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"content": "\u003cp>In a \u003ca href=\"https://news.theranos.com/2017/01/06/company-re-engineers-operations/\" target=\"_blank\">press release\u003c/a> titled \"Company Re-engineers Operations,\" Theranos announced it has re-engineered 155 workers right out the door.\u003c/p>\n\u003cp>The layoff leaves the reeling blood-testing company, once heralded as a major innovator on the basis of its claimed ability to conduct dozens of tests from just a few drops of blood, with just 220 employees. That's down from about 850 last October, when Theranos let go of about 340 people in conjunction with shuttering its disastrous consumer blood-testing business.\u003c/p>\n\u003cp>That business, which once included dozens of blood-draw locations in Walgreen's stores, collapsed in the wake of a series of events not exactly conducive to business. Among the company's misfortunes were a Wall Street Journal investigation alleging a bevy of improprieties and inaccuracies related to the company’s secret technology; unprecedented government sanctions due to uncovered deficiencies at its main lab; and a multiplicity of lawsuits.\u003c/p>\n\u003cp>Theranos has said for months now that its main focus is on its miniLab, a printer-sized device that integrates already available technologies into one machine.\u003c/p>\n\u003cp>But some scientists who attended the unveiling of the device at a scientific conference last August were \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/29/theranos-elizabeth-holmes-will-face-1000-scientists-monday-can-she-say-anything-to-gain-their-trust/\" target=\"_blank\">less than impressed\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>'“It’s not as if there’s something here we haven’t fundamentally seen before,\" said Dr. Stephen R. Master, one of the event’s moderators,\u003c/p>\n\u003cp>Getting FDA approval for the miniLab could also take years. How much of the $900 million that Theranos once raised from investors might be left at that point ... well, the math doesn't look good.\u003c/p>\n\u003cp>\u003cstrong>More Bad Test Results\u003c/strong>\u003c/p>\n\u003cp>Also today, The Wall Street Journal reported Theranos sent out more notices of bad test results. Last April, the company said it had voided tens of thousands of tests that may have been inaccurate.\u003c/p>\n\u003cp>From the \u003ca href=\"http://www.wsj.com/articles/theranos-cuts-40-of-remaining-workforce-1483731874\" target=\"_blank\">Journal\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As recently as last week the company sent out newly corrected results saying some tests done in 2015 and 2016 for hemoglobin A1c, a protein doctors measure to help diagnose diabetes, shouldn’t be relied upon, according to copies of the corrected reports.\u003c/p>\n\u003cp>In a letter sent last week, Theranos said a patient who previously had gotten a “normal to prediabetic” result should have received a result in the “prediabetic to diabetic” range.\u003c/p>\n\u003cp>Kim Toy, a house cleaner in Phoenix, also learned last week that a past Theranos lab-test result had been voided, according to her lawyer.\u003c/p>\n\u003cp>Ms. Toy had the diabetes test at a Theranos location at a Walgreens in February 2016, indicating she may be on the brink of becoming diabetic. She doubted the result then, but hadn’t received any corrected information until now.\u003c/p>\u003c/blockquote>\n\u003cp>Then, to top it all off, there's this:\u003c/p>\n\u003cp>https://twitter.com/JohnCarreyrou/status/817516317754408960\u003c/p>\n\u003cp>John Carreyrou, of course, is The Wall Street Journal reporter who started the company on its long road to ruin with his investigative reports.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.vanityfair.com/news/2016/09/elizabeth-holmes-theranos-exclusive\" target=\"_blank\">Vanity Fair\u003c/a> reported last October that Theranos employees had chanted \"Fuck you, Carreyrou!\" during a company meeting at which founder and CEO Elizabeth Holmes had claimed the Journal's investigation was inaccurate.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a \u003ca href=\"https://news.theranos.com/2017/01/06/company-re-engineers-operations/\" target=\"_blank\">press release\u003c/a> titled \"Company Re-engineers Operations,\" Theranos announced it has re-engineered 155 workers right out the door.\u003c/p>\n\u003cp>The layoff leaves the reeling blood-testing company, once heralded as a major innovator on the basis of its claimed ability to conduct dozens of tests from just a few drops of blood, with just 220 employees. That's down from about 850 last October, when Theranos let go of about 340 people in conjunction with shuttering its disastrous consumer blood-testing business.\u003c/p>\n\u003cp>That business, which once included dozens of blood-draw locations in Walgreen's stores, collapsed in the wake of a series of events not exactly conducive to business. Among the company's misfortunes were a Wall Street Journal investigation alleging a bevy of improprieties and inaccuracies related to the company’s secret technology; unprecedented government sanctions due to uncovered deficiencies at its main lab; and a multiplicity of lawsuits.\u003c/p>\n\u003cp>Theranos has said for months now that its main focus is on its miniLab, a printer-sized device that integrates already available technologies into one machine.\u003c/p>\n\u003cp>But some scientists who attended the unveiling of the device at a scientific conference last August were \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/29/theranos-elizabeth-holmes-will-face-1000-scientists-monday-can-she-say-anything-to-gain-their-trust/\" target=\"_blank\">less than impressed\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>'“It’s not as if there’s something here we haven’t fundamentally seen before,\" said Dr. Stephen R. Master, one of the event’s moderators,\u003c/p>\n\u003cp>Getting FDA approval for the miniLab could also take years. How much of the $900 million that Theranos once raised from investors might be left at that point ... well, the math doesn't look good.\u003c/p>\n\u003cp>\u003cstrong>More Bad Test Results\u003c/strong>\u003c/p>\n\u003cp>Also today, The Wall Street Journal reported Theranos sent out more notices of bad test results. Last April, the company said it had voided tens of thousands of tests that may have been inaccurate.\u003c/p>\n\u003cp>From the \u003ca href=\"http://www.wsj.com/articles/theranos-cuts-40-of-remaining-workforce-1483731874\" target=\"_blank\">Journal\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As recently as last week the company sent out newly corrected results saying some tests done in 2015 and 2016 for hemoglobin A1c, a protein doctors measure to help diagnose diabetes, shouldn’t be relied upon, according to copies of the corrected reports.\u003c/p>\n\u003cp>In a letter sent last week, Theranos said a patient who previously had gotten a “normal to prediabetic” result should have received a result in the “prediabetic to diabetic” range.\u003c/p>\n\u003cp>Kim Toy, a house cleaner in Phoenix, also learned last week that a past Theranos lab-test result had been voided, according to her lawyer.\u003c/p>\n\u003cp>Ms. Toy had the diabetes test at a Theranos location at a Walgreens in February 2016, indicating she may be on the brink of becoming diabetic. She doubted the result then, but hadn’t received any corrected information until now.\u003c/p>\u003c/blockquote>\n\u003cp>Then, to top it all off, there's this:\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cp>Being overweight can raise your blood pressure, cholesterol and risk for developing diabetes. It could be bad for your brain, too.\u003c/p>\n\u003cp>A diet high in saturated fats and sugars, the so-called \u003ca href=\"http://www.npr.org/2011/03/24/132745785/how-western-diets-are-making-the-world-sick\">Western diet\u003c/a>, actually affects the parts of the brain that are important to memory and make people more likely to crave the unhealthful food, says psychologist \u003ca href=\"http://www.american.edu/cas/faculty/terryd.cfm\">Terry Davidson\u003c/a>, director of the Center for Behavioral Neuroscience at American University in Washington, D.C.\u003c/p>\n\u003cp>He didn't start out studying what people ate. Instead, he was interested in learning more about the hippocampus, a part of the brain that's heavily involved in memory.\u003c/p>\n\u003cp>He was trying to figure out which parts of the hippocampus do what. He did that by studying rats that had very specific types of hippocampal damage and seeing what happened to them.\u003c/p>\n\u003cp>In the process, Davidson noticed something strange. The rats with the hippocampal damage would go to pick up food more often than the other rats, but they would eat a little bit, then drop it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Davidson realized these rats \u003ca href=\"http://psycnet.apa.org/?&fa=main.doiLanding&doi=10.1037/a0018402\">didn't know they were full\u003c/a>. He says something similar may happen in human brains when people eat a diet high in fat and sugar. Davidson says \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S2352154615001801\">there's \u003c/a>a vicious cycle of bad diets and brain changes. He points to \u003ca href=\"http://www.jpeds.com/article/S0022-3476(14)00953-6/abstract\">a 2015 study\u003c/a> in the \u003cem>Journal of Pediatrics\u003c/em> that found obese children performed more poorly on memory tasks that test the hippocampus compared with kids who weren't overweight.\u003c/p>\n\u003cp>He says if our brain system is impaired by that kind of diet, \"that makes it more difficult for us to stop eating that diet. ... I think the evidence is fairly substantial that you have an effect of these diets and obesity on brain function and cognitive function.\"\u003c/p>\n\u003cp>The evidence is growing. Research from the Cambridge Centre for Ageing and Neuroscience \u003ca href=\"http://www.tandfonline.com/doi/full/10.1080/17470218.2015.1099163\">published in July\u003c/a> found that obese people have less white matter in their brains than their lean peers — as if their brains were 10 years older. A \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0889159116304329\">more recent study\u003c/a> from researchers at the University of Arizona supports one of the leading theories, that high body mass is linked to inflammation, which \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/25/451169292/could-depression-be-caused-by-an-infection\">affects the brain\u003c/a>.\u003c/p>\n\u003cp>But if we understand how obesity affects the brain and memory, then maybe we could use that relationship to prevent people from becoming obese in the first place.\u003c/p>\n\u003cp>Lucy Cheke, a psychologist at the University of Cambridge, says \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000869/\">her study\u003c/a> in \u003cem>The Quarterly Journal of Experimental Psychology\u003c/em> this November gives her some idea of how to do that.\u003c/p>\n\u003cp>Her researchers asked obese and lean people to do a memory task that's a virtual treasure hunt. The subjects had to hide something in a scene across various computer sessions, then they were asked what they hid, where they hid it and in which session.\u003c/p>\n\u003cp>The obese people were 15 to 20 percent worse than lean ones in all aspects of the experiment. The finding confirmed what other researchers had already seen in rodents. \"This really picks apart spatial, item and temporal memory, as well as, crucially, the ability to integrate them,\" which Cheke says is \"one of the most fundamental aspects of memory.\"\u003c/p>\n\u003cp>If you're obese, she says, you might just be \"10 to 15 to 20 percent more likely to not quite remember where you put your keys.\"\u003c/p>\n\u003cp>Diet isn't necessarily destiny. People can compensate. As American University's Davidson puts it, \"Let's say I had a kid and I gave him a high-fat diet and he showed hippocampal dysfunction. That kid may not do worse in school.\"\u003c/p>\n\u003cp>But, Davidson adds, the processes that help the kid do well in school may be impaired. When that happens, the kid would have to work harder and be more motivated and would \"have a tougher go of it.\"\u003c/p>\n\u003cp>Cheke says with the link between obesity and the brain growing as a field of research, we could see more ways of targeting obesity.\u003c/p>\n\u003cp>For example, if the issue is that the diet of obese people degrades their memory and makes them more likely to overeat, then maybe making their meals more memorable would help them eat less of the bad stuff. Cheke says there's \u003ca href=\"http://ajcn.nutrition.org/content/early/2013/02/25/ajcn.112.045245.abstract\">already some research\u003c/a> showing that if you watch TV while you eat lunch, you'll eat more and also be more likely to get hungry in the afternoon and later to eat more at dinner.\u003c/p>\n\u003cp>She says not watching TV while you eat is one of the \"small easy changes that people can make that don't involve a lot of self-control and that don't involve a lot of sacrifices, but that can still make a significant difference into how much you're eating.\"\u003c/p>\n\u003cp>However, even though we are beginning to understand that obesity affects the brain, we don't exactly know how, says John Gunstad, professor and director of the Applied Psychology Center at Kent State University in Ohio.\u003c/p>\n\u003cp>He points out that obesity changes a lot about the body: blood sugar levels, the cardiovascular system, inflammation levels throughout the body. Any one of those things could affect the brain.\u003c/p>\n\u003cp>\"Most likely, the effect of obesity on the brain is related to not just one cause but a combination of causes,\" Gunstad says.\u003c/p>\n\u003cp>Davidson is also moving forward by \u003ca href=\"https://projectreporter.nih.gov/project_info_description.cfm?aid=9159757&icde=32009517&ddparam=&ddvalue=&ddsub=&cr=1&csb=default&cs=ASC\">studying how\u003c/a> to break the vicious cycle of a Western diet, obesity and brain changes. But he says the underlying idea that obesity affects the brain is clear.\u003c/p>\n\u003cp>\"It's surprising to me that people would question that obesity would have a negative effect on the brain, because it has a negative effect on so many other bodily systems,\" he says, adding, why would \"the brain would be spared?\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Alan Yu is a freelance reporter who also contributes to the \u003c/em>South China Morning Post\u003cem> \u003cem>in Hong Kong\u003cem>. You can follow him on Twitter: \u003c/em>\u003c/em>\u003c/em>\u003ca href=\"https://twitter.com/Alan_Yu039\">@Alan_Yu039\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=The+Wrong+Eating+Habits+Can+Hurt+Your+Brain%2C+Not+Just+Your+Waistline&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "A diet high in saturated fats and sugars can affect the parts of the brain that are important to memory. Diet-linked brain changes can also make people more likely to crave unhealthful food.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Being overweight can raise your blood pressure, cholesterol and risk for developing diabetes. It could be bad for your brain, too.\u003c/p>\n\u003cp>A diet high in saturated fats and sugars, the so-called \u003ca href=\"http://www.npr.org/2011/03/24/132745785/how-western-diets-are-making-the-world-sick\">Western diet\u003c/a>, actually affects the parts of the brain that are important to memory and make people more likely to crave the unhealthful food, says psychologist \u003ca href=\"http://www.american.edu/cas/faculty/terryd.cfm\">Terry Davidson\u003c/a>, director of the Center for Behavioral Neuroscience at American University in Washington, D.C.\u003c/p>\n\u003cp>He didn't start out studying what people ate. Instead, he was interested in learning more about the hippocampus, a part of the brain that's heavily involved in memory.\u003c/p>\n\u003cp>He was trying to figure out which parts of the hippocampus do what. He did that by studying rats that had very specific types of hippocampal damage and seeing what happened to them.\u003c/p>\n\u003cp>In the process, Davidson noticed something strange. The rats with the hippocampal damage would go to pick up food more often than the other rats, but they would eat a little bit, then drop it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Davidson realized these rats \u003ca href=\"http://psycnet.apa.org/?&fa=main.doiLanding&doi=10.1037/a0018402\">didn't know they were full\u003c/a>. He says something similar may happen in human brains when people eat a diet high in fat and sugar. Davidson says \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S2352154615001801\">there's \u003c/a>a vicious cycle of bad diets and brain changes. He points to \u003ca href=\"http://www.jpeds.com/article/S0022-3476(14)00953-6/abstract\">a 2015 study\u003c/a> in the \u003cem>Journal of Pediatrics\u003c/em> that found obese children performed more poorly on memory tasks that test the hippocampus compared with kids who weren't overweight.\u003c/p>\n\u003cp>He says if our brain system is impaired by that kind of diet, \"that makes it more difficult for us to stop eating that diet. ... I think the evidence is fairly substantial that you have an effect of these diets and obesity on brain function and cognitive function.\"\u003c/p>\n\u003cp>The evidence is growing. Research from the Cambridge Centre for Ageing and Neuroscience \u003ca href=\"http://www.tandfonline.com/doi/full/10.1080/17470218.2015.1099163\">published in July\u003c/a> found that obese people have less white matter in their brains than their lean peers — as if their brains were 10 years older. A \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0889159116304329\">more recent study\u003c/a> from researchers at the University of Arizona supports one of the leading theories, that high body mass is linked to inflammation, which \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/25/451169292/could-depression-be-caused-by-an-infection\">affects the brain\u003c/a>.\u003c/p>\n\u003cp>But if we understand how obesity affects the brain and memory, then maybe we could use that relationship to prevent people from becoming obese in the first place.\u003c/p>\n\u003cp>Lucy Cheke, a psychologist at the University of Cambridge, says \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000869/\">her study\u003c/a> in \u003cem>The Quarterly Journal of Experimental Psychology\u003c/em> this November gives her some idea of how to do that.\u003c/p>\n\u003cp>Her researchers asked obese and lean people to do a memory task that's a virtual treasure hunt. The subjects had to hide something in a scene across various computer sessions, then they were asked what they hid, where they hid it and in which session.\u003c/p>\n\u003cp>The obese people were 15 to 20 percent worse than lean ones in all aspects of the experiment. The finding confirmed what other researchers had already seen in rodents. \"This really picks apart spatial, item and temporal memory, as well as, crucially, the ability to integrate them,\" which Cheke says is \"one of the most fundamental aspects of memory.\"\u003c/p>\n\u003cp>If you're obese, she says, you might just be \"10 to 15 to 20 percent more likely to not quite remember where you put your keys.\"\u003c/p>\n\u003cp>Diet isn't necessarily destiny. People can compensate. As American University's Davidson puts it, \"Let's say I had a kid and I gave him a high-fat diet and he showed hippocampal dysfunction. That kid may not do worse in school.\"\u003c/p>\n\u003cp>But, Davidson adds, the processes that help the kid do well in school may be impaired. When that happens, the kid would have to work harder and be more motivated and would \"have a tougher go of it.\"\u003c/p>\n\u003cp>Cheke says with the link between obesity and the brain growing as a field of research, we could see more ways of targeting obesity.\u003c/p>\n\u003cp>For example, if the issue is that the diet of obese people degrades their memory and makes them more likely to overeat, then maybe making their meals more memorable would help them eat less of the bad stuff. Cheke says there's \u003ca href=\"http://ajcn.nutrition.org/content/early/2013/02/25/ajcn.112.045245.abstract\">already some research\u003c/a> showing that if you watch TV while you eat lunch, you'll eat more and also be more likely to get hungry in the afternoon and later to eat more at dinner.\u003c/p>\n\u003cp>She says not watching TV while you eat is one of the \"small easy changes that people can make that don't involve a lot of self-control and that don't involve a lot of sacrifices, but that can still make a significant difference into how much you're eating.\"\u003c/p>\n\u003cp>However, even though we are beginning to understand that obesity affects the brain, we don't exactly know how, says John Gunstad, professor and director of the Applied Psychology Center at Kent State University in Ohio.\u003c/p>\n\u003cp>He points out that obesity changes a lot about the body: blood sugar levels, the cardiovascular system, inflammation levels throughout the body. Any one of those things could affect the brain.\u003c/p>\n\u003cp>\"Most likely, the effect of obesity on the brain is related to not just one cause but a combination of causes,\" Gunstad says.\u003c/p>\n\u003cp>Davidson is also moving forward by \u003ca href=\"https://projectreporter.nih.gov/project_info_description.cfm?aid=9159757&icde=32009517&ddparam=&ddvalue=&ddsub=&cr=1&csb=default&cs=ASC\">studying how\u003c/a> to break the vicious cycle of a Western diet, obesity and brain changes. But he says the underlying idea that obesity affects the brain is clear.\u003c/p>\n\u003cp>\"It's surprising to me that people would question that obesity would have a negative effect on the brain, because it has a negative effect on so many other bodily systems,\" he says, adding, why would \"the brain would be spared?\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Alan Yu is a freelance reporter who also contributes to the \u003c/em>South China Morning Post\u003cem> \u003cem>in Hong Kong\u003cem>. You can follow him on Twitter: \u003c/em>\u003c/em>\u003c/em>\u003ca href=\"https://twitter.com/Alan_Yu039\">@Alan_Yu039\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=The+Wrong+Eating+Habits+Can+Hurt+Your+Brain%2C+Not+Just+Your+Waistline&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Crowdfunding is a now a popular way to raise money for everything from birthday bashes to political protests. But on some of the big online fund raising sites, you'll find public pleas for something far more personal — infertility treatments.\u003c/p>\n\u003cp>Greg and Julia Fry of Ithaca, N.Y., were in their early 30s when they got married three years ago and set out to start a family. But a year passed and they didn't get pregnant. Six more months went by and, still, no baby.\u003c/p>\n\u003cp>So they consulted a medical specialist, Greg says. \"And we wound up realizing that fertility treatments were what we would need.\"\u003c/p>\n\u003cp>They began with a less costly and less invasive option: \u003ca href=\"http://www.cdc.gov/reproductivehealth/Infertility/index.htm\">IUI\u003c/a> or intrauterine insemination. That's where sperm is inserted with a catheter directly into the woman's uterus at the time of ovulation. The procedure costs, on average, just under $1,000 a try. The Frys have tried four times in the past year — with no luck.\u003c/p>\n\u003cp>\"This, by far, is the hardest thing that we've ever been through together,\" says Greg. \"There is always hope going into every cycle. And that hope, sort of, gets dashed at the end of the cycle, and then we start again.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The next step they took was to try \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/18/279035110/ivf-baby-boom-births-from-fertility-procedure-hit-new-high\">in vitro fertilization\u003c/a>, or IVF. This involves fertilizing eggs with sperm in a laboratory dish, then transferring the embryo into the woman's uterus. It can cost $15,000 to $20,000 each try.\u003c/p>\n\u003cp>At first, Greg says, they thought about traveling overseas for more affordable treatments, but travel costs would have gobbled up any savings. So, they went online instead, to the crowdfunding site GiveForward. They \u003ca href=\"https://pages.giveforward.com/medical/page-bwg4ty5/activity/595921\">posted\u003c/a> a video in which they talk about their decision to ask for financial help.\u003c/p>\n\u003cp>\"You know us as Julia and Greg,\" Greg begins. \"The couple with so much love to give,\" Julia continues, and they alternate telling their story.