program director for Dignity Health, a health care system with nearly 40 hospitals in California, Nevada and Arizona.\u003c/p>\n\u003cp>Gibbs knows the issue well. She was forced briefly into prostitution in Atlantic City, N.J., after meeting a man at a shopping mall as a 14-year-old and running away with him. The man persuaded Gibbs to go with him with promises of a new, glamorous life as a musician or model.\u003c/p>\n\u003cp>At the time, Gibbs says, she thought that what happened to her was her own fault, a result of choices she made. No health care or law enforcement professional connected her to social services that could have helped her understand otherwise. She was reunited with her family by law enforcement personnel, who arrested the man, who was later convicted.\u003c/p>\n\u003cp>Dignity Health has implemented a human trafficking response program in the emergency departments and labor and delivery areas of each of its hospitals. Now it's rolling out the program at clinics and physicians' offices as well.\u003c/p>\n\u003cp>A key priority is to help clinicians know how to talk to patients about any violence they may be facing and to connect the patients with outside sources of help.\u003c/p>\n\u003cp>But in the end, if these patients don't want assistance, \"you respect their wishes,\" Gibbs says. \"They may not be ready to accept help now, but you may plant seeds so they'll be able to accept it later on.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>\u003cem> is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that isn't affiliated with Kaiser Permanente. You can follow Michelle Andrews on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/mandrews110\" target=\"_blank\" rel=\"noopener\">@mandrews110\u003c/a>.\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=Hospitals+Gear+Up+For+New+Diagnosis%3A+Human+Trafficking+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>There's new evidence that a woman's levels of female sex hormones, including estrogen and progesterone, can influence her risk of Alzheimer's and other forms of dementia.[contextly_sidebar id=\"rPJOdHYPkIXQXRx2JEsrHPZVgzMtEJk7\"]\u003c/p>\n\u003cp>Women are less likely to develop dementia later in life if they begin to menstruate earlier, go through menopause later, and have more than one child, researchers \u003ca href=\"https://www.alz.org/aaic/pressroom.asp\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> Monday at the \u003ca href=\"https://www.alz.org/aaic/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Association International Conference\u003c/a> in Chicago.\u003c/p>\n\u003cp>And recent studies offer hints that \u003ca href=\"https://medlineplus.gov/hormonereplacementtherapy.html\" target=\"_blank\" rel=\"noopener\">hormone replacement therapy\u003c/a>, which fell out of favor more than a decade ago, might offer a way to protect a woman's brain if it is given at the right time, the researchers said.\u003c/p>\n\u003cp>The findings could help explain why women make up nearly two-thirds of people in the U.S. with Alzheimer's, says \u003ca href=\"http://nationalacademies.org/hmd/Activities/Research/NeuroForum/Member%20Profiles/Maria%20Carrillo.aspx\" target=\"_blank\" rel=\"noopener\">Maria Carrillo\u003c/a>, the association's chief scientific officer.\u003c/p>\n\u003cp>\"It isn't just that women are living longer,\" Carrillo says. \"There is some biological underpinning. And because of the large numbers of women that are affected, it is important to find out [what it is].\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Scientists have long suspected that sex hormones such as estrogen and progesterone play a role in Alzheimer's. And two studies on dementia and what occurs during a women's reproductive years support that idea.[contextly_sidebar id=\"Wwp2fmV71pvuOzg04oa6uZxzPex1NtQ3\"]\u003c/p>\n\u003cp>One of the studies looked at nearly 15,000 women in California. And it found an association between a woman's reproductive history and her risk of memory problems later in life.\u003c/p>\n\u003cp>The risk of dementia for women who had three or more children was 12 percent lower than the risk for women who had one child, according to \u003ca href=\"https://divisionofresearch.kaiserpermanente.org/researchers/gilsanz-paola\" target=\"_blank\" rel=\"noopener\">Paola Gilsanz\u003c/a> of Kaiser Permanente Northern California Division of Research, and \u003ca href=\"https://profiles.ucsf.edu/rachel.whitmer\" target=\"_blank\" rel=\"noopener\">Rachel Whitmer\u003c/a> of the University of California, Davis.\u003c/p>\n\u003cp>Also, women who began to menstruate earlier and went through menopause later were less likely to develop dementia. Menopause at age 45 or younger seemed to increase the risk by 28 percent.\u003c/p>\n\u003cp>Another study of 133 elderly women in the U.K. found that the more months of pregnancy they experienced during their lives, the lower their risk of developing Alzheimer's.\u003c/p>\n\u003cp>The findings all suggest that female sex hormones — which rise at puberty and during pregnancy, then fall at menopause — are somehow affecting a woman's risk of developing Alzheimer's and other forms of dementia. The results also suggest that greater exposure to these hormones, through more pregnancies or more reproductive years, can reduce a woman's risk.