\u003c/p>\n\u003cp>Asking for IVF assistance like this is one of the fastest growing crowdfunding categories, according to \u003ca href=\"https://www.linkedin.com/in/joshuacchapman\">Josh Chapman\u003c/a>, CEO of \u003ca href=\"https://pages.giveforward.com/homepage/\">GiveForward\u003c/a>. It's outpaced all categories except adoption at his firm in 2016, Chapman says, adding, \"we believe this trend will continue into 2017.\"\u003c/p>\n\u003cp>Most health insurance doesn't cover treatments for infertility. That was the case for Janet Carter and her wife Jackie. They live in Charleston, S.C., and both have job-based health insurance.\u003c/p>\n\u003cp>Janet says their insurance was helpful for the diagnostic part of the process, but that was the extent of the reimbursement. \"[The insurance] will cover anything that is testing beforehand, like any underlying issues that are leading to the need for fertility treatment. They do not cover any of the actual procedures at all,\" she says.\u003c/p>\n\u003cp>As their August, 2015 wedding approached, the couple asked their guests to consider giving them cash for fertility treatments.\u003c/p>\n\u003cp>\"We not only had a regular registry for Target, but we also decided to have it be an option for our friends and family that wanted to be a part of us starting our little new family,\" Janet says.\u003c/p>\n\u003cp>The wedding guests gave them about $3,000, which they used to help pay for nine failed IUI attempts. Janet wanted to try asking friends again for money, this time for help with IVF. But, initially, Jackie wasn't so sure.\u003c/p>\n\u003cp>\"Does it seem like we're begging, or asking people for money,\" she recalls wondering. \"Am I ready to do that? Am I ready for people to be that involved?\"\u003c/p>\n\u003cp>They asked friends for their opinions about crowdfunding, and the support was resounding, the women say, save for a wee bit of hesitation from Janet's mom.\u003c/p>\n\u003cp>\"I think that's just a generational difference in opinion,\" Janet says.\u003c/p>\n\u003cp>But, Jackie became convinced.\u003c/p>\n\u003cp>\"I realized, 'Hey, you know what? There are thousands of people out there using these crowdfunding sources for honeymoons and, you know, maybe things that aren't as impactful as having a child,' \" she says.\u003c/p>\n\u003cp>The couple went forward with a site called, \u003ca href=\"https://www.youcaring.com/janet-carter-and-jackie-regan-368536\">YouCaring.com\u003c/a>, that's helped them raise about $5,000 so far.\u003c/p>\n\u003cp>Still, crowdfunding \u003cem>is\u003c/em> hard for a lot of people, says \u003ca href=\"http://www.rachelgurevich.com/\">Rachel Gurevich\u003c/a>, who writes about fertility issues.\u003c/p>\n\u003cp>\"I wouldn't do it unless you have a lot of social connections,\" she says. \"A lot of people think that it's automatic — they're going to put it up and raise a bunch of money. And they're not — and that can be really disappointing.\"\u003c/p>\n\u003cp>Indeed, dozens of IVF campaigns on these sites show $0 raised. Both the Frys and the Carters received money from friends, family and some acquaintances, which is more typical for these crowdfunds, Gurevich says. Most donations range from $20 to $100.\u003c/p>\n\u003cp>Greg and Julia Fry's crowdfunding page has earned about $1,200.\u003c/p>\n\u003cp>\"It's been very positive — everybody that I've worked with,\" says Julia. \"People come up to me. And they've come into my office and they hand me $20,\" she says. \"They say, 'We love you guys. We think you will be such great parents — please take it.' \"\u003c/p>\n\u003cp>Their friend Jordanna Larish gave $50, even though she's unemployed right now. \"Julia and Greg are incredibly generous people, always helping others,\" she writes in an email to NPR. \"They've been trying for so long to have a baby, and they'll be excellent parents.\"\u003c/p>\n\u003cp>Jessie Simpson, who is friends with Jackie and Janet Carter, says she gave them $500 — \"and a whole lot of prayers.\" Simpson was moved by how easy it was for her to have her son and how difficult it has been for her friends.\u003c/p>\n\u003cp>\"Watching their struggle for over a year, all while the medical bills rack up each month, it was heartbreaking,\" Simpson writes to NPR. \"That is the power of crowdfunding though — connect their story to your experiences and you want to melt in a puddle of tears and give them the shirt off your back.\"\u003c/p>\n\u003cp>The Carters are using their fundraising to pay down a credit card bill for their IVF. And Janet is now pregnant — their baby is due in June, 2017.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with \u003ca href=\"http://www.kaiserhealthnews.org\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Please%2C+Baby%2C+Please%3A+Some+Couples+Turn+To+Crowdfunding+For+IVF&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Crowdfunding is a now a popular way to raise money for everything from birthday bashes to political protests. But on some of the big online fund raising sites, you'll find public pleas for something far more personal — infertility treatments.\u003c/p>\n\u003cp>Greg and Julia Fry of Ithaca, N.Y., were in their early 30s when they got married three years ago and set out to start a family. But a year passed and they didn't get pregnant. Six more months went by and, still, no baby.\u003c/p>\n\u003cp>So they consulted a medical specialist, Greg says. \"And we wound up realizing that fertility treatments were what we would need.\"\u003c/p>\n\u003cp>They began with a less costly and less invasive option: \u003ca href=\"http://www.cdc.gov/reproductivehealth/Infertility/index.htm\">IUI\u003c/a> or intrauterine insemination. That's where sperm is inserted with a catheter directly into the woman's uterus at the time of ovulation. The procedure costs, on average, just under $1,000 a try. The Frys have tried four times in the past year — with no luck.\u003c/p>\n\u003cp>\"This, by far, is the hardest thing that we've ever been through together,\" says Greg. \"There is always hope going into every cycle. And that hope, sort of, gets dashed at the end of the cycle, and then we start again.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The next step they took was to try \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/18/279035110/ivf-baby-boom-births-from-fertility-procedure-hit-new-high\">in vitro fertilization\u003c/a>, or IVF. This involves fertilizing eggs with sperm in a laboratory dish, then transferring the embryo into the woman's uterus. It can cost $15,000 to $20,000 each try.\u003c/p>\n\u003cp>At first, Greg says, they thought about traveling overseas for more affordable treatments, but travel costs would have gobbled up any savings. So, they went online instead, to the crowdfunding site GiveForward. They \u003ca href=\"https://pages.giveforward.com/medical/page-bwg4ty5/activity/595921\">posted\u003c/a> a video in which they talk about their decision to ask for financial help.\u003c/p>\n\u003cp>\"You know us as Julia and Greg,\" Greg begins. \"The couple with so much love to give,\" Julia continues, and they alternate telling their story.\u003c/p>\n\u003cp>Asking for IVF assistance like this is one of the fastest growing crowdfunding categories, according to \u003ca href=\"https://www.linkedin.com/in/joshuacchapman\">Josh Chapman\u003c/a>, CEO of \u003ca href=\"https://pages.giveforward.com/homepage/\">GiveForward\u003c/a>. It's outpaced all categories except adoption at his firm in 2016, Chapman says, adding, \"we believe this trend will continue into 2017.\"\u003c/p>\n\u003cp>Most health insurance doesn't cover treatments for infertility. That was the case for Janet Carter and her wife Jackie. They live in Charleston, S.C., and both have job-based health insurance.\u003c/p>\n\u003cp>Janet says their insurance was helpful for the diagnostic part of the process, but that was the extent of the reimbursement. \"[The insurance] will cover anything that is testing beforehand, like any underlying issues that are leading to the need for fertility treatment. They do not cover any of the actual procedures at all,\" she says.\u003c/p>\n\u003cp>As their August, 2015 wedding approached, the couple asked their guests to consider giving them cash for fertility treatments.\u003c/p>\n\u003cp>\"We not only had a regular registry for Target, but we also decided to have it be an option for our friends and family that wanted to be a part of us starting our little new family,\" Janet says.\u003c/p>\n\u003cp>The wedding guests gave them about $3,000, which they used to help pay for nine failed IUI attempts. Janet wanted to try asking friends again for money, this time for help with IVF. But, initially, Jackie wasn't so sure.\u003c/p>\n\u003cp>\"Does it seem like we're begging, or asking people for money,\" she recalls wondering. \"Am I ready to do that? Am I ready for people to be that involved?\"\u003c/p>\n\u003cp>They asked friends for their opinions about crowdfunding, and the support was resounding, the women say, save for a wee bit of hesitation from Janet's mom.\u003c/p>\n\u003cp>\"I think that's just a generational difference in opinion,\" Janet says.\u003c/p>\n\u003cp>But, Jackie became convinced.\u003c/p>\n\u003cp>\"I realized, 'Hey, you know what? There are thousands of people out there using these crowdfunding sources for honeymoons and, you know, maybe things that aren't as impactful as having a child,' \" she says.\u003c/p>\n\u003cp>The couple went forward with a site called, \u003ca href=\"https://www.youcaring.com/janet-carter-and-jackie-regan-368536\">YouCaring.com\u003c/a>, that's helped them raise about $5,000 so far.\u003c/p>\n\u003cp>Still, crowdfunding \u003cem>is\u003c/em> hard for a lot of people, says \u003ca href=\"http://www.rachelgurevich.com/\">Rachel Gurevich\u003c/a>, who writes about fertility issues.\u003c/p>\n\u003cp>\"I wouldn't do it unless you have a lot of social connections,\" she says. \"A lot of people think that it's automatic — they're going to put it up and raise a bunch of money. And they're not — and that can be really disappointing.\"\u003c/p>\n\u003cp>Indeed, dozens of IVF campaigns on these sites show $0 raised. Both the Frys and the Carters received money from friends, family and some acquaintances, which is more typical for these crowdfunds, Gurevich says. Most donations range from $20 to $100.\u003c/p>\n\u003cp>Greg and Julia Fry's crowdfunding page has earned about $1,200.\u003c/p>\n\u003cp>\"It's been very positive — everybody that I've worked with,\" says Julia. \"People come up to me. And they've come into my office and they hand me $20,\" she says. \"They say, 'We love you guys. We think you will be such great parents — please take it.' \"\u003c/p>\n\u003cp>Their friend Jordanna Larish gave $50, even though she's unemployed right now. \"Julia and Greg are incredibly generous people, always helping others,\" she writes in an email to NPR. \"They've been trying for so long to have a baby, and they'll be excellent parents.\"\u003c/p>\n\u003cp>Jessie Simpson, who is friends with Jackie and Janet Carter, says she gave them $500 — \"and a whole lot of prayers.\" Simpson was moved by how easy it was for her to have her son and how difficult it has been for her friends.\u003c/p>\n\u003cp>\"Watching their struggle for over a year, all while the medical bills rack up each month, it was heartbreaking,\" Simpson writes to NPR. \"That is the power of crowdfunding though — connect their story to your experiences and you want to melt in a puddle of tears and give them the shirt off your back.\"\u003c/p>\n\u003cp>The Carters are using their fundraising to pay down a credit card bill for their IVF. And Janet is now pregnant — their baby is due in June, 2017.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with \u003ca href=\"http://www.kaiserhealthnews.org\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Please%2C+Baby%2C+Please%3A+Some+Couples+Turn+To+Crowdfunding+For+IVF&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Best TED Talks in Biomed 2016",
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"content": "\u003cp>As usual TED talked ... and talked and talked ... in 2016. Here are our fave presentations in biomed last year.\u003c/p>\n\u003cp>1. \u003ca href=\"https://www.ted.com/talks/jennifer_kahn_gene_editing_can_now_change_an_entire_species_forever\">Gene Editing Can Now Change An Entire Species -- Forever\u003c/a>\u003c/p>\n\u003cp>[ted id=2494]\u003c/p>\n\u003cp>CRISPR gene drives allow scientists to change sequences of DNA and guarantee that the resulting edited genetic trait is inherited by future generations, opening up the possibility of altering entire species forever. More than anything, the technology has led to questions: How will this new power affect humanity? What are we going to use it to change? Are we gods now? Join journalist Jennifer Kahn as she ponders these questions and shares a potentially powerful application of gene drives: the development of disease-resistant mosquitoes that could knock out malaria and Zika.\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">\u003ci>“We have a very powerful, but also somewhat alarming new tool…..\u003c/i>\u003c/span>\u003ci> \u003c/i>\u003cspan class=\"s3\">\u003ci>Gene drives are so effective that even an accidental release could change an entire species, and often very quickly.”\u003c/i>\u003c/span>\u003cspan class=\"s3\">\u003ci>---Jennifer Kahn\u003c/i>\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>2. \u003ca href=\"https://www.ted.com/talks/jocelyne_bloch_the_brain_may_be_able_to_repair_itself_with_help\">Helping A Damaged Brain Repair Itself\u003c/a>\u003c/p>\n\u003cp>[ted id=2429]\u003c/p>\n\u003cp>Through treating everything from strokes to car accident traumas, neurosurgeon Jocelyne Bloch knows the brain's inability to repair itself all too well. But now, she suggests, she and her colleagues may have found the key to neural repair: Doublecortin-positive cells. Similar to stem cells, they are extremely adaptable and, when extracted from a brain, cultured and then reinjected in a lesioned area of the same brain, they can help repair and rebuild it. \"With a little help,\" Bloch says, \"the brain may be able to help itself.\"\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003ci> ”The dream of functional neurosurgeons is to repair the brain. I think that we are approaching this dream.” --- Jocelyne Bloch\u003c/i>\u003c/span>\u003c/p>\n\u003cp>3. \u003ca href=\"https://www.ted.com/talks/riccardo_sabatini_how_to_read_the_genome_and_build_a_human_being/transcript?language=en\">How To Read The Genome and Build a Human Being\u003c/a>\u003c/p>\n\u003cp>[ted id=2490]\u003c/p>\n\u003cp>Secrets, disease and beauty are all written in the human genome, the complete set of genetic instructions needed to build a human being. Now, as scientist and entrepreneur Riccardo Sabatini shows us, we have the power to read this complex code, predicting things like height, eye color, age and even facial structure — all from a vial of blood. And soon, Sabatini says, our new understanding of the genome will allow us to personalize treatments for diseases like cancer. We have the power to change life as we know it. How will we use it?\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003ci>“We are touching the very inner detail on how life works. And it's a revolution that cannot be confined in the domain of science or technology. This must be a global conversation. We must start to think of the future we're building as humanity.” --- Riccardo Sabatini\u003c/i>\u003c/span>\u003c/p>\n\u003cp>4. \u003ca href=\"https://www.ted.com/talks/paula_hammond_a_new_superweapon_in_the_fight_against_cancer\">A New Superweapon In The Fight Against Cancer\u003c/a>\u003c/p>\n\u003cp>[ted id=2467]\u003c/p>\n\u003cp>Cancer is a very clever, adaptable disease. To defeat it, says medical researcher and educator Paula Hammond, we need a new and powerful mode of attack. With her colleagues at MIT, Hammond engineered a nanoparticle one-hundredth the size of a human hair that can treat the most aggressive, drug-resistant cancers. Learn more about this molecular superweapon and join Hammond's quest to fight a disease that affects us all.\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">\u003ci>“It's not just about building really elegant science. It's about changing people's lives. It's about understanding the power of engineering on the scale of molecules.”\u003cspan class=\"Apple-converted-space\"> \u003c/span>---Paula Hammond\u003c/i>\u003c/span>\u003c/p>\n\u003cp>5. \u003ca href=\"https://www.ted.com/talks/david_camarillo_why_helmets_don_t_prevent_concussions_and_what_might\">Why Helmets Don’t Prevent Concussions – And What Might\u003c/a>\u003c/p>\n\u003cp>[ted id=2581]\u003c/p>\n\u003cp>What is a concussion? Probably not what you think it is. In this talk from the cutting edge of research, bioengineer (and former football player) David Camarillo shows what really happens during a concussion — and why standard sports helmets don't prevent it. Here's what the future of concussion prevention looks like.\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003ci>“What we think is that if we can slow the head down just enough so that the brain does not lag behind the skull but instead it moves in synchrony with the skull, then we might be able to prevent this mechanism of concussion.” --- David Camarillo\u003c/i>\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As usual TED talked ... and talked and talked ... in 2016. Here are our fave presentations in biomed last year.\u003c/p>\n\u003cp>1. \u003ca href=\"https://www.ted.com/talks/jennifer_kahn_gene_editing_can_now_change_an_entire_species_forever\">Gene Editing Can Now Change An Entire Species -- Forever\u003c/a>\u003c/p>\n\u003cp>[ted id=2494]\u003c/p>\n\u003cp>CRISPR gene drives allow scientists to change sequences of DNA and guarantee that the resulting edited genetic trait is inherited by future generations, opening up the possibility of altering entire species forever. More than anything, the technology has led to questions: How will this new power affect humanity? What are we going to use it to change? Are we gods now? Join journalist Jennifer Kahn as she ponders these questions and shares a potentially powerful application of gene drives: the development of disease-resistant mosquitoes that could knock out malaria and Zika.\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">\u003ci>“We have a very powerful, but also somewhat alarming new tool…..\u003c/i>\u003c/span>\u003ci> \u003c/i>\u003cspan class=\"s3\">\u003ci>Gene drives are so effective that even an accidental release could change an entire species, and often very quickly.”\u003c/i>\u003c/span>\u003cspan class=\"s3\">\u003ci>---Jennifer Kahn\u003c/i>\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>2. \u003ca href=\"https://www.ted.com/talks/jocelyne_bloch_the_brain_may_be_able_to_repair_itself_with_help\">Helping A Damaged Brain Repair Itself\u003c/a>\u003c/p>\n\u003cp>[ted id=2429]\u003c/p>\n\u003cp>Through treating everything from strokes to car accident traumas, neurosurgeon Jocelyne Bloch knows the brain's inability to repair itself all too well. But now, she suggests, she and her colleagues may have found the key to neural repair: Doublecortin-positive cells. Similar to stem cells, they are extremely adaptable and, when extracted from a brain, cultured and then reinjected in a lesioned area of the same brain, they can help repair and rebuild it. \"With a little help,\" Bloch says, \"the brain may be able to help itself.\"\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003ci> ”The dream of functional neurosurgeons is to repair the brain. I think that we are approaching this dream.” --- Jocelyne Bloch\u003c/i>\u003c/span>\u003c/p>\n\u003cp>3. \u003ca href=\"https://www.ted.com/talks/riccardo_sabatini_how_to_read_the_genome_and_build_a_human_being/transcript?language=en\">How To Read The Genome and Build a Human Being\u003c/a>\u003c/p>\n\u003cp>[ted id=2490]\u003c/p>\n\u003cp>Secrets, disease and beauty are all written in the human genome, the complete set of genetic instructions needed to build a human being. Now, as scientist and entrepreneur Riccardo Sabatini shows us, we have the power to read this complex code, predicting things like height, eye color, age and even facial structure — all from a vial of blood. And soon, Sabatini says, our new understanding of the genome will allow us to personalize treatments for diseases like cancer. We have the power to change life as we know it. How will we use it?\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003ci>“We are touching the very inner detail on how life works. And it's a revolution that cannot be confined in the domain of science or technology. This must be a global conversation. We must start to think of the future we're building as humanity.” --- Riccardo Sabatini\u003c/i>\u003c/span>\u003c/p>\n\u003cp>4. \u003ca href=\"https://www.ted.com/talks/paula_hammond_a_new_superweapon_in_the_fight_against_cancer\">A New Superweapon In The Fight Against Cancer\u003c/a>\u003c/p>\n\u003cp>[ted id=2467]\u003c/p>\n\u003cp>Cancer is a very clever, adaptable disease. To defeat it, says medical researcher and educator Paula Hammond, we need a new and powerful mode of attack. With her colleagues at MIT, Hammond engineered a nanoparticle one-hundredth the size of a human hair that can treat the most aggressive, drug-resistant cancers. Learn more about this molecular superweapon and join Hammond's quest to fight a disease that affects us all.\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">\u003ci>“It's not just about building really elegant science. It's about changing people's lives. It's about understanding the power of engineering on the scale of molecules.”\u003cspan class=\"Apple-converted-space\"> \u003c/span>---Paula Hammond\u003c/i>\u003c/span>\u003c/p>\n\u003cp>5. \u003ca href=\"https://www.ted.com/talks/david_camarillo_why_helmets_don_t_prevent_concussions_and_what_might\">Why Helmets Don’t Prevent Concussions – And What Might\u003c/a>\u003c/p>\n\u003cp>[ted id=2581]\u003c/p>\n\u003cp>What is a concussion? Probably not what you think it is. In this talk from the cutting edge of research, bioengineer (and former football player) David Camarillo shows what really happens during a concussion — and why standard sports helmets don't prevent it. Here's what the future of concussion prevention looks like.\u003cem>--- TED\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003ci>“What we think is that if we can slow the head down just enough so that the brain does not lag behind the skull but instead it moves in synchrony with the skull, then we might be able to prevent this mechanism of concussion.” --- David Camarillo\u003c/i>\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Will California’s New 'Right to Try' Law Empower or Exploit Patients?",
"title": "Will California’s New 'Right to Try' Law Empower or Exploit Patients?",
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"content": "\u003cp>With the enactment of a new “Right to Try” law, California joins 31 other states that have already passed legislation to support patients’ efforts to access experimental drugs.\u003c/p>\n\u003cp>As of Jan. 1, state agencies and licensing boards will not penalize California doctors or hospitals that want to help patients directly petition pharmaceutical companies for the investigational drugs.\u003c/p>\n\u003cp>Proponents of the “Right to Try” movement had contended that doctors could be hesitant to help such patients because of the risk of using drugs or devices that haven’t passed FDA tests for safety and effectiveness.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/300768363\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>The new law makes it clear that California doctors can proceed without fear of censure from the state’s medical board. It also eliminates other possible regulatory obstacles on the state level and creates processes for patient consent and data collection.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The idea is to kind of get government out of the way in this situation and allow people to just go at it with a doctor to try to get access to these potentially life-saving medications,” said the law’s sponsor \u003ca href=\"http://asmdc.org/members/a57/\" target=\"_blank\">Ian Calderon\u003c/a>, the Democratic majority leader in the California Assembly.\u003c/p>\n\u003cp>Supporters of “Right to Try” laws sometimes frame them as the logical counterpart to “Right to Die” laws, which allow physician-assisted suicide for terminally ill patients. California enacted such a law in 2016.\u003c/p>\n\u003cp>\"The patient community is saying, ‘We are smart, we’re informed, we feel it is our right to try some of these therapies, because we’re going to die anyway,’” said Lina Clark, a patients’ rights \u003ca href=\"http://www.hopenowforals.org\" target=\"_blank\">activist\u003c/a> in San Diego.\u003c/p>\n\u003cp>Clark’s husband, \u003ca href=\"http://sci.sdsu.edu/geology/remembering-dr-david-huntley/\" target=\"_blank\">David Huntley\u003c/a>, had wanted to try an experimental drug before his death in 2015 from \u003ca href=\"https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Amyotrophic-Lateral-Sclerosis-ALS-Fact-Sheet\" target=\"_blank\">amyotrophic lateral sclerosis\u003c/a> (ALS).\u003c/p>\n\u003cfigure id=\"attachment_278363\" class=\"wp-caption alignnone\" style=\"max-width: 720px\">\u003cimg class=\"size-full wp-image-278363\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento.jpg\" alt=\"David Huntley testified in favor of California's "Right to Try" bill in April, 2015. He died three months later. \" width=\"720\" height=\"960\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento.jpg 720w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento-160x213.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento-240x320.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento-375x500.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento-520x693.jpg 520w\" sizes=\"(max-width: 720px) 100vw, 720px\">\u003cfigcaption class=\"wp-caption-text\">David Huntley testified in favor of California's \"Right to Try\" bill in April 2015. He died three months later. \u003ccite>(Courtesy of Lina Clark)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The FDA already offers a \u003ca href=\"http://www.fda.gov/NewsEvents/PublicHealthFocus/ExpandedAccessCompassionateUse/default.htm\" target=\"_blank\">process\u003c/a>, called “expanded access” or “compassionate use,” for some patients to obtain experimental drugs. But critics say it’s too slow and cumbersome, even though the FDA approves more than 99 percent of requests that come through that pipeline.\u003c/p>\n\u003cp>“It just takes so long, it’s inefficient, it’s ridiculous,” Calderon said of the FDA process. “I don’t understand.”\u003c/p>\n\u003cp>As the state laws proliferate, clinicians and medical ethicists are growing increasingly concerned about the potential safety and financial risks to patients.\u003c/p>\n\u003cp>“If we take the FDA out of it, how do we protect people from physicians or drug companies that will want to sell them things and will want to prey on their desperation?” asked \u003ca href=\"http://healthpolicy.ucsf.edu/people/r-adams-dudley-md-mba\" target=\"_blank\">Dr. R. Adams Dudley\u003c/a>, director of UCSF’s \u003ca href=\"http://healthvalue.ucsf.edu/\" target=\"_blank\">Center for Healthcare Value\u003c/a>.\u003c/p>\n\u003cp>Dudley says the FDA and the clinical trial process were put in place for a reason.\u003c/p>\n\u003cp>\"Have we somehow gotten better at managing snake oil salesmen now, than we were back when we decided we needed an FDA in the first place?\" Dudley said.\u003c/p>\n\u003cp>Under the new law, all that patients and doctors can really do is \u003cem>ask\u003c/em> for an experimental drug. Drug companies don’t have to give it to them, and insurance companies don’t have to pay for it.\u003c/p>\n\u003cp>Dudley fears that family members of a patient might exhaust their life savings trying a drug that hasn’t been proven to work -- and could even speed up death or increase end-of-life suffering.\u003c/p>\n\u003cp>That’s one reason the \u003ca href=\"http://www.nationalnursesunited.org/site/entry/california-nurses-association\" target=\"_blank\">California Nurses Association\u003c/a>, among other groups, strongly opposed the bill.\u003c/p>\n\u003cp>“It basically turns patients -- terminally-ill patients -- into guinea pigs,” said Don Nielsen, the CNA's director of government relations.\u003c/p>\n\u003cp>“There’s really no demonstrated need for this,” Nielsen said. “This so-called \"Right to Try\" movement is nothing more than boilerplate legislation promoted by the far-right Goldwater Institute.”\u003c/p>\n\u003cp>(While the Arizona-based Goldwater Institute has taken an active role in \u003ca href=\"http://goldwaterinstitute.org/en/work/topics/healthcare/right-to-try/right-try/\" target=\"_blank\">promoting\u003c/a> the laws, in California and other states, Calderon insists he came upon the issue independently, while researching physician-assisted suicide for California.)\u003c/p>\n\u003cp>It’s unclear how effective the state laws have been. There’s no data yet on how many patients have used the state laws, compared to the FDA’s expanded access process.\u003c/p>\n\u003cp>Dudley predicts the state-based Right to Try laws may eventually face a court challenge and be declared unconstitutional. That’s because federal law gives the power to regulate pharmaceuticals to the FDA, not the states.\u003c/p>\n\u003cp>But Clark thinks Congress might be open to amending that authority.\u003c/p>\n\u003cp>“It’s kind of parallel with what’s going on with medical marijuana,” Clark said. “It’s legal at the state level, but we still have a federal Drug Enforcement Agency to whom it is illegal. It’s not an ideal situation. It’s kind of similar to that. We ultimately need a federal law.”\u003c/p>\n\u003cp>A federal version of Right to Try was introduced in the Senate last year. In the meantime, a recently passed federal law addressing medical research, the \u003ca href=\"http://docs.house.gov/billsthisweek/20161128/CPRT-114-HPRT-RU00-SAHR34.pdf\" target=\"_blank\">21st Century Cures Act\u003c/a>, contains a \u003ca href=\"https://www.statnews.com/pharmalot/2016/11/28/21st-century-experimental-drugs/\" target=\"_blank\">provision\u003c/a> that requires drug companies to be more transparent about how they decide who gets access to experimental drugs and how long it will take.\u003c/p>\n\u003cfigure id=\"attachment_278364\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-278364\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-800x800.jpg\" alt='Lina Clark and her husband David Huntley on vacation in Croatia in 2014, before he succumbed to ALS. The disease made both of them activists for the \"right to try\" in California. ' width=\"800\" height=\"800\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-150x150.jpg 150w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Lina Clark and her husband David Huntley on vacation in Croatia in 2014, before he succumbed to ALS. The disease made both of them activists for the \"Right to Try\" in California. \u003ccite>(Courtesy of Lina Clark)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's note: The original version of this article incorrectly stated the California \"Right To Try\" law allowed access to an experimental drug at any stage. The law actually only allows a patient to request a drug that has passed through Phase I of the FDA clinical process, when a candidate drug is tested for toxicity on otherwise healthy subjects.\u003cbr>\n\u003c/em>\u003c/p>\n\n",
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"excerpt": "California is the 32nd state to pass a law supporting patients’ efforts to access experimental drugs. But critics say the movement poses potential safety and financial risks to vulnerable patients. ",
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"description": "California is the 32nd state to pass a law supporting patients’ efforts to access experimental drugs. But critics say the movement poses potential safety and financial risks to vulnerable patients. ",
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"headline": "Will California’s New 'Right to Try' Law Empower or Exploit Patients?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>With the enactment of a new “Right to Try” law, California joins 31 other states that have already passed legislation to support patients’ efforts to access experimental drugs.\u003c/p>\n\u003cp>As of Jan. 1, state agencies and licensing boards will not penalize California doctors or hospitals that want to help patients directly petition pharmaceutical companies for the investigational drugs.\u003c/p>\n\u003cp>Proponents of the “Right to Try” movement had contended that doctors could be hesitant to help such patients because of the risk of using drugs or devices that haven’t passed FDA tests for safety and effectiveness.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/300768363&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/300768363'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The new law makes it clear that California doctors can proceed without fear of censure from the state’s medical board. It also eliminates other possible regulatory obstacles on the state level and creates processes for patient consent and data collection.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The idea is to kind of get government out of the way in this situation and allow people to just go at it with a doctor to try to get access to these potentially life-saving medications,” said the law’s sponsor \u003ca href=\"http://asmdc.org/members/a57/\" target=\"_blank\">Ian Calderon\u003c/a>, the Democratic majority leader in the California Assembly.\u003c/p>\n\u003cp>Supporters of “Right to Try” laws sometimes frame them as the logical counterpart to “Right to Die” laws, which allow physician-assisted suicide for terminally ill patients. California enacted such a law in 2016.\u003c/p>\n\u003cp>\"The patient community is saying, ‘We are smart, we’re informed, we feel it is our right to try some of these therapies, because we’re going to die anyway,’” said Lina Clark, a patients’ rights \u003ca href=\"http://www.hopenowforals.org\" target=\"_blank\">activist\u003c/a> in San Diego.\u003c/p>\n\u003cp>Clark’s husband, \u003ca href=\"http://sci.sdsu.edu/geology/remembering-dr-david-huntley/\" target=\"_blank\">David Huntley\u003c/a>, had wanted to try an experimental drug before his death in 2015 from \u003ca href=\"https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Amyotrophic-Lateral-Sclerosis-ALS-Fact-Sheet\" target=\"_blank\">amyotrophic lateral sclerosis\u003c/a> (ALS).\u003c/p>\n\u003cfigure id=\"attachment_278363\" class=\"wp-caption alignnone\" style=\"max-width: 720px\">\u003cimg class=\"size-full wp-image-278363\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento.jpg\" alt=\"David Huntley testified in favor of California's "Right to Try" bill in April, 2015. He died three months later. \" width=\"720\" height=\"960\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento.jpg 720w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento-160x213.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento-240x320.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento-375x500.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Sacramento-520x693.jpg 520w\" sizes=\"(max-width: 720px) 100vw, 720px\">\u003cfigcaption class=\"wp-caption-text\">David Huntley testified in favor of California's \"Right to Try\" bill in April 2015. He died three months later. \u003ccite>(Courtesy of Lina Clark)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The FDA already offers a \u003ca href=\"http://www.fda.gov/NewsEvents/PublicHealthFocus/ExpandedAccessCompassionateUse/default.htm\" target=\"_blank\">process\u003c/a>, called “expanded access” or “compassionate use,” for some patients to obtain experimental drugs. But critics say it’s too slow and cumbersome, even though the FDA approves more than 99 percent of requests that come through that pipeline.\u003c/p>\n\u003cp>“It just takes so long, it’s inefficient, it’s ridiculous,” Calderon said of the FDA process. “I don’t understand.”\u003c/p>\n\u003cp>As the state laws proliferate, clinicians and medical ethicists are growing increasingly concerned about the potential safety and financial risks to patients.\u003c/p>\n\u003cp>“If we take the FDA out of it, how do we protect people from physicians or drug companies that will want to sell them things and will want to prey on their desperation?” asked \u003ca href=\"http://healthpolicy.ucsf.edu/people/r-adams-dudley-md-mba\" target=\"_blank\">Dr. R. Adams Dudley\u003c/a>, director of UCSF’s \u003ca href=\"http://healthvalue.ucsf.edu/\" target=\"_blank\">Center for Healthcare Value\u003c/a>.\u003c/p>\n\u003cp>Dudley says the FDA and the clinical trial process were put in place for a reason.\u003c/p>\n\u003cp>\"Have we somehow gotten better at managing snake oil salesmen now, than we were back when we decided we needed an FDA in the first place?\" Dudley said.\u003c/p>\n\u003cp>Under the new law, all that patients and doctors can really do is \u003cem>ask\u003c/em> for an experimental drug. Drug companies don’t have to give it to them, and insurance companies don’t have to pay for it.\u003c/p>\n\u003cp>Dudley fears that family members of a patient might exhaust their life savings trying a drug that hasn’t been proven to work -- and could even speed up death or increase end-of-life suffering.\u003c/p>\n\u003cp>That’s one reason the \u003ca href=\"http://www.nationalnursesunited.org/site/entry/california-nurses-association\" target=\"_blank\">California Nurses Association\u003c/a>, among other groups, strongly opposed the bill.\u003c/p>\n\u003cp>“It basically turns patients -- terminally-ill patients -- into guinea pigs,” said Don Nielsen, the CNA's director of government relations.\u003c/p>\n\u003cp>“There’s really no demonstrated need for this,” Nielsen said. “This so-called \"Right to Try\" movement is nothing more than boilerplate legislation promoted by the far-right Goldwater Institute.”\u003c/p>\n\u003cp>(While the Arizona-based Goldwater Institute has taken an active role in \u003ca href=\"http://goldwaterinstitute.org/en/work/topics/healthcare/right-to-try/right-try/\" target=\"_blank\">promoting\u003c/a> the laws, in California and other states, Calderon insists he came upon the issue independently, while researching physician-assisted suicide for California.)\u003c/p>\n\u003cp>It’s unclear how effective the state laws have been. There’s no data yet on how many patients have used the state laws, compared to the FDA’s expanded access process.\u003c/p>\n\u003cp>Dudley predicts the state-based Right to Try laws may eventually face a court challenge and be declared unconstitutional. That’s because federal law gives the power to regulate pharmaceuticals to the FDA, not the states.\u003c/p>\n\u003cp>But Clark thinks Congress might be open to amending that authority.\u003c/p>\n\u003cp>“It’s kind of parallel with what’s going on with medical marijuana,” Clark said. “It’s legal at the state level, but we still have a federal Drug Enforcement Agency to whom it is illegal. It’s not an ideal situation. It’s kind of similar to that. We ultimately need a federal law.”\u003c/p>\n\u003cp>A federal version of Right to Try was introduced in the Senate last year. In the meantime, a recently passed federal law addressing medical research, the \u003ca href=\"http://docs.house.gov/billsthisweek/20161128/CPRT-114-HPRT-RU00-SAHR34.pdf\" target=\"_blank\">21st Century Cures Act\u003c/a>, contains a \u003ca href=\"https://www.statnews.com/pharmalot/2016/11/28/21st-century-experimental-drugs/\" target=\"_blank\">provision\u003c/a> that requires drug companies to be more transparent about how they decide who gets access to experimental drugs and how long it will take.\u003c/p>\n\u003cfigure id=\"attachment_278364\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-278364\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-800x800.jpg\" alt='Lina Clark and her husband David Huntley on vacation in Croatia in 2014, before he succumbed to ALS. The disease made both of them activists for the \"right to try\" in California. ' width=\"800\" height=\"800\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing.jpg 960w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/27/2016/12/Right-to-Try-Huntley-Clark-Sailing-150x150.jpg 150w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Lina Clark and her husband David Huntley on vacation in Croatia in 2014, before he succumbed to ALS. The disease made both of them activists for the \"Right to Try\" in California. \u003ccite>(Courtesy of Lina Clark)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's note: The original version of this article incorrectly stated the California \"Right To Try\" law allowed access to an experimental drug at any stage. The law actually only allows a patient to request a drug that has passed through Phase I of the FDA clinical process, when a candidate drug is tested for toxicity on otherwise healthy subjects.\u003cbr>\n\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "For Many, Fewer Obamacare Choices Doesn't Mean Higher Prices",
"title": "For Many, Fewer Obamacare Choices Doesn't Mean Higher Prices",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>People in Columbia, S.C., had their pick of four health insurers last year when they shopped for policies during the Affordable Care Act's open enrollment.\u003c/p>\n\u003cp>This time they have just one: Blue Cross Blue Shield of South Carolina, which had the most Obamacare enrollees in Richland County in 2016 due to its low prices.\u003c/p>\n\u003cp>It's a change that's been repeated around the country after big health insurers such as Aetna, Humana and United Healthcare pulled out of dozens of Obamacare marketplaces that they judged unprofitable.\u003c/p>\n\u003cp>Almost a third of all counties in the United States have just one insurer in the marketplace for people buying individual coverage for 2017. In 2015, just 7 percent had one insurer, according to a Kaiser Family Foundation \u003ca href=\"http://kff.org/slideshow/insurer-participation-in-the-2017-individual-marketplace/\">analysis\u003c/a>. Twenty percent of Obamacare consumers will choose 2017 plans in counties served by a \u003ca href=\"http://www.npr.org/sections/health-shots/2016/10/24/499190020/rates-rise-again-for-obamacare-health-plans-but-so-do-subsidies\">single insurer\u003c/a>, according to the government.\u003c/p>\n\u003cp>But there's a surprising bottom line: Although prices are going up in almost all areas, they're not significantly higher than they are for people living in areas served by multiple insurers, according to data reviewed by consulting firm Avalere Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"A lack of competition is bad for the insurance market in the long term, but in counties that have only one plan it hasn't proven to be catastrophic for consumers for 2017,\" says Caroline Pearson, a senior vice president with Avalere. \"We expected to see the biggest price hikes in areas without competition.\"\u003c/p>\n\u003cp>She suggests that didn't happen because insurers had to file their initial 2017 rates to regulators earlier this year, before they knew exactly where competitors were dropping out.\u003c/p>\n\u003cp>\"Those rates could be adjusted, but broadly the pricing was set in the absence of full competitive information,\" Pearson says. When open enrollment for 2018 begins next fall, \"you could see big price increases in regions without competition.\"\u003c/p>\n\u003cp>Uncertainty surrounds the future of the exchanges after the Trump administration and Republican-led Congress take power. Worries about the future of Obamacare may be spurring a burst in enrollments, which were up by 400,000 to 6.4 million from Nov. 1 to Dec. 19, compared with the same period last year, the government\u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-12-21.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending\"> reported\u003c/a>.\u003c/p>\n\u003cp>Even in Richland County, where premium increases exceeded the average rate hike nationwide, individuals and the navigators who help them enroll say they have found good deals\u003cstrong> —\u003c/strong> especially for people with lower incomes that make them eligible for subsidies.\u003c/p>\n\u003cp>Open enrollment for 2017 ends Jan. 31, with a \u003ca href=\"https://www.healthcare.gov/glossary/special-enrollment-period/\">few exceptions\u003c/a>.\u003c/p>\n\u003cp>Richland was one of 74 counties that dropped from at least four insurers in 2016 to just one in 2017, according to a Kaiser Health News analysis of federal data for the 39 states that enroll people through \u003ca href=\"https://www.healthcare.gov/\">healthcare.gov\u003c/a>. In 66 of those counties, the Blue Cross and Blue Shield affiliated plan was the sole survivor.\u003c/p>\n\u003cp>Blue Cross plans generally dominated the individual insurance market before the 2010 health law was passed, and they have recaptured their place in many cities and counties, says Pearson. That helped them outlast insurers such as UnitedHealthcare and Humana, which lacked that experience when they began selling individual plans under Obamacare in 2014. Even so, Blue Cross plans have withdrawn from Nebraska and Minnesota for 2017, as well as from densely populated counties in Arizona and Tennessee.\u003c/p>\n\u003cp>\"In some ways the individual market looks today much like it did before the ACA, from a competitive standpoint,\" Pearson says.\u003c/p>\n\u003cp>Stephanie Hickman, 29, of West Columbia, S.C., feared the worst when she began shopping for 2017 coverage on the exchange with help from a federally funded navigator at the downtown library. Hickman was uninsured most of the year, and paid $200 a month for her prescription drugs.\u003c/p>\n\u003cp>After sorting 20 options, the certified nursing assistant was stunned to find a subsidized plan that would cost her $22.30 a month and not more than $700 a year out-of-pocket in co-pays and deductibles. She would pay nothing to see a primary care doctor.\u003c/p>\n\u003cp>\"Wow, it seems almost too good to be true,\" says Hickman, who makes about $16,000 a year.\u003c/p>\n\u003cp>The impact of subsidies makes Hickman's case \"pretty typical,\" says Shelli Quenga, director of programs for the nonprofit Palmetto Project, which hires navigators to help enroll people in Obamacare.\u003c/p>\n\u003cp>More than 80 percent of the nearly 13 million people who enrolled for coverage on the marketplace last year qualified for subsidies, which are pegged to the price of the second-lowest silver premiums. That means that as the cost of the silver plans rise, so do the subsidies.\u003c/p>\n\u003cp>But that doesn't help the millions of people with higher incomes who don't qualify for subsidies and are facing higher premiums. For them, the loss of insurance competition and higher rates has been a double blow, according to insurance agents. \"People are getting slammed and having to pay through the nose,\" says Jocelyn Boland, an insurance agent in the Columbia, S.C., area who is handling about 500 Obamacare clients this year. \"I have a lot of upset people.\"\u003c/p>\n\u003cp>Despite the higher prices and promises by president-elect Donald Trump and GOP leaders to repeal the health law in 2017, most are still signing up, she says.\u003c/p>\n\u003cp>Seventy miles south of Columbia, Augusta, Ga., is also down to just one Obamacare insurer after having four in 2016. Among those who have signed up for the remaining Blue Cross Blue Shield of Georgia plan, some are thrilled at low rates and others, not so much.\u003c/p>\n\u003cp>Dorothy Johnson, 57, a caterer who lives in a mobile home with her disabled husband, was disappointed that the lowest Obamacare premium would still cost her $56 a month, even with a subsidy.\u003c/p>\n\u003cp>Sitting with navigator Monica Baldwin inside a converted storage room just big enough for a desk and two chairs at Christ Community Health Services, Johnson broke down in tears when told that if she did not enroll, she would owe the IRS the higher of $695 or 2 percent of her income under the health law's individual mandate. She and her husband live on $1,400 a month, mostly from his disability check and her part-time job, Johnson says. She gets around in a 1994 car and after paying the electric bill, trash, food, gas and car insurance, there is little left.\u003c/p>\n\u003cp>\"Well, just go ahead and enroll me because there's no way I want to pay the government that penalty,\" Johnson told Baldwin.\u003c/p>\n\u003cp>She and her husband had been shopping for life insurance, but they've decided they can't afford it as well as health insurance.\u003c/p>\n\u003cp>The Augusta area lost Humana, Cigna and Coventry health plans for next year. Humana was the most popular plan because of its price and its inclusion of University Hospital, one of four major area hospitals which Blue Cross Blue Shield of Georgia does not cover.\u003c/p>\n\u003cp>But so far, Baldwin says, most people are switching to the Blue Cross plans without complaint. Joel Caceres, 27, of Augusta, said he is pleased that his monthly premium for the same subsidized Blue Cross plan that he had in 2016 will drop to $40 from $43 and his annual deductible will stay at $250. The pastry chef says subsidized coverage is vital for him because the insulin and other medications he takes will only cost him $15 a month after insurance. \"Having the insurance really helps ends meet,\" he says after Baldwin helped him find a plan.