\u003c/p>\n\u003cp>But it's still not clear whether the mere presence of female sex hormones is a reason that the frequency of Alzheimer's is greater in women than in men.\u003c/p>\n\u003cp>One possibility is that it's not female sex hormones on their own, but rapid changes in their levels that are a problem, says \u003ca href=\"https://crwg.uic.edu/crwg-home/crwg-staff/pauline-maki-phd/\" target=\"_blank\" rel=\"noopener\">Pauline Maki\u003c/a>, a professor of psychiatry and psychology at the University of Illinois at Chicago, who presented research at the Alzheimer's conference.[contextly_sidebar id=\"YEYwp8N3sM3v9aN2dUZdqE3yWweQzhJS\"]\u003c/p>\n\u003cp>\"Women experience these very dramatic hormonal transitions that in the long run can give rise to Alzheimer's disease,\" she says.\u003c/p>\n\u003cp>One way for women to minimize the dramatic hormonal changes that occur at menopause is to use hormone replacement therapy.\u003c/p>\n\u003cp>That approach fell out of favor more than a decade ago when a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/12771112\" target=\"_blank\" rel=\"noopener\">large study\u003c/a> found that women who took estrogen plus progestin after menopause were actually more likely to get some form of dementia. They also appeared to have a higher risk of heart disease and breast cancer.\u003c/p>\n\u003cp>But Maki says more recent studies suggest that hormone therapy — especially estrogen alone — really can be helpful if women get it at the right time.\u003c/p>\n\u003cp>\"The effects of hormone therapy depend on the timing of use,\" Maki says. \"Use later in life is detrimental, whereas use early in the menopausal transition could be beneficial.\"\u003c/p>\n\u003cp>An analysis presented at the Alzheimer's conference supports that idea.\u003c/p>\n\u003cp>It found that in two recent studies, women who started taking estrogen after age 65 were more likely to have trouble with thinking and memory. But women who started taking estrogen between 50 and 54 were not.\u003c/p>\n\u003cp>And estrogen may benefit the mental function of younger women because it reduces the hot flashes associated with menopause, Maki says.[contextly_sidebar id=\"v9bruUJ5zucWs4sZPfqccXVqvwa2qouD\"]\u003c/p>\n\u003cp>\"The more hot flashes a woman has, the worse her memory performance,\" Maki says, citing her own research. \"And when we intervene to address those hot flashes, her memory performance bounces back.\"\u003c/p>\n\u003cp>Findings like that are renewing interest in the idea that someday, it may be possible to use hormones around the time of menopause to prevent Alzheimer's and other forms of dementia later on, Maki says.\u003c/p>\n\u003cp>In the meantime, there's evidence that hormonal differences between men and women may affect their brains in ways that affect doctors' ability to accurately diagnose Alzheimer's, Maki says.\u003c/p>\n\u003cp>At the Alzheimer's conference, she presented research showing that women tend to have higher verbal memory skills than men, even when they are in the early stages of Alzheimer's. As a result, women are likely to be diagnosed with the disease later than men.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>It's unclear whether male hormones, such as testosterone, affect a man's risk of Alzheimer's.\u003c/p>\n\u003chr>\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=Hormone+Levels+Likely+Influence+A+Woman%27s+Risk+Of+Alzheimer%27s.+But+Exactly+How%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There's new evidence that a woman's levels of female sex hormones, including estrogen and progesterone, can influence her risk of Alzheimer's and other forms of dementia.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Women are less likely to develop dementia later in life if they begin to menstruate earlier, go through menopause later, and have more than one child, researchers \u003ca href=\"https://www.alz.org/aaic/pressroom.asp\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> Monday at the \u003ca href=\"https://www.alz.org/aaic/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Association International Conference\u003c/a> in Chicago.\u003c/p>\n\u003cp>And recent studies offer hints that \u003ca href=\"https://medlineplus.gov/hormonereplacementtherapy.html\" target=\"_blank\" rel=\"noopener\">hormone replacement therapy\u003c/a>, which fell out of favor more than a decade ago, might offer a way to protect a woman's brain if it is given at the right time, the researchers said.\u003c/p>\n\u003cp>The findings could help explain why women make up nearly two-thirds of people in the U.S. with Alzheimer's, says \u003ca href=\"http://nationalacademies.org/hmd/Activities/Research/NeuroForum/Member%20Profiles/Maria%20Carrillo.aspx\" target=\"_blank\" rel=\"noopener\">Maria Carrillo\u003c/a>, the association's chief scientific officer.\u003c/p>\n\u003cp>\"It isn't just that women are living longer,\" Carrillo says. \"There is some biological underpinning. And because of the large numbers of women that are affected, it is important to find out [what it is].