\u003c/p>\n\u003cp>Ron Ellis, 55, another Obamacare customer aided by Baldwin, says he voted for Trump despite his pledge to repeal the law. \"I didn't like Hillary (Clinton),\" he says.\u003c/p>\n\u003cp>His subsidized monthly premium for his Blue Cross policy will be $65 next year, up slightly from the $63.30 he paid this year. Ellis says he went without health insurance for many years before Obamacare. With high blood pressure, arthritis in his knees and a potential need for another hip replacement, he says, \"It's been great for me.\"\u003c/p>\n\u003cp>\u003cem>Elizabeth Lucas contributed to this report. Kaiser Health News is an editorially independent news service supported by the nonpartisan Kaiser Family Foundation. \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=For+Many%2C+Fewer+Obamacare+Choices+Doesn%27t+Mean+Higher+Prices&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "One in five people getting health care through the Affordable Care Act no longer have a choice of insurers. But those markets don't have significantly higher prices than areas with competition.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People in Columbia, S.C., had their pick of four health insurers last year when they shopped for policies during the Affordable Care Act's open enrollment.\u003c/p>\n\u003cp>This time they have just one: Blue Cross Blue Shield of South Carolina, which had the most Obamacare enrollees in Richland County in 2016 due to its low prices.\u003c/p>\n\u003cp>It's a change that's been repeated around the country after big health insurers such as Aetna, Humana and United Healthcare pulled out of dozens of Obamacare marketplaces that they judged unprofitable.\u003c/p>\n\u003cp>Almost a third of all counties in the United States have just one insurer in the marketplace for people buying individual coverage for 2017. In 2015, just 7 percent had one insurer, according to a Kaiser Family Foundation \u003ca href=\"http://kff.org/slideshow/insurer-participation-in-the-2017-individual-marketplace/\">analysis\u003c/a>. Twenty percent of Obamacare consumers will choose 2017 plans in counties served by a \u003ca href=\"http://www.npr.org/sections/health-shots/2016/10/24/499190020/rates-rise-again-for-obamacare-health-plans-but-so-do-subsidies\">single insurer\u003c/a>, according to the government.\u003c/p>\n\u003cp>But there's a surprising bottom line: Although prices are going up in almost all areas, they're not significantly higher than they are for people living in areas served by multiple insurers, according to data reviewed by consulting firm Avalere Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"A lack of competition is bad for the insurance market in the long term, but in counties that have only one plan it hasn't proven to be catastrophic for consumers for 2017,\" says Caroline Pearson, a senior vice president with Avalere. \"We expected to see the biggest price hikes in areas without competition.\"\u003c/p>\n\u003cp>She suggests that didn't happen because insurers had to file their initial 2017 rates to regulators earlier this year, before they knew exactly where competitors were dropping out.\u003c/p>\n\u003cp>\"Those rates could be adjusted, but broadly the pricing was set in the absence of full competitive information,\" Pearson says. When open enrollment for 2018 begins next fall, \"you could see big price increases in regions without competition.\"\u003c/p>\n\u003cp>Uncertainty surrounds the future of the exchanges after the Trump administration and Republican-led Congress take power. Worries about the future of Obamacare may be spurring a burst in enrollments, which were up by 400,000 to 6.4 million from Nov. 1 to Dec. 19, compared with the same period last year, the government\u003ca href=\"https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-12-21.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending\"> reported\u003c/a>.\u003c/p>\n\u003cp>Even in Richland County, where premium increases exceeded the average rate hike nationwide, individuals and the navigators who help them enroll say they have found good deals\u003cstrong> —\u003c/strong> especially for people with lower incomes that make them eligible for subsidies.\u003c/p>\n\u003cp>Open enrollment for 2017 ends Jan. 31, with a \u003ca href=\"https://www.healthcare.gov/glossary/special-enrollment-period/\">few exceptions\u003c/a>.\u003c/p>\n\u003cp>Richland was one of 74 counties that dropped from at least four insurers in 2016 to just one in 2017, according to a Kaiser Health News analysis of federal data for the 39 states that enroll people through \u003ca href=\"https://www.healthcare.gov/\">healthcare.gov\u003c/a>. In 66 of those counties, the Blue Cross and Blue Shield affiliated plan was the sole survivor.\u003c/p>\n\u003cp>Blue Cross plans generally dominated the individual insurance market before the 2010 health law was passed, and they have recaptured their place in many cities and counties, says Pearson. That helped them outlast insurers such as UnitedHealthcare and Humana, which lacked that experience when they began selling individual plans under Obamacare in 2014. Even so, Blue Cross plans have withdrawn from Nebraska and Minnesota for 2017, as well as from densely populated counties in Arizona and Tennessee.\u003c/p>\n\u003cp>\"In some ways the individual market looks today much like it did before the ACA, from a competitive standpoint,\" Pearson says.\u003c/p>\n\u003cp>Stephanie Hickman, 29, of West Columbia, S.C., feared the worst when she began shopping for 2017 coverage on the exchange with help from a federally funded navigator at the downtown library. Hickman was uninsured most of the year, and paid $200 a month for her prescription drugs.\u003c/p>\n\u003cp>After sorting 20 options, the certified nursing assistant was stunned to find a subsidized plan that would cost her $22.30 a month and not more than $700 a year out-of-pocket in co-pays and deductibles. She would pay nothing to see a primary care doctor.\u003c/p>\n\u003cp>\"Wow, it seems almost too good to be true,\" says Hickman, who makes about $16,000 a year.\u003c/p>\n\u003cp>The impact of subsidies makes Hickman's case \"pretty typical,\" says Shelli Quenga, director of programs for the nonprofit Palmetto Project, which hires navigators to help enroll people in Obamacare.\u003c/p>\n\u003cp>More than 80 percent of the nearly 13 million people who enrolled for coverage on the marketplace last year qualified for subsidies, which are pegged to the price of the second-lowest silver premiums. That means that as the cost of the silver plans rise, so do the subsidies.\u003c/p>\n\u003cp>But that doesn't help the millions of people with higher incomes who don't qualify for subsidies and are facing higher premiums. For them, the loss of insurance competition and higher rates has been a double blow, according to insurance agents. \"People are getting slammed and having to pay through the nose,\" says Jocelyn Boland, an insurance agent in the Columbia, S.C., area who is handling about 500 Obamacare clients this year. \"I have a lot of upset people.\"\u003c/p>\n\u003cp>Despite the higher prices and promises by president-elect Donald Trump and GOP leaders to repeal the health law in 2017, most are still signing up, she says.\u003c/p>\n\u003cp>Seventy miles south of Columbia, Augusta, Ga., is also down to just one Obamacare insurer after having four in 2016. Among those who have signed up for the remaining Blue Cross Blue Shield of Georgia plan, some are thrilled at low rates and others, not so much.\u003c/p>\n\u003cp>Dorothy Johnson, 57, a caterer who lives in a mobile home with her disabled husband, was disappointed that the lowest Obamacare premium would still cost her $56 a month, even with a subsidy.\u003c/p>\n\u003cp>Sitting with navigator Monica Baldwin inside a converted storage room just big enough for a desk and two chairs at Christ Community Health Services, Johnson broke down in tears when told that if she did not enroll, she would owe the IRS the higher of $695 or 2 percent of her income under the health law's individual mandate. She and her husband live on $1,400 a month, mostly from his disability check and her part-time job, Johnson says. She gets around in a 1994 car and after paying the electric bill, trash, food, gas and car insurance, there is little left.\u003c/p>\n\u003cp>\"Well, just go ahead and enroll me because there's no way I want to pay the government that penalty,\" Johnson told Baldwin.\u003c/p>\n\u003cp>She and her husband had been shopping for life insurance, but they've decided they can't afford it as well as health insurance.\u003c/p>\n\u003cp>The Augusta area lost Humana, Cigna and Coventry health plans for next year. Humana was the most popular plan because of its price and its inclusion of University Hospital, one of four major area hospitals which Blue Cross Blue Shield of Georgia does not cover.\u003c/p>\n\u003cp>But so far, Baldwin says, most people are switching to the Blue Cross plans without complaint. Joel Caceres, 27, of Augusta, said he is pleased that his monthly premium for the same subsidized Blue Cross plan that he had in 2016 will drop to $40 from $43 and his annual deductible will stay at $250. The pastry chef says subsidized coverage is vital for him because the insulin and other medications he takes will only cost him $15 a month after insurance. \"Having the insurance really helps ends meet,\" he says after Baldwin helped him find a plan.\u003c/p>\n\u003cp>Ron Ellis, 55, another Obamacare customer aided by Baldwin, says he voted for Trump despite his pledge to repeal the law. \"I didn't like Hillary (Clinton),\" he says.\u003c/p>\n\u003cp>His subsidized monthly premium for his Blue Cross policy will be $65 next year, up slightly from the $63.30 he paid this year. Ellis says he went without health insurance for many years before Obamacare. With high blood pressure, arthritis in his knees and a potential need for another hip replacement, he says, \"It's been great for me.\"\u003c/p>\n\u003cp>\u003cem>Elizabeth Lucas contributed to this report. Kaiser Health News is an editorially independent news service supported by the nonpartisan Kaiser Family Foundation. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=For+Many%2C+Fewer+Obamacare+Choices+Doesn%27t+Mean+Higher+Prices&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "One of the Problems With E-Cigarettes: They Can Explode",
"title": "One of the Problems With E-Cigarettes: They Can Explode",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Katrina Williams wanted a safer alternative to smoking, and e-cigarettes seemed to be the answer until the day one exploded in her pocket as she drove home from a beauty salon.\u003c/p>\n\u003cp>\"It was like a firecracker\" as it seared third-degree burns in her leg, blasted through her charred pants and stuck in the dashboard, the New Yorker said. That was in April. Williams, a freight manager, said she still hasn't returned to work. \"It was very disturbing.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'It was like a firecracker.'\u003c/aside>\n\u003cp>Similar painful accidents have been recorded with increasing frequency over the past year as use of e-cigarettes has climbed, with faulty batteries seen as the suspected culprit. The industry maintains e-cigarettes are safe when used properly.\u003c/p>\n\u003cp>The U.S. Food and Drug Administration, which started regulating e-cigarettes in May, identified about 66 explosions in 2015 and early 2016, after recording 92 explosions from 2009 to September 2015.\u003c/p>\n\u003cp>In late November, a clerk at a liquor store in New York's Grand Central Station was casually leaning against a counter when the e-cigarette in his pocket erupted. A security camera captured him frantically trying to snuff out a fountain of white-hot sparks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Surveillance video also captured an e-cigarette explosion in September at a New Jersey mall that left a woman's Louis Vuitton bag smoking as she stood at a checkout counter.\u003c/p>\n\u003cp>Police say a teenage girl on a train at the Universal Orlando amusement park suffered burns in October when an electronic cigarette belonging to another visitor exploded and shot a fireball at her.\u003c/p>\n\u003cp>The numbers kept by the FDA may be an undercount. One hospital, the UW Medicine Regional Burn Center at Harborview Medical Center in Seattle, says it has seen about 23 patients with e-cigarette burns since it started tracking them informally in October 2015.\u003c/p>\n\u003cp>\"They are extremely dangerous and need to be revamped or revised,\" said Marc Freund, a New York attorney who represents both Williams and a 14-year-old boy who was partially blinded when an e-cigarette device exploded at a kiosk selling e-cigarettes at a Brooklyn mall.\u003c/p>\n\u003cp>The problems with the devices are linked to their lithium-ion batteries, which help vaporize liquid nicotine into a mist that distributors and some health experts say is far less harmful than traditional tobacco cigarettes.\u003c/p>\n\u003cp>The same types of batteries are used safely in many consumer electronics, but they've also been behind fires in hover boards and smartphones. Last year, the federal Department of Transportation issued a rule prohibiting passengers from packing e-cigarettes in checked luggage to protect against in-flight fires.\u003c/p>\n\u003cp>Thomas Kiklas, co-founder of the Tobacco Vapor Electronic Cigarette Association, argues the devices are safe when used properly. He said the TVECA encourages proper recharging of the batteries as a way to prevent possible injuries.\u003c/p>\n\u003cp>Euromonitor International, a market research company, noted there were 10.8 million regular e-cigarette users in the U.S. in 2015, generating $3.5 billion in sales.\u003c/p>\n\u003cp>Gregory L. Bentley, an Irvine attorney, won a nearly $2 million judgment in a product liability lawsuit for a woman burned by an e-cigarette last year. He said he has a growing list of similar cases, most of which involve batteries and other components manufactured in China that have been subject to little safety oversight.\u003c/p>\n\u003cp>\"The problem is defectively manufactured batteries,\" he said. \"Consumers need to know it's next to impossible to sue a Chinese company. If people want to seek compensation they have to target distributors, wholesalers and retailers.\"\u003c/p>\n\u003cp>Last week, the U.S. surgeon general called e-cigarettes an emerging public health threat to the nation's youth, although he highlighted the risk of nicotine addiction, not explosions.\u003c/p>\n\u003cp>New York Sen. Charles Schumer said the FDA should consider a recall.\u003c/p>\n\u003cp>\"It's bad enough that e-cigarettes cause nicotine addiction and may be dangerous to a person's health, but now it seems they're doubling as a ticking time bomb,\" he said.\u003c/p>\n\u003cp>FDA spokesman Michael Felberbaum said the agency is reviewing the health impacts of all tobacco products, including e-cigarettes. He said the review will include an evaluation of the use of e-cigarette batteries, including \"amperage, voltage, wattage, battery type\" and other issues.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Associated Press researcher Jennifer Farrar contributed to this report. Follow Eltman on Twitter at @feltman41.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Katrina Williams wanted a safer alternative to smoking, and e-cigarettes seemed to be the answer until the day one exploded in her pocket as she drove home from a beauty salon.\u003c/p>\n\u003cp>\"It was like a firecracker\" as it seared third-degree burns in her leg, blasted through her charred pants and stuck in the dashboard, the New Yorker said. That was in April. Williams, a freight manager, said she still hasn't returned to work. \"It was very disturbing.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'It was like a firecracker.'\u003c/aside>\n\u003cp>Similar painful accidents have been recorded with increasing frequency over the past year as use of e-cigarettes has climbed, with faulty batteries seen as the suspected culprit. The industry maintains e-cigarettes are safe when used properly.\u003c/p>\n\u003cp>The U.S. Food and Drug Administration, which started regulating e-cigarettes in May, identified about 66 explosions in 2015 and early 2016, after recording 92 explosions from 2009 to September 2015.\u003c/p>\n\u003cp>In late November, a clerk at a liquor store in New York's Grand Central Station was casually leaning against a counter when the e-cigarette in his pocket erupted. A security camera captured him frantically trying to snuff out a fountain of white-hot sparks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Surveillance video also captured an e-cigarette explosion in September at a New Jersey mall that left a woman's Louis Vuitton bag smoking as she stood at a checkout counter.\u003c/p>\n\u003cp>Police say a teenage girl on a train at the Universal Orlando amusement park suffered burns in October when an electronic cigarette belonging to another visitor exploded and shot a fireball at her.\u003c/p>\n\u003cp>The numbers kept by the FDA may be an undercount. One hospital, the UW Medicine Regional Burn Center at Harborview Medical Center in Seattle, says it has seen about 23 patients with e-cigarette burns since it started tracking them informally in October 2015.\u003c/p>\n\u003cp>\"They are extremely dangerous and need to be revamped or revised,\" said Marc Freund, a New York attorney who represents both Williams and a 14-year-old boy who was partially blinded when an e-cigarette device exploded at a kiosk selling e-cigarettes at a Brooklyn mall.\u003c/p>\n\u003cp>The problems with the devices are linked to their lithium-ion batteries, which help vaporize liquid nicotine into a mist that distributors and some health experts say is far less harmful than traditional tobacco cigarettes.\u003c/p>\n\u003cp>The same types of batteries are used safely in many consumer electronics, but they've also been behind fires in hover boards and smartphones. Last year, the federal Department of Transportation issued a rule prohibiting passengers from packing e-cigarettes in checked luggage to protect against in-flight fires.\u003c/p>\n\u003cp>Thomas Kiklas, co-founder of the Tobacco Vapor Electronic Cigarette Association, argues the devices are safe when used properly. He said the TVECA encourages proper recharging of the batteries as a way to prevent possible injuries.\u003c/p>\n\u003cp>Euromonitor International, a market research company, noted there were 10.8 million regular e-cigarette users in the U.S. in 2015, generating $3.5 billion in sales.\u003c/p>\n\u003cp>Gregory L. Bentley, an Irvine attorney, won a nearly $2 million judgment in a product liability lawsuit for a woman burned by an e-cigarette last year. He said he has a growing list of similar cases, most of which involve batteries and other components manufactured in China that have been subject to little safety oversight.\u003c/p>\n\u003cp>\"The problem is defectively manufactured batteries,\" he said. \"Consumers need to know it's next to impossible to sue a Chinese company. If people want to seek compensation they have to target distributors, wholesalers and retailers.\"\u003c/p>\n\u003cp>Last week, the U.S. surgeon general called e-cigarettes an emerging public health threat to the nation's youth, although he highlighted the risk of nicotine addiction, not explosions.\u003c/p>\n\u003cp>New York Sen. Charles Schumer said the FDA should consider a recall.\u003c/p>\n\u003cp>\"It's bad enough that e-cigarettes cause nicotine addiction and may be dangerous to a person's health, but now it seems they're doubling as a ticking time bomb,\" he said.\u003c/p>\n\u003cp>FDA spokesman Michael Felberbaum said the agency is reviewing the health impacts of all tobacco products, including e-cigarettes. He said the review will include an evaluation of the use of e-cigarette batteries, including \"amperage, voltage, wattage, battery type\" and other issues.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Associated Press researcher Jennifer Farrar contributed to this report. Follow Eltman on Twitter at @feltman41.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Radiolab, a frequent favorite among the public radio set, uncharacteristically covered a bit of breaking news on Dec. 8, \u003ca href=\"http://www.radiolab.org/story/bringing-gamma-back/\" target=\"_blank\">speaking to researchers\u003c/a> who'd just published their novel approach to treating Alzheimer's-infected lab mice.\u003c/p>\n\u003cp>They found that after a week of treatment using optogenetics, which allows researchers to switch specific neurons in the brain on and off, the amyloid plaque that's believed to contribute to Alzheimer's was \u003ca href=\"http://news.mit.edu/2016/visual-stimulation-treatment-alzheimer-1207\" target=\"_blank\">reduced by a startling 40 to 50 percent\u003c/a>.\u003cbr>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"600\" height=\"50\" src=\"https://www.wnyc.org/widgets/ondemand_player/radiolab/#file=%2Faudio%2Fxspf%2F690533%2F\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>The researchers at MIT's Picower Institute for Learning and Memory inundated the brains of mice with bright flashing lights at a specific frequency, in order to trigger the nonfunctioning cells that normally clean the plaque to do their job again.\u003c/p>\n\u003cp>Li-Huei Tsai, the research laboratory's director, told Radiolab the results were exciting, but she didn't want to get ahead of the research in predicting it would translate into success in humans. The failure rate in Alzheimer's research has been notoriously \u003ca href=\"https://www.insidescience.org/news/failure-upon-failure-alzheimers-drugs\" target=\"_blank\">high\u003c/a>.\u003c/p>\n\u003cp>[contextly_sidebar id=\"EEe6W1a2ZdfW3jWfCnS5bM2vzwgDkmbv\"]\u003c/p>\n\u003cp>One of the interesting things about the technique is that it not only worked using the maximally invasive procedure of drilling holes in the mice's skulls, but also by simply flashing lights into their eyes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Are you going to tell me you don't believe it, it's science fiction?\" Tsai giddily asks Radiolab's interviewer.\u003c/p>\n\u003cp>While the plaque only vanished if the neurons were exposed to the flashing lights every 24 hours, the group is looking at ways to make the disappearance permanent.\u003c/p>\n\u003cp>Tsai is planning to undertake human clinical trials through a medical technology startup she co-founded. The hope is to develop a non-invasive treatment that could slow the inevitable decline in Alzheimer's patients.\u003c/p>\n\u003cp>Groundbreaking research? TBD. Super-good radio? Definitely. Worth a \u003ca href=\"http://www.radiolab.org/story/bringing-gamma-back/\" target=\"_blank\">listen here\u003c/a> or above in the post.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/O_p4QWkE2Ls?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen>\u003c/iframe>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Radiolab, a frequent favorite among the public radio set, uncharacteristically covered a bit of breaking news on Dec. 8, \u003ca href=\"http://www.radiolab.org/story/bringing-gamma-back/\" target=\"_blank\">speaking to researchers\u003c/a> who'd just published their novel approach to treating Alzheimer's-infected lab mice.\u003c/p>\n\u003cp>They found that after a week of treatment using optogenetics, which allows researchers to switch specific neurons in the brain on and off, the amyloid plaque that's believed to contribute to Alzheimer's was \u003ca href=\"http://news.mit.edu/2016/visual-stimulation-treatment-alzheimer-1207\" target=\"_blank\">reduced by a startling 40 to 50 percent\u003c/a>.\u003cbr>\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"600\" height=\"50\" src=\"https://www.wnyc.org/widgets/ondemand_player/radiolab/#file=%2Faudio%2Fxspf%2F690533%2F\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>The researchers at MIT's Picower Institute for Learning and Memory inundated the brains of mice with bright flashing lights at a specific frequency, in order to trigger the nonfunctioning cells that normally clean the plaque to do their job again.\u003c/p>\n\u003cp>Li-Huei Tsai, the research laboratory's director, told Radiolab the results were exciting, but she didn't want to get ahead of the research in predicting it would translate into success in humans. The failure rate in Alzheimer's research has been notoriously \u003ca href=\"https://www.insidescience.org/news/failure-upon-failure-alzheimers-drugs\" target=\"_blank\">high\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>One of the interesting things about the technique is that it not only worked using the maximally invasive procedure of drilling holes in the mice's skulls, but also by simply flashing lights into their eyes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Are you going to tell me you don't believe it, it's science fiction?\" Tsai giddily asks Radiolab's interviewer.\u003c/p>\n\u003cp>While the plaque only vanished if the neurons were exposed to the flashing lights every 24 hours, the group is looking at ways to make the disappearance permanent.\u003c/p>\n\u003cp>Tsai is planning to undertake human clinical trials through a medical technology startup she co-founded. The hope is to develop a non-invasive treatment that could slow the inevitable decline in Alzheimer's patients.\u003c/p>\n\u003cp>Groundbreaking research? TBD. Super-good radio? Definitely. Worth a \u003ca href=\"http://www.radiolab.org/story/bringing-gamma-back/\" target=\"_blank\">listen here\u003c/a> or above in the post.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/O_p4QWkE2Ls?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen>\u003c/iframe>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Dolls With Disabilities Go Mainstream",
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"content": "\u003cp>When Dominika Tamley chose \"Isebelle,\" her American Girl doll, she picked a toy whose hair and eye color matched her own. But the 10-year-old is quick to point out that's not the only way the doll resembles the real child who plays with her.\u003c/p>\n\u003cp>\"She's like a mini-me,\" Tamley explained with pride. \"Because she has a hearing aid and I have a hearing aid.\"\u003c/p>\n\u003cp>American Girl has for years offered a wide variety of accessories reflecting \u003ca href=\"http://www.americangirl.com/shop/dolls/doll-hospital#hearing\">a range of disabilities\u003c/a>. Arm crutches, leg braces, a sporty red wheelchair and allergy-free lunch sets. You can order a doll without hair — like a child with cancer — or one outfitted with a diabetes kit that includes insulin pumps, pens, glucose tablets and a blood sugar monitor.\u003c/p>\n\u003cp>\"The designer who worked on that had Type 1 diabetes, and it was a really personal item for him to create,\" said Stephanie Spanos, a public relations manager at American Girl. The designers developed the diabetes kit with the input of doctors, nurses and dietitians at American Family Children's Hospital in Madison, Wis., Spanos added. \"We introduced that at the very beginning of 2016 and it's been in and out of stock all year.\"\u003c/p>\n\u003cp>American Girl dolls, which can cost more than $100, often come with a built-in back story, such as Nellie, the Irish immigrant orphan, or Cécile, the Creole girl growing up in 1850s New Orleans. Some activists remain irked that no American Girl comes with a built-in back story related to a disability. (A petition to add one last year, during the 25\u003csup>th\u003c/sup> anniversary of the Americans with Disabilities Act, \u003ca href=\"http://www.philly.com/philly/news/20160911_American_Girl_said_no_to_doll_with_disability__so_ex-Chesco_sisters_wrote_novel.html\">was unsuccessful\u003c/a>.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Still, more and more mainstream companies are adding characters with disabilities to their roster of toys. Earlier this year, Lego introduced, for the first time, a figure of a little boy in a wheelchair. Significantly, he's not in the hospital — instead, \u003ca href=\"https://www.amazon.com/LEGO-City-Town-60134-park/dp/B01CU9WX08/ref=pd_lpo_21_bs_img_2?_encoding=UTF8&psc=1&refRID=0C4XNTVEGD1PDP1FHDEX\">he's part of a city park set\u003c/a>, representing people with disabilities out in the world. And in 2013, Toys R Us added its Journey Girls line of dolls, with accessories including \u003ca href=\"http://www.toysrus.com/buy/journey-girls-wheelchair-playset-5f5fcdf-55750766\">wheelchairs and crutches\u003c/a>.\u003c/p>\n\u003cp>Is this good business? Or just good public relations?\u003c/p>\n\u003cp>\"It's not about PR for us,\" said the chief merchandising officer of Toys R Us, Richard Barry. \"Our job as a company is to make sure we have the best assortment for all kids.\" Barry pointed out that Toys R Us catalog has also started including children with disabilities in its photos of kids playing with the company's toys.\u003c/p>\n\u003cp>Representation of kids with disabilities was harder to find at a big-box store in the suburbs of Washington D.C., where \u003ca href=\"http://www.ncd.gov/newsroom/2013/041613\">Rebecca Cokley\u003c/a> took me shopping. Cokley is executive director of the National Council on Disability, and the first female little person to have worked in the White House. She's 4 feet 2 inches tall and white, with red hair and freckles. \"My family is interracial and interspatial,\" she said. \"My husband's average height and African American. And, so, our kids are biracial dwarf kids.\"\u003c/p>\n\u003cp>There were all kinds of toys Cokely liked in the aisles — she's a Lego nerd and a big fan of Batgirl, a character with her own deep \u003ca href=\"http://www.wnyc.org/story/160174-batgirl-sheds-wheelchair/\">connection to the disability community\u003c/a>. But it was nearly impossible to find a single toy that represented disability. In the Barbie aisle, we found chef Barbies, vet Barbies and gymnast Barbies.\u003c/p>\n\u003cp>\"Why can't one of these come with a hearing aid?\" Cokely wondered. And Mattel has stopped making Becky, Barbie's friend who uses a wheelchair (although you can still find Becky dolls to buy on secondary retail sites online.)\u003c/p>\n\u003cp>\"And look — there's Barbie's inaccessible dream house!\" Cokely said. \"It's got a working garage, but the elevator is too small for a wheelchair.\" It would be tough for Becky to come over for a visit.\u003c/p>\n\u003cp>We had more luck in the Star Wars aisle. Cokely noticed a Luke Skywalker doll that comes with a prosthetic arm. \"That counts!\" she exclaimed, with a wry aside: \"People do tend to claim Vader, but I don't know if that's a good thing or a bad thing.\"\u003c/p>\n\u003cp>Aside from Luke, only one other toy (among many hundreds) explicitly represented a disability: Nemo. The friendly orange clownfish from the Pixar movie has one shortened fin, and the store sold a stuffed plush version.\u003c/p>\n\u003cp>\"Both \u003cem>Finding Nemo\u003c/em> and \u003cem>Finding Dory\u003c/em> have been phenomenal resources for parents with disabilities,\" she said. \"Not only in terms of showing good examples of kids with disabilities, but also the challenges of being that overprotective helicopter parent.\" She pointed out that some toys – such as \u003ca href=\"http://tvtropes.org/pmwiki/pmwiki.php/WebAnimation/Snowdrop\">My Little Pony\u003c/a> — have been \u003ca href=\"http://copingwithpony.weebly.com/\">embraced by some disability activists\u003c/a>, but that so much of the toy section represented missed opportunities.\u003c/p>\n\u003cp>\"Why don't we have any GI Joes that are disabled vets?\" Cokely asked. \"Think about that, what that would mean to a young boy whose dad's a vet or whose mom's a vet. To see their parents' experience reflected in the toys — that would be massive.\"\u003c/p>\n\u003cp>Research by social psychologist \u003ca href=\"http://www.gold.ac.uk/psychology/staff/jones-sian/\">Sian Jones\u003c/a> of Goldsmith University of London, as well as that of others, shows that all children benefit from playing with toys representing disability — \u003ca href=\"https://goldsmithspsychologyblog.wordpress.com/2016/06/06/one-like-me-toying-with-the-doll-industry/\">it heightens empathy\u003c/a>.\u003c/p>\n\u003cp>And activist \u003ca href=\"http://rebeccaatkinson.co.uk/toy-like-me/\">Rebecca Atkinson\u003c/a>, who runs the \u003ca href=\"http://www.toylikeme.org/\">Toy Like Me website\u003c/a> in the United Kingdom, told me she'd love it if every toybox included a wheelchair and a seeing-eye dog for children to play with. (Atkinson's website points consumers towards \u003ca href=\"http://www.toylikeme.org/toys/bespoke-toys/\">toys that represent disability\u003c/a>, and also creates playful images meant to inspire manufacturers, such as \u003ca href=\"http://www.toylikeme.org/toys/makeovers/\">princesses with eye patches\u003c/a> and scars, and superheros with tracheostomies.\u003c/p>\n\u003cp>This isn't a niche market, Cokely added. One in four people will experience a disability at some point in their lives. \"Everyone has a family member with a disability,\" she said. \"Everyone knows someone with a disability.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And playing with toys in an imagined world where, just like in real life, people walk or use wheelchairs or have hearing aids is a world where kids can imagine other kids — disabled and otherwise — as friends.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Dolls+With+Disabilities+Escape+The+Toy+Hospital%2C+Go+Mainstream&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Dominika Tamley chose \"Isebelle,\" her American Girl doll, she picked a toy whose hair and eye color matched her own. But the 10-year-old is quick to point out that's not the only way the doll resembles the real child who plays with her.\u003c/p>\n\u003cp>\"She's like a mini-me,\" Tamley explained with pride. \"Because she has a hearing aid and I have a hearing aid.\"\u003c/p>\n\u003cp>American Girl has for years offered a wide variety of accessories reflecting \u003ca href=\"http://www.americangirl.com/shop/dolls/doll-hospital#hearing\">a range of disabilities\u003c/a>. Arm crutches, leg braces, a sporty red wheelchair and allergy-free lunch sets. You can order a doll without hair — like a child with cancer — or one outfitted with a diabetes kit that includes insulin pumps, pens, glucose tablets and a blood sugar monitor.\u003c/p>\n\u003cp>\"The designer who worked on that had Type 1 diabetes, and it was a really personal item for him to create,\" said Stephanie Spanos, a public relations manager at American Girl. The designers developed the diabetes kit with the input of doctors, nurses and dietitians at American Family Children's Hospital in Madison, Wis., Spanos added. \"We introduced that at the very beginning of 2016 and it's been in and out of stock all year.\"\u003c/p>\n\u003cp>American Girl dolls, which can cost more than $100, often come with a built-in back story, such as Nellie, the Irish immigrant orphan, or Cécile, the Creole girl growing up in 1850s New Orleans. Some activists remain irked that no American Girl comes with a built-in back story related to a disability. (A petition to add one last year, during the 25\u003csup>th\u003c/sup> anniversary of the Americans with Disabilities Act, \u003ca href=\"http://www.philly.com/philly/news/20160911_American_Girl_said_no_to_doll_with_disability__so_ex-Chesco_sisters_wrote_novel.html\">was unsuccessful\u003c/a>.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Still, more and more mainstream companies are adding characters with disabilities to their roster of toys. Earlier this year, Lego introduced, for the first time, a figure of a little boy in a wheelchair. Significantly, he's not in the hospital — instead, \u003ca href=\"https://www.amazon.com/LEGO-City-Town-60134-park/dp/B01CU9WX08/ref=pd_lpo_21_bs_img_2?_encoding=UTF8&psc=1&refRID=0C4XNTVEGD1PDP1FHDEX\">he's part of a city park set\u003c/a>, representing people with disabilities out in the world. And in 2013, Toys R Us added its Journey Girls line of dolls, with accessories including \u003ca href=\"http://www.toysrus.com/buy/journey-girls-wheelchair-playset-5f5fcdf-55750766\">wheelchairs and crutches\u003c/a>.\u003c/p>\n\u003cp>Is this good business? Or just good public relations?\u003c/p>\n\u003cp>\"It's not about PR for us,\" said the chief merchandising officer of Toys R Us, Richard Barry. \"Our job as a company is to make sure we have the best assortment for all kids.\" Barry pointed out that Toys R Us catalog has also started including children with disabilities in its photos of kids playing with the company's toys.\u003c/p>\n\u003cp>Representation of kids with disabilities was harder to find at a big-box store in the suburbs of Washington D.C., where \u003ca href=\"http://www.ncd.gov/newsroom/2013/041613\">Rebecca Cokley\u003c/a> took me shopping. Cokley is executive director of the National Council on Disability, and the first female little person to have worked in the White House. She's 4 feet 2 inches tall and white, with red hair and freckles. \"My family is interracial and interspatial,\" she said. \"My husband's average height and African American. And, so, our kids are biracial dwarf kids.\"\u003c/p>\n\u003cp>There were all kinds of toys Cokely liked in the aisles — she's a Lego nerd and a big fan of Batgirl, a character with her own deep \u003ca href=\"http://www.wnyc.org/story/160174-batgirl-sheds-wheelchair/\">connection to the disability community\u003c/a>. But it was nearly impossible to find a single toy that represented disability. In the Barbie aisle, we found chef Barbies, vet Barbies and gymnast Barbies.\u003c/p>\n\u003cp>\"Why can't one of these come with a hearing aid?\" Cokely wondered. And Mattel has stopped making Becky, Barbie's friend who uses a wheelchair (although you can still find Becky dolls to buy on secondary retail sites online.)\u003c/p>\n\u003cp>\"And look — there's Barbie's inaccessible dream house!\" Cokely said. \"It's got a working garage, but the elevator is too small for a wheelchair.\" It would be tough for Becky to come over for a visit.\u003c/p>\n\u003cp>We had more luck in the Star Wars aisle. Cokely noticed a Luke Skywalker doll that comes with a prosthetic arm. \"That counts!\" she exclaimed, with a wry aside: \"People do tend to claim Vader, but I don't know if that's a good thing or a bad thing.\"\u003c/p>\n\u003cp>Aside from Luke, only one other toy (among many hundreds) explicitly represented a disability: Nemo. The friendly orange clownfish from the Pixar movie has one shortened fin, and the store sold a stuffed plush version.\u003c/p>\n\u003cp>\"Both \u003cem>Finding Nemo\u003c/em> and \u003cem>Finding Dory\u003c/em> have been phenomenal resources for parents with disabilities,\" she said. \"Not only in terms of showing good examples of kids with disabilities, but also the challenges of being that overprotective helicopter parent.\" She pointed out that some toys – such as \u003ca href=\"http://tvtropes.org/pmwiki/pmwiki.php/WebAnimation/Snowdrop\">My Little Pony\u003c/a> — have been \u003ca href=\"http://copingwithpony.weebly.com/\">embraced by some disability activists\u003c/a>, but that so much of the toy section represented missed opportunities.\u003c/p>\n\u003cp>\"Why don't we have any GI Joes that are disabled vets?\" Cokely asked. \"Think about that, what that would mean to a young boy whose dad's a vet or whose mom's a vet. To see their parents' experience reflected in the toys — that would be massive.\"\u003c/p>\n\u003cp>Research by social psychologist \u003ca href=\"http://www.gold.ac.uk/psychology/staff/jones-sian/\">Sian Jones\u003c/a> of Goldsmith University of London, as well as that of others, shows that all children benefit from playing with toys representing disability — \u003ca href=\"https://goldsmithspsychologyblog.wordpress.com/2016/06/06/one-like-me-toying-with-the-doll-industry/\">it heightens empathy\u003c/a>.\u003c/p>\n\u003cp>And activist \u003ca href=\"http://rebeccaatkinson.co.uk/toy-like-me/\">Rebecca Atkinson\u003c/a>, who runs the \u003ca href=\"http://www.toylikeme.org/\">Toy Like Me website\u003c/a> in the United Kingdom, told me she'd love it if every toybox included a wheelchair and a seeing-eye dog for children to play with. (Atkinson's website points consumers towards \u003ca href=\"http://www.toylikeme.org/toys/bespoke-toys/\">toys that represent disability\u003c/a>, and also creates playful images meant to inspire manufacturers, such as \u003ca href=\"http://www.toylikeme.org/toys/makeovers/\">princesses with eye patches\u003c/a> and scars, and superheros with tracheostomies.\u003c/p>\n\u003cp>This isn't a niche market, Cokely added. One in four people will experience a disability at some point in their lives. \"Everyone has a family member with a disability,\" she said. \"Everyone knows someone with a disability.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And playing with toys in an imagined world where, just like in real life, people walk or use wheelchairs or have hearing aids is a world where kids can imagine other kids — disabled and otherwise — as friends.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Dolls+With+Disabilities+Escape+The+Toy+Hospital%2C+Go+Mainstream&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Drugmakers Push Unproven Solution to Opioid Epidemic They Helped Create",
"title": "Drugmakers Push Unproven Solution to Opioid Epidemic They Helped Create",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Pilloried for their role in the epidemic of prescription painkiller abuse, drugmakers are aggressively pushing their remedy to the problem: a new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there's little proof they reduce rates of overdoses or deaths.\u003c/p>\n\u003caside class=\"pullquote alignright\">Harder-to-manipulate opioids have racked up billions in sales, despite a lack of proof that they reduce overdoses.\u003c/aside>\n\u003cp>More than prescriptions are at stake. Critics worry the drugmakers' nationwide lobbying campaign is distracting from more productive solutions and delaying crucial efforts to steer physicians away from prescription opioids — addictive pain medications involved in the deaths of more than 165,000 Americans since 2000.\u003c/p>\n\u003cp>\"If we've learned one lesson from the last 20 years on opioids it's that these products have very, very high inherent risks,\" said Dr. Caleb Alexander, co-director of Johns Hopkins University's Center for Drug Safety and Effectiveness. \"My concern is that they'll contribute to a perception that there is a safe opioid, and there's no such thing as a fully safe opioid.\"\u003c/p>\n\u003cp>The latest drugs — known as abuse-deterrent formulations, or ADFs — are generally harder to crush or dissolve, which the drugmakers tout as making them difficult to snort or inject. But they still are vulnerable to manipulation and potentially addictive when simply swallowed. National data from an industry-sponsored tracking system also show drug abusers quickly drop the reformulated drugs in favor of older painkillers or heroin.\u003c/p>\n\u003cp>In the last two years, pharmaceutical companies have made a concerted under-the-radar push for bills benefiting the anti-abuse opioids in statehouses and in Congress, where proposed legislation would require the Food and Drug Administration to replace older opioids with the new drugs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The lobbying push features industry-funded advocacy groups and physicians, along with grieving family members, who rarely disclosed the drugmakers' ties during their testimony in support of the drugs.\u003c/p>\n\u003cp>Besides the tamper-resistant pills, ADF opioids are being rolled out in other forms, including injectable drugs and pills that irritate users when they're snorted or contain substances that counteract highs.\u003c/p>\n\u003cp>\u003cstrong>Sales Opportunity\u003c/strong>\u003c/p>\n\u003cp>Making painkillers harder to abuse is a common-sense step. But it's also a multibillion-dollar sales opportunity, offering drugmakers the potential to wipe out lower-cost generic competitors and lock in sales of their higher-priced versions, which cost many times more than conventional pills. The big companies hold multiple patents on the reformulated drugs, shielding them from competition for years — in some cases decades.\u003c/p>\n\u003cp>Though abuse-deterrent painkillers represented less than 5 percent of all opioids prescribed last year, they generated more than $2.4 billion in sales, or roughly a quarter of the nearly $10 billion U.S. market for the drugs, according to IMS Health. The field is dominated by Purdue Pharma's OxyContin, patent-protected until 2030.\u003c/p>\n\u003cp>\"We at Purdue make certain that prescribers and other stakeholders understand that opioids with abuse-deterrent properties won't stop all prescription drug abuse, but they are an important part of the comprehensive approach needed to address this public health issue,\" Purdue spokesman Robert Josephson said in a statement.\u003c/p>\n\u003cp>Like a spokeswoman for Pfizer Inc., Josephson also noted that some public health officials, including the Food and Drug Administration, have endorsed using ADFs.\u003c/p>\n\u003cp>\"We need every tool that we can have in our toolbox,\" said Kentucky state Rep. Addia Wuchner, a Republican who has worked on several bills to benefit reformulated opioids. \"The extra steps are worth the effort in order to prevent this escalation of more addiction.\"\u003c/p>\n\u003cp>\u003cstrong>Massive Lobbying Effort\u003c/strong>\u003c/p>\n\u003cp>The current industry campaign draws on the same 50-state strategy that painkiller manufacturers successfully deployed to help kill or weaken measures aimed at stemming the tide of prescription opioids, a playbook The Associated Press and Center for Public Integrity exposed in September.\u003c/p>\n\u003cp>The \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/09/19/how-drugmakers-used-money-and-influence-to-shape-the-national-response-to-opioid-abuse/\" target=\"_blank\">reporting \u003c/a>detailed how opioid drugmakers and the nonprofits they help fund spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade, eight times what the gun lobby reported for the same period. The money represents the drugmakers' spending on all their legislative interests, including opioids.\u003c/p>\n\u003cp>The FDA has approved a handful of the reformulated drugs but has not yet concluded that any reduce rates of addiction, abuse or death, and the evidence gap has led to diverging views among health authorities.\u003c/p>\n\u003cp>\u003cstrong>'No less addictive'\u003c/strong>\u003c/p>\n\u003cp>Whereas FDA regulators emphasize the potential promise of reformulated painkillers, other government officials stress that they contain the same heroin-like ingredients as traditional opioids. An estimated 78 Americans die from heroin and prescription opioid overdoses every day.\u003c/p>\n\u003cp>\"'Abuse-deterrent' sounds to people sometimes like 'Oh, maybe it's not addictive.' But it's no less addictive,\" said Dr. Tom Frieden, head of the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Survey results published this year in the Clinical Journal of Pain showed nearly half of U.S. physicians incorrectly believed that reformulated opioids are less addictive than their predecessors.\u003c/p>\n\u003cp>Many experts see a key role for ADFs in reducing the number of people who first begin abusing opioids, and some say the abuse-deterrent formulations should be the default painkiller for patients with histories of drug use, anxiety or depression. But even they worry that some drugmakers are overselling the technology. They stress that separate measures are needed for the majority of opioid abusers who ingest the pills orally.\u003c/p>\n\u003cp>\"The way they're handling the ADF is that this is the answer. And it's not the answer — it's part of the bigger puzzle,\" said Theodore Cicero, a psychiatry professor at Washington University in St. Louis, who has authored several studies on the drugs.\u003c/p>\n\u003cp>\u003cstrong>'You can't put a price tag on anybody's life'\u003c/strong>\u003c/p>\n\u003cp>Two years after the overdose that killed her 21-year-old son, Terri Bartlett traveled to Illinois' state capital to champion an unlikely cause: revamped painkillers.\u003c/p>\n\u003cp>Bartlett's son Michael became hooked on Vicodin and later graduated to heroin. In emotional testimony last year, she urged lawmakers to support a bill that would prioritize the new harder-to-crush pills, saying she believed her son would still be alive if abuse-deterrent formulations had been on the market then.\u003c/p>\n\u003cp>\"You can't put a price tag on anybody's life,\" she said.\u003c/p>\n\u003cp>Bartlett didn't know then that she had been recruited into a wide-ranging lobbying campaign. A public relations firm hired by OxyContin-maker Purdue had helped recruit her to support the bill, along with local sheriffs and fire chiefs.\u003c/p>\n\u003cp>Her words, and similar testimony from parents of drug abusers elsewhere, reflect a tactic used by the drugmakers across the country. For instance, Purdue paid nearly $95,000 for similar lobbying efforts in New York, state records show.\u003c/p>\n\u003cp>And the industry's fingerprints are easy to spot in other areas. Of more than 100 bills dealing with the drugs introduced in 35 states in 2015 and 2016, at least 49 featured nearly identical language requiring insurers to cover abuse-deterrent drugs, according to an analysis of data from Quorum, a legislative tracking service. Several of the bill sponsors said they received the wording from pharmaceutical lobbyists.