\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Scientists have long suspected that sex hormones such as estrogen and progesterone play a role in Alzheimer's. And two studies on dementia and what occurs during a women's reproductive years support that idea.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>One of the studies looked at nearly 15,000 women in California. And it found an association between a woman's reproductive history and her risk of memory problems later in life.\u003c/p>\n\u003cp>The risk of dementia for women who had three or more children was 12 percent lower than the risk for women who had one child, according to \u003ca href=\"https://divisionofresearch.kaiserpermanente.org/researchers/gilsanz-paola\" target=\"_blank\" rel=\"noopener\">Paola Gilsanz\u003c/a> of Kaiser Permanente Northern California Division of Research, and \u003ca href=\"https://profiles.ucsf.edu/rachel.whitmer\" target=\"_blank\" rel=\"noopener\">Rachel Whitmer\u003c/a> of the University of California, Davis.\u003c/p>\n\u003cp>Also, women who began to menstruate earlier and went through menopause later were less likely to develop dementia. Menopause at age 45 or younger seemed to increase the risk by 28 percent.\u003c/p>\n\u003cp>Another study of 133 elderly women in the U.K. found that the more months of pregnancy they experienced during their lives, the lower their risk of developing Alzheimer's.\u003c/p>\n\u003cp>The findings all suggest that female sex hormones — which rise at puberty and during pregnancy, then fall at menopause — are somehow affecting a woman's risk of developing Alzheimer's and other forms of dementia. The results also suggest that greater exposure to these hormones, through more pregnancies or more reproductive years, can reduce a woman's risk.\u003c/p>\n\u003cp>But it's still not clear whether the mere presence of female sex hormones is a reason that the frequency of Alzheimer's is greater in women than in men.\u003c/p>\n\u003cp>One possibility is that it's not female sex hormones on their own, but rapid changes in their levels that are a problem, says \u003ca href=\"https://crwg.uic.edu/crwg-home/crwg-staff/pauline-maki-phd/\" target=\"_blank\" rel=\"noopener\">Pauline Maki\u003c/a>, a professor of psychiatry and psychology at the University of Illinois at Chicago, who presented research at the Alzheimer's conference.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Women experience these very dramatic hormonal transitions that in the long run can give rise to Alzheimer's disease,\" she says.\u003c/p>\n\u003cp>One way for women to minimize the dramatic hormonal changes that occur at menopause is to use hormone replacement therapy.\u003c/p>\n\u003cp>That approach fell out of favor more than a decade ago when a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/12771112\" target=\"_blank\" rel=\"noopener\">large study\u003c/a> found that women who took estrogen plus progestin after menopause were actually more likely to get some form of dementia. They also appeared to have a higher risk of heart disease and breast cancer.\u003c/p>\n\u003cp>But Maki says more recent studies suggest that hormone therapy — especially estrogen alone — really can be helpful if women get it at the right time.\u003c/p>\n\u003cp>\"The effects of hormone therapy depend on the timing of use,\" Maki says. \"Use later in life is detrimental, whereas use early in the menopausal transition could be beneficial.\"\u003c/p>\n\u003cp>An analysis presented at the Alzheimer's conference supports that idea.\u003c/p>\n\u003cp>It found that in two recent studies, women who started taking estrogen after age 65 were more likely to have trouble with thinking and memory. But women who started taking estrogen between 50 and 54 were not.\u003c/p>\n\u003cp>And estrogen may benefit the mental function of younger women because it reduces the hot flashes associated with menopause, Maki says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The more hot flashes a woman has, the worse her memory performance,\" Maki says, citing her own research. \"And when we intervene to address those hot flashes, her memory performance bounces back.\"\u003c/p>\n\u003cp>Findings like that are renewing interest in the idea that someday, it may be possible to use hormones around the time of menopause to prevent Alzheimer's and other forms of dementia later on, Maki says.\u003c/p>\n\u003cp>In the meantime, there's evidence that hormonal differences between men and women may affect their brains in ways that affect doctors' ability to accurately diagnose Alzheimer's, Maki says.\u003c/p>\n\u003cp>At the Alzheimer's conference, she presented research showing that women tend to have higher verbal memory skills than men, even when they are in the early stages of Alzheimer's. 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"order": 1
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
"site": "radio",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
"title": "Freakonomics Radio",
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"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"meta": {
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
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