\u003c/p>\n\u003cp>Since 2012, at least 21 bills related to the drugs have become law, including five that require insurers to pay for the more expensive drugs in Maine, Maryland, Massachusetts, Florida and West Virginia.\u003c/p>\n\u003cp>Wins in such states will give drugmakers momentum to successfully push for copycat laws elsewhere, noted Paul Kelly, a federal lobbyist who has worked on multistate lobbying campaigns for drugstores and major retailers.\u003c/p>\n\u003cp>\"It's like a foot in the door,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Fierce Opposition\u003c/strong>\u003c/p>\n\u003cp>Drugmakers have found fierce opposition to their ADF legislation from insurers and employers who would be on the hook for the far pricier opioid variations.\u003c/p>\n\u003cp>The Illinois bill — and the 48 strikingly similar measures in other states — would require insurers to cover the drugs in the same way as other opioids, which the insurance companies argue would allow drugmakers to charge whatever they want for them.\u003c/p>\n\u003cp>\"That is not the best use of our medical care resources,\" Vernon Rowen, vice president of state government affairs for the insurance company Aetna, told Illinois lawmakers after Bartlett testified. \"It totally eliminates our ability to negotiate discounts with manufacturers.\"\u003c/p>\n\u003cp>New York Gov. Andrew Cuomo and New Jersey Gov. Chris Christie both vetoed such insurance mandates in the past year, citing the high costs and lack of evidence that the drugs help.\u003c/p>\n\u003cp>Federal health officials also have pushed back against requirements to cover the drugs, citing the \"staggering\" costs. For example, a 30-day supply of Pfizer's abuse-deterrent Embeda, a combination drug containing morphine, costs $268, while a 30-day supply of a generic morphine costs roughly $38, according to data compiled by Truven Health Analytics, a company that tracks drug prices set by manufacturers.\u003c/p>\n\u003cp>The Department of Veterans Affairs' Dr. Bernie Good estimated that converting the 8.8 million patient system exclusively to the new reformulations would increase opioid spending more than tenfold, to over $1.6 billion annually. Good, who co-directs the VA's program for medication safety, said the vast majority of veterans are not at risk for snorting or injecting their medications.\u003c/p>\n\u003cp>\"Would the excess money to pay for abuse-deterrent products — mostly to pay for it in cases where it wouldn't be necessary — be better spent for drug treatment centers?\" he asked at a recent federal meeting on the drugs.\u003c/p>\n\u003cp>Federal estimates say at least 2.2 million Americans are addicted to prescription opioids or heroin, yet only one in five actually receives treatment, according to a Surgeon General's report published last month. That's despite some $35 billion already spent annually on substance abuse programs by private and public health providers.\u003c/p>\n\u003cp>State lawmakers who support the abuse-deterrent bills often defend them as an important piece of solving the opioid puzzle, preventing more costly overdoses and hospitalizations.\u003c/p>\n\u003cp>And Fred Brason, executive director of Project Lazarus, a North Carolina-based group that promotes anti-addiction policies in several states, called the focus on the drugs' cost too narrow.\u003c/p>\n\u003cp>\"You're already spending that money at the back end,\" he said. \"You're spending it at the emergency department.\" He also noted the costs of addiction treatment.\u003c/p>\n\u003cp>\u003cstrong>Industry-Supported Groups and Physicians\u003c/strong>\u003c/p>\n\u003cp>When critics raise alarms about higher costs and limited evidence, drugmakers can rely on groups they support financially to argue their side, including the National Association of Drug Diversion Investigators, the Academy of Integrative Pain Management and the Partnership for Drug-Free Kids. Representatives from those groups have testified in favor of abuse-deterrent legislation in at least seven states.\u003c/p>\n\u003cp>NADDI president Charlie Cichon acknowledged his group receives funds from several ADF-makers, but said it views the drugs as a proven part of the solution to the opioid crisis. \"We're not testifying for Purdue Pharma's product or Endo's product,\" he said.\u003c/p>\n\u003cp>And Bob Twillman, executive director of the Academy, said, \"Increased use of abuse-deterrent opioids makes it more likely that those patients who need opiates to treat their pain will be able to get them.\"\u003c/p>\n\u003cp>The Partnership for Drug-Free Kids did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Physicians with financial ties to drugmakers play similar roles. Dr. Gareth Shemesh, a pain specialist, testified in support of a Colorado bill last year brought to the sponsoring legislator by Pfizer. Shemesh had received more than $13,500 from Pfizer that year in speaking fees, travel and meals, and more than $5,000 from Purdue the year before. He did not respond to repeated calls for comment, but Pfizer said he was not paid to testify and did not speak on behalf of any specific product.\u003c/p>\n\u003cp>\u003cstrong>Political Contributions Ramped Up\u003c/strong>\u003c/p>\n\u003cp>Purdue and Pfizer also have ramped up contributions to the Republican and Democratic attorneys general associations, which raise unlimited funds to help elect AGs across the country. In 2015 and 2016, they gave a total of $950,000 — more than in the previous four years combined.\u003c/p>\n\u003cp>To date, 51 attorneys general from U.S. states and territories have signed at least one of two National Association of Attorneys General letters to the FDA, urging the agency to favor abuse-deterrent drugs.\u003c/p>\n\u003cp>The pro-ADF playbook even includes a bit of political theater. In at least seven states, lawmakers or advocates have pounded the reformulated pills with hammers to demonstrate how difficult they are to smash.\u003c/p>\n\u003cp>In Illinois, it was Democratic Rep. Sara Feigenholtz wielding the hammer on the same committee that heard Terri Bartlett's testimony. The main sponsor of the bill prioritizing ADFs, Feigenholtz ranked second-highest among legislative recipients of money from Pfizer since the start of 2010, according to an analysis of data from the National Institute on Money in State Politics. The $6,200 she received during that period was more than she had received in the 14 previous years combined. Her bill passed the committee but later stalled in the Legislature and remains pending.\u003c/p>\n\u003cp>She did not return multiple requests for comment. Pfizer said its contributions to Feigenholtz go back 20 years and it would be \"inaccurate and misleading\" to suggest a tie to any one piece of legislation.\u003c/p>\n\u003cp>Bartlett said she doesn't mind that Purdue was ultimately responsible for her invitation to testify, even though she didn't know that at the time. She still supports the bill.\u003c/p>\n\u003cp>\"I want to believe that in every pharmaceutical company there still remains some sort of humanity,\" she said. \"Saving life is expensive.\"\u003c/p>\n\u003cp>\u003cstrong>'An addict can find a way'\u003c/strong>\u003c/p>\n\u003cp>The FDA has walked a careful line on the new drugs, promoting them as a promising approach to discouraging abuse while acknowledging their real-world benefits remain largely theoretical.\u003c/p>\n\u003cp>Earlier this year, the agency highlighted the drugs in its \"opioids action plan,\" issued after scathing criticism from some members of Congress that the FDA wasn't doing enough to combat the epidemic.\u003c/p>\n\u003cp>Thus far, the agency has approved seven drugs with labeling suggesting they are \"expected to\" discourage abuse, based on studies conducted by pharmaceutical companies.\u003c/p>\n\u003cp>But the FDA has not yet concluded that any of the products have a \"real-world impact\" on measures like overdose or death, according to Dr. Douglas Throckmorton, an agency deputy director. He and other regulators predict, however, that the reformulations will eventually translate into public health results.\u003c/p>\n\u003cp>\"We stand by those predictions,\" Throckmorton said at a recent public meeting on the drugs. \"We're confident in the science, we're confident in the assessments we conducted.\"\u003c/p>\n\u003cp>Even some former FDA advisers who support expanded use of the drugs say they are only part of the solution. Dr. Lewis Nelson, who previously chaired an FDA panel on drug safety, notes that the drugs don't deter the most common form of abuse: swallowing pills whole.\u003c/p>\n\u003cp>\"Certainly, you might not eat one and get high,\" he said. \"You eat three and get high.\"\u003c/p>\n\u003cp>At least one study found that while OxyContin's reformulation coincided with many abusers switching to other drugs, other users still were able to defeat the pills' technology and snort or inject the contents.\u003c/p>\n\u003cp>David Rook, a 40-year-old Henrico, Virginia, resident who now operates a recovery facility, was among them. Before entering treatment, he said, he would break down abuse-deterrent OxyContins and crush-resistant Opanas using water, lemon juice and a microwave.\u003c/p>\n\u003cp>\"The truth is an addict can find a way to abuse a medication one way or the other,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Unpredictable Effects\u003c/strong>\u003c/p>\n\u003cp>A recent HIV outbreak in rural Indiana illustrates the sometimes unpredictable effect of ADFs on abusers' behavior.\u003c/p>\n\u003cp>Approximately 210 people have tested positive for the virus in Scott County since 2014, a public health crisis linked to needle-sharing among abusers of Opana. Endo Pharmaceuticals received approval for a reformulated version of the drug in 2011, making it harder to crush. As a result, many abusers switched from snorting the drug to injecting it with syringes, leading to the spread of the blood-borne HIV virus, according to the state health commissioner and other officials.\u003c/p>\n\u003cp>Endo spokeswoman Heather Zoumas Lubeski declined to comment on the outbreak, but issued a statement saying, \"Patient safety has always been a top priority for Endo and we are committed to providing patients with approved products that are safe and effective when used as prescribed.\"\u003c/p>\n\u003cp>The FDA declined to approve labeling claims for Opana's anti-abuse features, noting that the drug still can easily be cooked and injected.\u003c/p>\n\u003cp>Pfizer, Purdue, Endo and Teva Pharmaceuticals Industries Ltd. spent more than $20 million between 2012 and 2015 on federal lobbying efforts that included support of a bill that would require the FDA to gradually replace current opioids with harder-to-abuse versions that become available. Teva declined comment.\u003c/p>\n\u003cp>Rep. William Keating, D-Mass., first introduced the bill in 2012 and tried again in 2013 and 2015. Like his colleagues at the state level, he employed the hammer-smashing routine to illustrate the medications' crush-resistant properties.\u003c/p>\n\u003cp>Keating said the industry played no part in spurring the bill, even though the head of a nonprofit association funded by abuse-deterrent drugmakers spoke at the press conference introducing his legislation. He also received $2,500 in political contributions from makers of reformulated opioids in 2011 and 2012, a small fraction of his overall fundraising haul.\u003c/p>\n\u003cp>\"My interest in this stems from when I was a district attorney and I got to see the lives that were lost,\" Keating said in an interview.\u003c/p>\n\u003cp>While Keating's bill has not received a vote in Congress, the FDA already has begun moving in the direction suggested by companies, mapping out a process for removing older opioids from the market when newer versions are shown to be more effective at thwarting abuse.\u003c/p>\n\u003cp>\"You don't have to pass a bill, necessarily, to change policy,\" said Dan Cohen of the Abuse Deterrent Coalition, which represents smaller abuse-deterrent manufacturers.\u003c/p>\n\u003cp>The lack of real-world data on reformulated opioids is the main reason some federal officials haven't embraced them.\u003c/p>\n\u003cp>The CDC did not recommend ADFs in its landmark opioid guidelines this year, the first-ever federal recommendations for doctors prescribing the drugs. Why? Frieden, the agency's director, said his staff could not find any evidence showing the updated opioids actually reduce rates of addiction, overdoses or deaths.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Center for Public Integrity data reporter Ben Wieder contributed to this article.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Drugmakers aggressively push new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there's little proof they reduce rates of overdoses or deaths.",
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"nprByline": "Matthew Perrone\u003cbr />Geoff Mulvihill\u003cbr />Liz Essley Whyte\u003cbr />Associated Press and Center for Public Integrity",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Pilloried for their role in the epidemic of prescription painkiller abuse, drugmakers are aggressively pushing their remedy to the problem: a new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there's little proof they reduce rates of overdoses or deaths.\u003c/p>\n\u003caside class=\"pullquote alignright\">Harder-to-manipulate opioids have racked up billions in sales, despite a lack of proof that they reduce overdoses.\u003c/aside>\n\u003cp>More than prescriptions are at stake. Critics worry the drugmakers' nationwide lobbying campaign is distracting from more productive solutions and delaying crucial efforts to steer physicians away from prescription opioids — addictive pain medications involved in the deaths of more than 165,000 Americans since 2000.\u003c/p>\n\u003cp>\"If we've learned one lesson from the last 20 years on opioids it's that these products have very, very high inherent risks,\" said Dr. Caleb Alexander, co-director of Johns Hopkins University's Center for Drug Safety and Effectiveness. \"My concern is that they'll contribute to a perception that there is a safe opioid, and there's no such thing as a fully safe opioid.\"\u003c/p>\n\u003cp>The latest drugs — known as abuse-deterrent formulations, or ADFs — are generally harder to crush or dissolve, which the drugmakers tout as making them difficult to snort or inject. But they still are vulnerable to manipulation and potentially addictive when simply swallowed. National data from an industry-sponsored tracking system also show drug abusers quickly drop the reformulated drugs in favor of older painkillers or heroin.\u003c/p>\n\u003cp>In the last two years, pharmaceutical companies have made a concerted under-the-radar push for bills benefiting the anti-abuse opioids in statehouses and in Congress, where proposed legislation would require the Food and Drug Administration to replace older opioids with the new drugs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The lobbying push features industry-funded advocacy groups and physicians, along with grieving family members, who rarely disclosed the drugmakers' ties during their testimony in support of the drugs.\u003c/p>\n\u003cp>Besides the tamper-resistant pills, ADF opioids are being rolled out in other forms, including injectable drugs and pills that irritate users when they're snorted or contain substances that counteract highs.\u003c/p>\n\u003cp>\u003cstrong>Sales Opportunity\u003c/strong>\u003c/p>\n\u003cp>Making painkillers harder to abuse is a common-sense step. But it's also a multibillion-dollar sales opportunity, offering drugmakers the potential to wipe out lower-cost generic competitors and lock in sales of their higher-priced versions, which cost many times more than conventional pills. The big companies hold multiple patents on the reformulated drugs, shielding them from competition for years — in some cases decades.\u003c/p>\n\u003cp>Though abuse-deterrent painkillers represented less than 5 percent of all opioids prescribed last year, they generated more than $2.4 billion in sales, or roughly a quarter of the nearly $10 billion U.S. market for the drugs, according to IMS Health. The field is dominated by Purdue Pharma's OxyContin, patent-protected until 2030.\u003c/p>\n\u003cp>\"We at Purdue make certain that prescribers and other stakeholders understand that opioids with abuse-deterrent properties won't stop all prescription drug abuse, but they are an important part of the comprehensive approach needed to address this public health issue,\" Purdue spokesman Robert Josephson said in a statement.\u003c/p>\n\u003cp>Like a spokeswoman for Pfizer Inc., Josephson also noted that some public health officials, including the Food and Drug Administration, have endorsed using ADFs.\u003c/p>\n\u003cp>\"We need every tool that we can have in our toolbox,\" said Kentucky state Rep. Addia Wuchner, a Republican who has worked on several bills to benefit reformulated opioids. \"The extra steps are worth the effort in order to prevent this escalation of more addiction.\"\u003c/p>\n\u003cp>\u003cstrong>Massive Lobbying Effort\u003c/strong>\u003c/p>\n\u003cp>The current industry campaign draws on the same 50-state strategy that painkiller manufacturers successfully deployed to help kill or weaken measures aimed at stemming the tide of prescription opioids, a playbook The Associated Press and Center for Public Integrity exposed in September.\u003c/p>\n\u003cp>The \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/09/19/how-drugmakers-used-money-and-influence-to-shape-the-national-response-to-opioid-abuse/\" target=\"_blank\">reporting \u003c/a>detailed how opioid drugmakers and the nonprofits they help fund spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade, eight times what the gun lobby reported for the same period. The money represents the drugmakers' spending on all their legislative interests, including opioids.\u003c/p>\n\u003cp>The FDA has approved a handful of the reformulated drugs but has not yet concluded that any reduce rates of addiction, abuse or death, and the evidence gap has led to diverging views among health authorities.\u003c/p>\n\u003cp>\u003cstrong>'No less addictive'\u003c/strong>\u003c/p>\n\u003cp>Whereas FDA regulators emphasize the potential promise of reformulated painkillers, other government officials stress that they contain the same heroin-like ingredients as traditional opioids. An estimated 78 Americans die from heroin and prescription opioid overdoses every day.\u003c/p>\n\u003cp>\"'Abuse-deterrent' sounds to people sometimes like 'Oh, maybe it's not addictive.' But it's no less addictive,\" said Dr. Tom Frieden, head of the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Survey results published this year in the Clinical Journal of Pain showed nearly half of U.S. physicians incorrectly believed that reformulated opioids are less addictive than their predecessors.\u003c/p>\n\u003cp>Many experts see a key role for ADFs in reducing the number of people who first begin abusing opioids, and some say the abuse-deterrent formulations should be the default painkiller for patients with histories of drug use, anxiety or depression. But even they worry that some drugmakers are overselling the technology. They stress that separate measures are needed for the majority of opioid abusers who ingest the pills orally.\u003c/p>\n\u003cp>\"The way they're handling the ADF is that this is the answer. And it's not the answer — it's part of the bigger puzzle,\" said Theodore Cicero, a psychiatry professor at Washington University in St. Louis, who has authored several studies on the drugs.\u003c/p>\n\u003cp>\u003cstrong>'You can't put a price tag on anybody's life'\u003c/strong>\u003c/p>\n\u003cp>Two years after the overdose that killed her 21-year-old son, Terri Bartlett traveled to Illinois' state capital to champion an unlikely cause: revamped painkillers.\u003c/p>\n\u003cp>Bartlett's son Michael became hooked on Vicodin and later graduated to heroin. In emotional testimony last year, she urged lawmakers to support a bill that would prioritize the new harder-to-crush pills, saying she believed her son would still be alive if abuse-deterrent formulations had been on the market then.\u003c/p>\n\u003cp>\"You can't put a price tag on anybody's life,\" she said.\u003c/p>\n\u003cp>Bartlett didn't know then that she had been recruited into a wide-ranging lobbying campaign. A public relations firm hired by OxyContin-maker Purdue had helped recruit her to support the bill, along with local sheriffs and fire chiefs.\u003c/p>\n\u003cp>Her words, and similar testimony from parents of drug abusers elsewhere, reflect a tactic used by the drugmakers across the country. For instance, Purdue paid nearly $95,000 for similar lobbying efforts in New York, state records show.\u003c/p>\n\u003cp>And the industry's fingerprints are easy to spot in other areas. Of more than 100 bills dealing with the drugs introduced in 35 states in 2015 and 2016, at least 49 featured nearly identical language requiring insurers to cover abuse-deterrent drugs, according to an analysis of data from Quorum, a legislative tracking service. Several of the bill sponsors said they received the wording from pharmaceutical lobbyists.\u003c/p>\n\u003cp>Since 2012, at least 21 bills related to the drugs have become law, including five that require insurers to pay for the more expensive drugs in Maine, Maryland, Massachusetts, Florida and West Virginia.\u003c/p>\n\u003cp>Wins in such states will give drugmakers momentum to successfully push for copycat laws elsewhere, noted Paul Kelly, a federal lobbyist who has worked on multistate lobbying campaigns for drugstores and major retailers.\u003c/p>\n\u003cp>\"It's like a foot in the door,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Fierce Opposition\u003c/strong>\u003c/p>\n\u003cp>Drugmakers have found fierce opposition to their ADF legislation from insurers and employers who would be on the hook for the far pricier opioid variations.\u003c/p>\n\u003cp>The Illinois bill — and the 48 strikingly similar measures in other states — would require insurers to cover the drugs in the same way as other opioids, which the insurance companies argue would allow drugmakers to charge whatever they want for them.\u003c/p>\n\u003cp>\"That is not the best use of our medical care resources,\" Vernon Rowen, vice president of state government affairs for the insurance company Aetna, told Illinois lawmakers after Bartlett testified. \"It totally eliminates our ability to negotiate discounts with manufacturers.\"\u003c/p>\n\u003cp>New York Gov. Andrew Cuomo and New Jersey Gov. Chris Christie both vetoed such insurance mandates in the past year, citing the high costs and lack of evidence that the drugs help.\u003c/p>\n\u003cp>Federal health officials also have pushed back against requirements to cover the drugs, citing the \"staggering\" costs. For example, a 30-day supply of Pfizer's abuse-deterrent Embeda, a combination drug containing morphine, costs $268, while a 30-day supply of a generic morphine costs roughly $38, according to data compiled by Truven Health Analytics, a company that tracks drug prices set by manufacturers.\u003c/p>\n\u003cp>The Department of Veterans Affairs' Dr. Bernie Good estimated that converting the 8.8 million patient system exclusively to the new reformulations would increase opioid spending more than tenfold, to over $1.6 billion annually. Good, who co-directs the VA's program for medication safety, said the vast majority of veterans are not at risk for snorting or injecting their medications.\u003c/p>\n\u003cp>\"Would the excess money to pay for abuse-deterrent products — mostly to pay for it in cases where it wouldn't be necessary — be better spent for drug treatment centers?\" he asked at a recent federal meeting on the drugs.\u003c/p>\n\u003cp>Federal estimates say at least 2.2 million Americans are addicted to prescription opioids or heroin, yet only one in five actually receives treatment, according to a Surgeon General's report published last month. That's despite some $35 billion already spent annually on substance abuse programs by private and public health providers.\u003c/p>\n\u003cp>State lawmakers who support the abuse-deterrent bills often defend them as an important piece of solving the opioid puzzle, preventing more costly overdoses and hospitalizations.\u003c/p>\n\u003cp>And Fred Brason, executive director of Project Lazarus, a North Carolina-based group that promotes anti-addiction policies in several states, called the focus on the drugs' cost too narrow.\u003c/p>\n\u003cp>\"You're already spending that money at the back end,\" he said. \"You're spending it at the emergency department.\" He also noted the costs of addiction treatment.\u003c/p>\n\u003cp>\u003cstrong>Industry-Supported Groups and Physicians\u003c/strong>\u003c/p>\n\u003cp>When critics raise alarms about higher costs and limited evidence, drugmakers can rely on groups they support financially to argue their side, including the National Association of Drug Diversion Investigators, the Academy of Integrative Pain Management and the Partnership for Drug-Free Kids. Representatives from those groups have testified in favor of abuse-deterrent legislation in at least seven states.\u003c/p>\n\u003cp>NADDI president Charlie Cichon acknowledged his group receives funds from several ADF-makers, but said it views the drugs as a proven part of the solution to the opioid crisis. \"We're not testifying for Purdue Pharma's product or Endo's product,\" he said.\u003c/p>\n\u003cp>And Bob Twillman, executive director of the Academy, said, \"Increased use of abuse-deterrent opioids makes it more likely that those patients who need opiates to treat their pain will be able to get them.\"\u003c/p>\n\u003cp>The Partnership for Drug-Free Kids did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Physicians with financial ties to drugmakers play similar roles. Dr. Gareth Shemesh, a pain specialist, testified in support of a Colorado bill last year brought to the sponsoring legislator by Pfizer. Shemesh had received more than $13,500 from Pfizer that year in speaking fees, travel and meals, and more than $5,000 from Purdue the year before. He did not respond to repeated calls for comment, but Pfizer said he was not paid to testify and did not speak on behalf of any specific product.\u003c/p>\n\u003cp>\u003cstrong>Political Contributions Ramped Up\u003c/strong>\u003c/p>\n\u003cp>Purdue and Pfizer also have ramped up contributions to the Republican and Democratic attorneys general associations, which raise unlimited funds to help elect AGs across the country. In 2015 and 2016, they gave a total of $950,000 — more than in the previous four years combined.\u003c/p>\n\u003cp>To date, 51 attorneys general from U.S. states and territories have signed at least one of two National Association of Attorneys General letters to the FDA, urging the agency to favor abuse-deterrent drugs.\u003c/p>\n\u003cp>The pro-ADF playbook even includes a bit of political theater. In at least seven states, lawmakers or advocates have pounded the reformulated pills with hammers to demonstrate how difficult they are to smash.\u003c/p>\n\u003cp>In Illinois, it was Democratic Rep. Sara Feigenholtz wielding the hammer on the same committee that heard Terri Bartlett's testimony. The main sponsor of the bill prioritizing ADFs, Feigenholtz ranked second-highest among legislative recipients of money from Pfizer since the start of 2010, according to an analysis of data from the National Institute on Money in State Politics. The $6,200 she received during that period was more than she had received in the 14 previous years combined. Her bill passed the committee but later stalled in the Legislature and remains pending.\u003c/p>\n\u003cp>She did not return multiple requests for comment. Pfizer said its contributions to Feigenholtz go back 20 years and it would be \"inaccurate and misleading\" to suggest a tie to any one piece of legislation.\u003c/p>\n\u003cp>Bartlett said she doesn't mind that Purdue was ultimately responsible for her invitation to testify, even though she didn't know that at the time. She still supports the bill.\u003c/p>\n\u003cp>\"I want to believe that in every pharmaceutical company there still remains some sort of humanity,\" she said. \"Saving life is expensive.\"\u003c/p>\n\u003cp>\u003cstrong>'An addict can find a way'\u003c/strong>\u003c/p>\n\u003cp>The FDA has walked a careful line on the new drugs, promoting them as a promising approach to discouraging abuse while acknowledging their real-world benefits remain largely theoretical.\u003c/p>\n\u003cp>Earlier this year, the agency highlighted the drugs in its \"opioids action plan,\" issued after scathing criticism from some members of Congress that the FDA wasn't doing enough to combat the epidemic.\u003c/p>\n\u003cp>Thus far, the agency has approved seven drugs with labeling suggesting they are \"expected to\" discourage abuse, based on studies conducted by pharmaceutical companies.\u003c/p>\n\u003cp>But the FDA has not yet concluded that any of the products have a \"real-world impact\" on measures like overdose or death, according to Dr. Douglas Throckmorton, an agency deputy director. He and other regulators predict, however, that the reformulations will eventually translate into public health results.\u003c/p>\n\u003cp>\"We stand by those predictions,\" Throckmorton said at a recent public meeting on the drugs. \"We're confident in the science, we're confident in the assessments we conducted.\"\u003c/p>\n\u003cp>Even some former FDA advisers who support expanded use of the drugs say they are only part of the solution. Dr. Lewis Nelson, who previously chaired an FDA panel on drug safety, notes that the drugs don't deter the most common form of abuse: swallowing pills whole.\u003c/p>\n\u003cp>\"Certainly, you might not eat one and get high,\" he said. \"You eat three and get high.\"\u003c/p>\n\u003cp>At least one study found that while OxyContin's reformulation coincided with many abusers switching to other drugs, other users still were able to defeat the pills' technology and snort or inject the contents.\u003c/p>\n\u003cp>David Rook, a 40-year-old Henrico, Virginia, resident who now operates a recovery facility, was among them. Before entering treatment, he said, he would break down abuse-deterrent OxyContins and crush-resistant Opanas using water, lemon juice and a microwave.\u003c/p>\n\u003cp>\"The truth is an addict can find a way to abuse a medication one way or the other,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Unpredictable Effects\u003c/strong>\u003c/p>\n\u003cp>A recent HIV outbreak in rural Indiana illustrates the sometimes unpredictable effect of ADFs on abusers' behavior.\u003c/p>\n\u003cp>Approximately 210 people have tested positive for the virus in Scott County since 2014, a public health crisis linked to needle-sharing among abusers of Opana. Endo Pharmaceuticals received approval for a reformulated version of the drug in 2011, making it harder to crush. As a result, many abusers switched from snorting the drug to injecting it with syringes, leading to the spread of the blood-borne HIV virus, according to the state health commissioner and other officials.\u003c/p>\n\u003cp>Endo spokeswoman Heather Zoumas Lubeski declined to comment on the outbreak, but issued a statement saying, \"Patient safety has always been a top priority for Endo and we are committed to providing patients with approved products that are safe and effective when used as prescribed.\"\u003c/p>\n\u003cp>The FDA declined to approve labeling claims for Opana's anti-abuse features, noting that the drug still can easily be cooked and injected.\u003c/p>\n\u003cp>Pfizer, Purdue, Endo and Teva Pharmaceuticals Industries Ltd. spent more than $20 million between 2012 and 2015 on federal lobbying efforts that included support of a bill that would require the FDA to gradually replace current opioids with harder-to-abuse versions that become available. Teva declined comment.\u003c/p>\n\u003cp>Rep. William Keating, D-Mass., first introduced the bill in 2012 and tried again in 2013 and 2015. Like his colleagues at the state level, he employed the hammer-smashing routine to illustrate the medications' crush-resistant properties.\u003c/p>\n\u003cp>Keating said the industry played no part in spurring the bill, even though the head of a nonprofit association funded by abuse-deterrent drugmakers spoke at the press conference introducing his legislation. He also received $2,500 in political contributions from makers of reformulated opioids in 2011 and 2012, a small fraction of his overall fundraising haul.\u003c/p>\n\u003cp>\"My interest in this stems from when I was a district attorney and I got to see the lives that were lost,\" Keating said in an interview.\u003c/p>\n\u003cp>While Keating's bill has not received a vote in Congress, the FDA already has begun moving in the direction suggested by companies, mapping out a process for removing older opioids from the market when newer versions are shown to be more effective at thwarting abuse.\u003c/p>\n\u003cp>\"You don't have to pass a bill, necessarily, to change policy,\" said Dan Cohen of the Abuse Deterrent Coalition, which represents smaller abuse-deterrent manufacturers.\u003c/p>\n\u003cp>The lack of real-world data on reformulated opioids is the main reason some federal officials haven't embraced them.\u003c/p>\n\u003cp>The CDC did not recommend ADFs in its landmark opioid guidelines this year, the first-ever federal recommendations for doctors prescribing the drugs. Why? Frieden, the agency's director, said his staff could not find any evidence showing the updated opioids actually reduce rates of addiction, overdoses or deaths.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Center for Public Integrity data reporter Ben Wieder contributed to this article.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hospitalized Elderly Have Lower Death Rate When Cared for by Female Doc: Study",
"title": "Hospitalized Elderly Have Lower Death Rate When Cared for by Female Doc: Study",
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"content": "\u003cp>In a study that is sure to rile male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Patients cared for by women were less likely to die or return to the hospital after discharge.\u003c/p>\n\u003cp>Previous research has shown that female doctors are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/8769910\">more likely to follow\u003c/a> recommendations about prevention counseling and to order \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJM199308123290707#t=article\">preventive tests\u003c/a> like Pap smears and mammograms.\u003c/p>\n\u003cp>But the \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593255\">latest work\u003c/a>, published Monday in \u003cem>JAMA Internal Medicine\u003c/em>, is the first to show a big difference in the result that matters most to patients: life or death.\u003c/p>\n\u003cp>The study's authors estimate \"that approximately 32,000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year.\"\u003c/p>\n\u003cp>\"Of course! What did you expect?\" replied the wife of Dr. Ashish Jha, the study's senior author, when he shared his team's findings with her. Jha said he expects a backlash on the study results. But his team's methodology, successfully put through multiple analyses, makes this work noteworthy, he added.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But tens of thousands of fewer deaths per year if we just went with female doctors?\u003c/p>\n\u003cp>Whoa! To us, a man and woman who met as we were getting our start in medicine, them's fightin' words.\u003c/p>\n\u003cp>An \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593252\">editorial\u003c/a> about the study urges doctors to remedy the gender disparities in care and the pay gap that favors male physicians over women.\u003c/p>\n\u003cp>Since half the patients we treat are women and girls, it makes sense that at least half the physician corps should reflect the population. We've achieved that in \u003ca href=\"https://www.aamc.org/members/gwims/statistics/\">medical school\u003c/a> rolls, but overall only a third of practicing doctors are female. And many specialties, including orthopedics, cardiology and neurosurgery, are still dominated by men.\u003c/p>\n\u003cp>So why is there a gender-based difference in physicians' care? The authors admit that they are \"unable to identify exactly why female physicians have better outcomes than male physicians.\"\u003c/p>\n\u003cp>We don't pretend to know for sure, but as married doctors, we have our hunches. We talked it over and here are our thoughts about the research.\u003c/p>\n\u003cp>\u003cstrong>Dr. Sarah-Anne Henning Schumann:\u003c/strong> The actual effect reported in the study is small, but multiplied over a huge population it does add up to something significant.\u003c/p>\n\u003cp>\u003cstrong>Dr. John Henning Schumann:\u003c/strong> I like the Big Data aspect of it. The authors said, \"Let's look at more than a million Medicare patients over several years and see how they fared based on the gender of their doctor.\" While many people may want to tear this study apart, I think the findings make intuitive sense.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm assuming the difference is because of the way that women, in general, communicate. It's about being better listeners, more nurturing and having emotional intelligence.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> There are plenty of men who are good communicators.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Yes, just as there are plenty of women who don't really have those qualities. For female doctors, having worked their way through pre-med, med school, and residency, they can have some of that nurturing communication skill beaten out of them.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That happens to men, too!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> That's true. But this study shows us — just possibly — that if female doctors, on average, communicate better, their style might be more effective in treating disease and preventing death.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> It's interesting to me because I think about some of my older patients, who much prefer that I tell them what to do rather than to discuss options and share decision-making.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I think that traditionally men were the doctors. People often assume men are more intelligent and so would be more likely to take their advice.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That has to change, as we get closer to parity with women in the profession.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> My mother has had many experiences with male doctors, where she feels they haven't listened to her. They aren't warm or kind, but she feels reassured anyway. She thinks they're smart, and what's most important to her is their knowledge and technical skill, not their bedside manner.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Mom always knows best, if that's what she values.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Even in our family, we're both doctors. I'm a family doctor, trained to see adults and kids. You're an internist, trained to only see adults. And in both of our families, most of the time, our family members will reach out to you with their questions — even about kids. And my family, who attended my Harvard Medical School graduation, I'll remind you, seems to value your opinion more. They seem to be looking for opinions more from men. That's kind of an interesting thing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> I never really thought about that. I can see how that's totally male privilege. It has to be frustrating to be taken less seriously.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm in a Facebook group of physicians who are moms. While it's not every doctor-mom in the country, there are over 60,000 of us in it. So many tell stories of being mistaken for nurses—and taking great offense at that. We have worked so hard to get where we are and want to be treated as equals to our male colleagues.\u003c/p>\n\u003cp>But I see the mix-up as a compliment rather than an insult. To be compared with a nurse says that patients are seeing me as someone who is caring for them and nurturing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That's a smart way to reframe it. Our colleague Jill used to get angry when people assumed she was a nurse. Instead, she decided to embrace it and use it as a call to service. Now she asks patients if they need an extra blanket or something to drink. And she believes that she provides better, more empathic care.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Everyone is going to want to know what is it about women that leads to these better outcomes. I think it's going to be hard to figure out exactly.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Do you think people that read or hear about this study will take home the message that they need to choose female doctors?\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Some will no doubt oversimplify it to that. What I take away is that if communication is the key, as I suspect, then we need to better select and train medical students and residents to exhibit these qualities.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Amen to that. What about equal pay for equal (or better!) outcomes? Paging, \u003ca href=\"https://www.eeoc.gov/eeoc/publications/brochure-equal_pay_and_ledbetter_act.cfm\">Lilly Ledbetter\u003c/a>!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> You're not really asking me that, are you?\u003c/p>\n\u003cp>\u003cem>Sarah-Anne Henning Schumann is a family doctor and serves as medical director of \u003c/em>\u003ca href=\"http://communityhealthconnection.org/\">Community Health Connection\u003c/a>,\u003cem> a federally qualified community health center in Tulsa, Okla.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>John Henning Schumann is an internal medicine doctor and serves as President of the University of Oklahoma's Tulsa campus. He also hosts \u003c/em>\u003ca href=\"http://publicradiotulsa.org/term/john-henning-schumann\">Studio Tulsa: Medical Monday\u003c/a>\u003cem> on KWGS Public Radio Tulsa. He's on Twitter: @\u003c/em>\u003ca href=\"https://twitter.com/glasshospital?lang=en\">\u003cem>GlassHospital\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 KWGS-FM. To see more, visit \u003ca href=\"http://publicradiotulsa.org/\">KWGS-FM\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Patients+Cared+For+By+Female+Doctors+Fare+Better+Than+Those+Treated+By+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a study that is sure to rile male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Patients cared for by women were less likely to die or return to the hospital after discharge.\u003c/p>\n\u003cp>Previous research has shown that female doctors are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/8769910\">more likely to follow\u003c/a> recommendations about prevention counseling and to order \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJM199308123290707#t=article\">preventive tests\u003c/a> like Pap smears and mammograms.\u003c/p>\n\u003cp>But the \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593255\">latest work\u003c/a>, published Monday in \u003cem>JAMA Internal Medicine\u003c/em>, is the first to show a big difference in the result that matters most to patients: life or death.\u003c/p>\n\u003cp>The study's authors estimate \"that approximately 32,000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year.\"\u003c/p>\n\u003cp>\"Of course! What did you expect?\" replied the wife of Dr. Ashish Jha, the study's senior author, when he shared his team's findings with her. Jha said he expects a backlash on the study results. But his team's methodology, successfully put through multiple analyses, makes this work noteworthy, he added.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But tens of thousands of fewer deaths per year if we just went with female doctors?\u003c/p>\n\u003cp>Whoa! To us, a man and woman who met as we were getting our start in medicine, them's fightin' words.\u003c/p>\n\u003cp>An \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593252\">editorial\u003c/a> about the study urges doctors to remedy the gender disparities in care and the pay gap that favors male physicians over women.\u003c/p>\n\u003cp>Since half the patients we treat are women and girls, it makes sense that at least half the physician corps should reflect the population. We've achieved that in \u003ca href=\"https://www.aamc.org/members/gwims/statistics/\">medical school\u003c/a> rolls, but overall only a third of practicing doctors are female. And many specialties, including orthopedics, cardiology and neurosurgery, are still dominated by men.\u003c/p>\n\u003cp>So why is there a gender-based difference in physicians' care? The authors admit that they are \"unable to identify exactly why female physicians have better outcomes than male physicians.\"\u003c/p>\n\u003cp>We don't pretend to know for sure, but as married doctors, we have our hunches. We talked it over and here are our thoughts about the research.\u003c/p>\n\u003cp>\u003cstrong>Dr. Sarah-Anne Henning Schumann:\u003c/strong> The actual effect reported in the study is small, but multiplied over a huge population it does add up to something significant.\u003c/p>\n\u003cp>\u003cstrong>Dr. John Henning Schumann:\u003c/strong> I like the Big Data aspect of it. The authors said, \"Let's look at more than a million Medicare patients over several years and see how they fared based on the gender of their doctor.\" While many people may want to tear this study apart, I think the findings make intuitive sense.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm assuming the difference is because of the way that women, in general, communicate. It's about being better listeners, more nurturing and having emotional intelligence.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> There are plenty of men who are good communicators.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Yes, just as there are plenty of women who don't really have those qualities. For female doctors, having worked their way through pre-med, med school, and residency, they can have some of that nurturing communication skill beaten out of them.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That happens to men, too!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> That's true. But this study shows us — just possibly — that if female doctors, on average, communicate better, their style might be more effective in treating disease and preventing death.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> It's interesting to me because I think about some of my older patients, who much prefer that I tell them what to do rather than to discuss options and share decision-making.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I think that traditionally men were the doctors. People often assume men are more intelligent and so would be more likely to take their advice.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That has to change, as we get closer to parity with women in the profession.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> My mother has had many experiences with male doctors, where she feels they haven't listened to her. They aren't warm or kind, but she feels reassured anyway. She thinks they're smart, and what's most important to her is their knowledge and technical skill, not their bedside manner.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Mom always knows best, if that's what she values.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Even in our family, we're both doctors. I'm a family doctor, trained to see adults and kids. You're an internist, trained to only see adults. And in both of our families, most of the time, our family members will reach out to you with their questions — even about kids. And my family, who attended my Harvard Medical School graduation, I'll remind you, seems to value your opinion more. They seem to be looking for opinions more from men. That's kind of an interesting thing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> I never really thought about that. I can see how that's totally male privilege. It has to be frustrating to be taken less seriously.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm in a Facebook group of physicians who are moms. While it's not every doctor-mom in the country, there are over 60,000 of us in it. So many tell stories of being mistaken for nurses—and taking great offense at that. We have worked so hard to get where we are and want to be treated as equals to our male colleagues.\u003c/p>\n\u003cp>But I see the mix-up as a compliment rather than an insult. To be compared with a nurse says that patients are seeing me as someone who is caring for them and nurturing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That's a smart way to reframe it. Our colleague Jill used to get angry when people assumed she was a nurse. Instead, she decided to embrace it and use it as a call to service. Now she asks patients if they need an extra blanket or something to drink. And she believes that she provides better, more empathic care.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Everyone is going to want to know what is it about women that leads to these better outcomes. I think it's going to be hard to figure out exactly.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Do you think people that read or hear about this study will take home the message that they need to choose female doctors?\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Some will no doubt oversimplify it to that. What I take away is that if communication is the key, as I suspect, then we need to better select and train medical students and residents to exhibit these qualities.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Amen to that. What about equal pay for equal (or better!) outcomes? Paging, \u003ca href=\"https://www.eeoc.gov/eeoc/publications/brochure-equal_pay_and_ledbetter_act.cfm\">Lilly Ledbetter\u003c/a>!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> You're not really asking me that, are you?\u003c/p>\n\u003cp>\u003cem>Sarah-Anne Henning Schumann is a family doctor and serves as medical director of \u003c/em>\u003ca href=\"http://communityhealthconnection.org/\">Community Health Connection\u003c/a>,\u003cem> a federally qualified community health center in Tulsa, Okla.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>John Henning Schumann is an internal medicine doctor and serves as President of the University of Oklahoma's Tulsa campus. He also hosts \u003c/em>\u003ca href=\"http://publicradiotulsa.org/term/john-henning-schumann\">Studio Tulsa: Medical Monday\u003c/a>\u003cem> on KWGS Public Radio Tulsa. He's on Twitter: @\u003c/em>\u003ca href=\"https://twitter.com/glasshospital?lang=en\">\u003cem>GlassHospital\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 KWGS-FM. To see more, visit \u003ca href=\"http://publicradiotulsa.org/\">KWGS-FM\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Patients+Cared+For+By+Female+Doctors+Fare+Better+Than+Those+Treated+By+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New HIV Studies Offer Fresh Hope for a Cure",
"title": "New HIV Studies Offer Fresh Hope for a Cure",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>The HIV research community is increasingly optimistic about the promising \"shock and kill\" approach to eradicating HIV from infected patients. Such removal of all traces of the virus from an individual's body would represent an actual cure for AIDS.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We know from the science that a cure can happen.'\u003c/aside>\n\u003cp>A new small-scale human trial of the treatment is starting this week in New York and two sister sites, in Germany and Denmark. The trial will combine an anticancer drug, romidepsin, with antiretroviral drugs, also known as ARVs.\u003c/p>\n\u003cp>Another small human study will start in January, followed by a larger human shock and kill trial in June.\u003c/p>\n\u003cp>Shock and kill combines standard ARVs with an immune booster, a combo that’s been effective in test tube, animal and now human trials. The treatment flushes out and eradicates pockets of HIV, which lie inactive inside dormant immune cells even as antiretroviral drugs reduce the actively reproducing virus to undetectable levels in the blood.\u003c/p>\n\u003cp>The new trials follow validating shock and kill data from University of California, San Francisco researchers, shared at the HIV Cure Summit, held on Dec. 1 at UCSF.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">[contextly_sidebar id=\"mMgRCnE0h9dNvCoKR8ZADxCU0RnaFUGQ\"]\"I feel a very real sense of optimism based on the evidence that we know a cure can be achieved,” said Dr. Rowena Johnston, vice-president for amfAR, in a post-summit interview with KQED. “There is a fundamental understanding we have now of the barriers between us and a cure, and how we go about to solving the problems.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">In a related upcoming trial, a \u003cspan class=\"s1\">UCSF team will study whether an oral pill or IV drip is more effective in delivering drugs to tissue reservoirs where HIV hides. A separate observational study designed to serve as a reference for all HIV cure trials will monitor people who stop taking ARVs.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Building on a Breakthrough\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The mood at the HIV Cure Summit was one of cautious optimism, in part fueled by reports from the first human shock and kill trial in Britain. In October, UK scientists conducting a 50-person study announced that the first patient to complete the treatment, a 44-year-old man given Vorinostat, ARVs and vaccines to prod the immune system, \u003c/span>showed no detectable signs of the virus in his blood.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In short, he appeared cured. But \u003c/span>\u003cspan class=\"s1\">HIV scientists worldwide quickly deemed any declaration of victory premature, cautioning that more time, as well as tissue samples, are needed to judge the treatment's efficacy. The UK trial will wrap up in 2018, and no results are expected until then.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Animal Studies Offer Hope – And a Warning \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The early human findings mirror promising results from numerous lab and \u003cspan class=\"s2\">\u003ca href=\"http://www.iflscience.com/health-and-medicine/shock-and-kill-approach-cures-mice-hiv-world-first/\">animal studies\u003c/a> \u003c/span>employing shock and kill and related therapies. In October, researchers reported that several of eight monkeys given an immune therapy plus ARVs to flush out SIV, the simian cousin to HIV, now remain\u003ca href=\"http://www.reuters.com/article/us-aids-day-cure-analysis-idUSKBN13Q3BM\">\u003cspan class=\"s2\"> free\u003c/span>\u003c/a> of the virus after two years. The animals continue to be monitored. \u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cspan class=\"s1\">But another group has just issued a cautionary note. It may be that not all approaches to boosting the immune system will prove safe, even if effective. On Dec. 12, scientists reported \u003ca href=\"http://www.pharmpro.com/news/2016/12/hiv-shock-and-kill-strategy-may-harm-patient-brains\" target=\"_blank\">brain inflammation\u003c/a> in a study of three SIV-infected macaques given a year’s course of Vorinostat; Ingenol-B, another latency-reversing agent; and ARVs. While Vorinostat has passed human safety studies, Ingenol-B has not, said Johnston.\u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">\"Our study sounds a major cautionary note about the potential for unintended consequences of the shock-and-kill treatment strategy,\" stated Janice Clements, a veteran AIDS researchers at the Johns Hopkins University School of Medicine.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>The Berlin Patient\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the UCSF summit, researchers stressed the difference between a full or sterilizing cure, which would constitute eradication of every last particle of HIV, and a functional cure, meaning remission. In the latter, the immune system prevents HIV from ever emerging out of dormancy.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A total cure has only been achieved in one person to date: Timothy Ray Brown, also known as \u003ca href=\"http://www.sciencemag.org/news/2014/09/how-did-berlin-patient-rid-himself-hiv\" target=\"_blank\">The Berlin Patient\u003c/a>. Brown was initially infected with HIV in 1995. After years of antiretroviral drugs, Brown, who also suffers from acute myeloid leukemia, underwent chemotherapy followed by two stem cell transplants from a donor whose immune cells were genetically resistant to HIV. Today, nine years later, Brown remains free of any trace of the virus in not only his bloodstream but in myriad tissue samples. He recently relocated to participate in studies in San Francisco. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The Berlin Patient gave us the proof of concept” for an HIV cure, said Kevin Frost, amfAR CEO and the summit spokesperson. Referring to the number of people with HIV globally, he said, “Now we have to go from N-1 to N-37 million.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Berlin Patient's case was unique and his treatment prohibitively expensive, out of reach to millions with HIV. In the short term, a more realistic remedy than eradication of the virus is remission without antiretroviral drugs. A small minority of long-term HIV survivors, called \"\u003ca href=\"http://www.sfchronicle.com/health/article/Protected-from-HIV-elite-controllers-still-10420068.php\">\u003cspan class=\"s2\">elite controllers\u003c/span>\u003c/a>,\" already can manage without the drugs due to their own immune systems.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">If shock and kill therapies prove effective and durable, they will also prove a boon for HIV prevention. Two major \u003ca href=\"https://hptn.org/research/studies/33\">\u003cspan class=\"s2\">studies\u003c/span>\u003c/a> over the last five years in thousands of couples showed that individuals on ARVs with undetectable levels of HIV were \u003cspan class=\"s2\">\u003ca href=\"http://i-base.info/htb/30108\">not infectious. \u003c/a>\u003c/span>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A number of preventive shock and kill vaccines are now being evaluated in new laboratory studies.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Needed: R&D for New Tools\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Some of the buzz at the HIV Cure Summit focused on progress made with new tools to find, measure, and map latent HIV. UCSF's Peter Hunt introduced results of a new RNA-DNA probe that can simultaneously measure dormant and replicating HIV in tissue cells, as well as pinpoint the cell type. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">That allows for mapping of not only the regions where reservoirs of HIV are lurking but the individual cells, explained Johnston. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“It’s an incredible advance,\" Johnston said. \"There’s not a single group in the world who has done that.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Another UCSF researcher, Satish Pillai, presented a novel digital-drop technology and multifluid chip test that can analyze many cells at once. Such tools are critical to assess if patients off medicines will remain HIV-free.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Looking ahead, Frost of amfAR thought a barrier to more rapid progress is a lack of pharma investment in research and diagnostics. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“In the development of antiretrovirals, the pace of research accelerated at a speed commensurate with the revenue generated,\" he said. \"With only a few exceptions, pharma hasn’t even come to the table on cure research yet.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">HIV cure proponents also worry about possible cuts in research dollars under incoming President Donald Trump.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But such hurdles haven’t dampened their growing faith in a cure. \u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“We know from the science that a cure can happen,” said Pillai. “That’s definitely a reason to be hopeful. We just need more resources and more people involved to move us along faster.”\u003c/span>\u003c/p>\n\n",
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"excerpt": "Scientists are increasingly optimistic about the promising 'shock and kill' approach to eradicating HIV from infected patients. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The HIV research community is increasingly optimistic about the promising \"shock and kill\" approach to eradicating HIV from infected patients. Such removal of all traces of the virus from an individual's body would represent an actual cure for AIDS.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We know from the science that a cure can happen.'\u003c/aside>\n\u003cp>A new small-scale human trial of the treatment is starting this week in New York and two sister sites, in Germany and Denmark. The trial will combine an anticancer drug, romidepsin, with antiretroviral drugs, also known as ARVs.\u003c/p>\n\u003cp>Another small human study will start in January, followed by a larger human shock and kill trial in June.\u003c/p>\n\u003cp>Shock and kill combines standard ARVs with an immune booster, a combo that’s been effective in test tube, animal and now human trials. The treatment flushes out and eradicates pockets of HIV, which lie inactive inside dormant immune cells even as antiretroviral drugs reduce the actively reproducing virus to undetectable levels in the blood.\u003c/p>\n\u003cp>The new trials follow validating shock and kill data from University of California, San Francisco researchers, shared at the HIV Cure Summit, held on Dec. 1 at UCSF.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003c/p>\u003cp>\u003c/p>\u003cp>\"I feel a very real sense of optimism based on the evidence that we know a cure can be achieved,” said Dr. Rowena Johnston, vice-president for amfAR, in a post-summit interview with KQED. “There is a fundamental understanding we have now of the barriers between us and a cure, and how we go about to solving the problems.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">In a related upcoming trial, a \u003cspan class=\"s1\">UCSF team will study whether an oral pill or IV drip is more effective in delivering drugs to tissue reservoirs where HIV hides. A separate observational study designed to serve as a reference for all HIV cure trials will monitor people who stop taking ARVs.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Building on a Breakthrough\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The mood at the HIV Cure Summit was one of cautious optimism, in part fueled by reports from the first human shock and kill trial in Britain. In October, UK scientists conducting a 50-person study announced that the first patient to complete the treatment, a 44-year-old man given Vorinostat, ARVs and vaccines to prod the immune system, \u003c/span>showed no detectable signs of the virus in his blood.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In short, he appeared cured. But \u003c/span>\u003cspan class=\"s1\">HIV scientists worldwide quickly deemed any declaration of victory premature, cautioning that more time, as well as tissue samples, are needed to judge the treatment's efficacy. The UK trial will wrap up in 2018, and no results are expected until then.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Animal Studies Offer Hope – And a Warning \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The early human findings mirror promising results from numerous lab and \u003cspan class=\"s2\">\u003ca href=\"http://www.iflscience.com/health-and-medicine/shock-and-kill-approach-cures-mice-hiv-world-first/\">animal studies\u003c/a> \u003c/span>employing shock and kill and related therapies. In October, researchers reported that several of eight monkeys given an immune therapy plus ARVs to flush out SIV, the simian cousin to HIV, now remain\u003ca href=\"http://www.reuters.com/article/us-aids-day-cure-analysis-idUSKBN13Q3BM\">\u003cspan class=\"s2\"> free\u003c/span>\u003c/a> of the virus after two years. The animals continue to be monitored. \u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cspan class=\"s1\">But another group has just issued a cautionary note. It may be that not all approaches to boosting the immune system will prove safe, even if effective. On Dec. 12, scientists reported \u003ca href=\"http://www.pharmpro.com/news/2016/12/hiv-shock-and-kill-strategy-may-harm-patient-brains\" target=\"_blank\">brain inflammation\u003c/a> in a study of three SIV-infected macaques given a year’s course of Vorinostat; Ingenol-B, another latency-reversing agent; and ARVs. While Vorinostat has passed human safety studies, Ingenol-B has not, said Johnston.\u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">\"Our study sounds a major cautionary note about the potential for unintended consequences of the shock-and-kill treatment strategy,\" stated Janice Clements, a veteran AIDS researchers at the Johns Hopkins University School of Medicine.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>The Berlin Patient\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the UCSF summit, researchers stressed the difference between a full or sterilizing cure, which would constitute eradication of every last particle of HIV, and a functional cure, meaning remission. In the latter, the immune system prevents HIV from ever emerging out of dormancy.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A total cure has only been achieved in one person to date: Timothy Ray Brown, also known as \u003ca href=\"http://www.sciencemag.org/news/2014/09/how-did-berlin-patient-rid-himself-hiv\" target=\"_blank\">The Berlin Patient\u003c/a>. Brown was initially infected with HIV in 1995. After years of antiretroviral drugs, Brown, who also suffers from acute myeloid leukemia, underwent chemotherapy followed by two stem cell transplants from a donor whose immune cells were genetically resistant to HIV. Today, nine years later, Brown remains free of any trace of the virus in not only his bloodstream but in myriad tissue samples. He recently relocated to participate in studies in San Francisco. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The Berlin Patient gave us the proof of concept” for an HIV cure, said Kevin Frost, amfAR CEO and the summit spokesperson. Referring to the number of people with HIV globally, he said, “Now we have to go from N-1 to N-37 million.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Berlin Patient's case was unique and his treatment prohibitively expensive, out of reach to millions with HIV. In the short term, a more realistic remedy than eradication of the virus is remission without antiretroviral drugs. A small minority of long-term HIV survivors, called \"\u003ca href=\"http://www.sfchronicle.com/health/article/Protected-from-HIV-elite-controllers-still-10420068.php\">\u003cspan class=\"s2\">elite controllers\u003c/span>\u003c/a>,\" already can manage without the drugs due to their own immune systems.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">If shock and kill therapies prove effective and durable, they will also prove a boon for HIV prevention. Two major \u003ca href=\"https://hptn.org/research/studies/33\">\u003cspan class=\"s2\">studies\u003c/span>\u003c/a> over the last five years in thousands of couples showed that individuals on ARVs with undetectable levels of HIV were \u003cspan class=\"s2\">\u003ca href=\"http://i-base.info/htb/30108\">not infectious. \u003c/a>\u003c/span>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A number of preventive shock and kill vaccines are now being evaluated in new laboratory studies.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Needed: R&D for New Tools\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Some of the buzz at the HIV Cure Summit focused on progress made with new tools to find, measure, and map latent HIV. UCSF's Peter Hunt introduced results of a new RNA-DNA probe that can simultaneously measure dormant and replicating HIV in tissue cells, as well as pinpoint the cell type. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">That allows for mapping of not only the regions where reservoirs of HIV are lurking but the individual cells, explained Johnston. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“It’s an incredible advance,\" Johnston said. \"There’s not a single group in the world who has done that.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Another UCSF researcher, Satish Pillai, presented a novel digital-drop technology and multifluid chip test that can analyze many cells at once. Such tools are critical to assess if patients off medicines will remain HIV-free.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Looking ahead, Frost of amfAR thought a barrier to more rapid progress is a lack of pharma investment in research and diagnostics. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“In the development of antiretrovirals, the pace of research accelerated at a speed commensurate with the revenue generated,\" he said. \"With only a few exceptions, pharma hasn’t even come to the table on cure research yet.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">HIV cure proponents also worry about possible cuts in research dollars under incoming President Donald Trump.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But such hurdles haven’t dampened their growing faith in a cure. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The California Report",
"officialWebsiteLink": "/californiareport",
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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"amazon": "https://music.amazon.com/podcasts/26099305-72af-4542-9dde-ac1807fe36d5/kqed-s-the-california-report",
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"rss": "https://ww2.kqed.org/news/tag/tcram/feed/podcast"
}
},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Magazine-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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"rss": "https://ww2.kqed.org/news/tag/tcrmag/feed/podcast"
}
},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
"title": "Close All Tabs",
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/02/CAT_2_Tile-scaled.jpg",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
"link": "/podcasts/closealltabs",
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"code-switch-life-kit": {
"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": {
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"link": "/radio/program/code-switch-life-kit",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
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},
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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.",
"airtime": "THU 10pm, FRI 1am",
"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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}
},
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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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},
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"id": "freakonomics-radio",
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"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"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/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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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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"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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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"here-and-now": {
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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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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
"id": "how-i-built-this",
"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",
"subscribe": {
"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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"rss": "https://feeds.npr.org/510313/podcast.xml"
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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",
"meta": {
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"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",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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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/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
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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": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"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)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"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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"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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"spotify": "https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x",
"tuneIn": "https://tunein.com/radio/On-Our-Watch-p1436229/",
"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": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
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