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"disqusTitle": "USC Looks to Make East L.A. a Hub for Biotech",
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"content": "\u003cp>The University of Southern California is working to make East Los Angeles a hub for biotech research.\u003c/p>\n\u003cp>“(W)e’re hoping to develop our biotech industry in order to basically keep our students and stop the brain drain,\" says Martha Escutia, USC’s vice president of government relations.\u003c/p>\n\u003cp>The effort picked up steam in 2012, when the Los Angeles County Board of Supervisors commissioned a \u003ca href=\"http://file.lacounty.gov/SDSInter/bos/bc/217012_REPORTONCONSULTANTEVALUATIONFORAPOTENTIALCOUNTYWIDEBIOTECHNOLOGY.pdf\" target=\"_blank\">master plan\u003c/a> for developing a \u003ca href=\"http://www.latimes.com/opinion/op-ed/la-oe-0226-nikias-los-angeles-biotech-corridor-20150226-story.html\" target=\"_blank\">local biotech industry\u003c/a> that could make L.A. competitive with similar initiatives in San Francisco and San Diego.\u003c/p>\n\u003cp>The quest to develop a biotech center stems in part from the unavailability of local jobs in the field. In 2010, higher education institutions in Los Angeles County graduated more than 5,000 students with bioscience-related degrees. Many, however, have had to leave the region to find work. It took L.A. county nearly a decade, from 2001 to 2010, to add just 4,500 bioscience jobs, according to the master plan. Among the regional impediments for biotech firms is a lack of laboratory and office space close to research universities.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/285881433\" 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>A biotech hub would expand USC’s existing medical campus in East L.A. and is a high priority for USC president C.L. Max Nikias, who says dozens of biotech startups with roots in USC research have left the region to set up shop.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We are at the dawn of this new technological revolution, which is biotech,\" Nikias says. \"I don't want us to be marginalized or fall behind in this new industrial revolution.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'Why wouldn’t the local community want to receive benefits in terms of jobs, research opportunities for their students; why wouldn’t people want that?'\u003c/aside>\n\u003cp>To that end, he says, USC has recruited dozens of professors in bioscience fields over the past several years. Research institutes on brain science, Alzheimer's treatment and diabetes and obesity are located at the university.\u003c/p>\n\u003cp>USC's proposal for a biotech hub is a partnership with the California Institute of Technology, whose scientists would potentially be able to locate their startups in the area; and the Los Angeles Unified School District. Nikias envisions establishing a training center in the area for high school and community college graduates who want biotech jobs.\u003c/p>\n\u003cp>Officials at USC say the hub could create 3,000 construction and 4,000 permanent jobs that would provide employment opportunities in the largely Latino, low-income neighborhood.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It is going to change the complexion of the neighborhood, literally.'\u003c/aside>\n\u003cp>\"Now why wouldn’t we want to have that in L.A.?\" Escutia says. \"And why wouldn’t the local community want to receive benefits in terms of jobs, research opportunities for their students; why wouldn’t people want that?”\u003c/p>\n\u003cp>But county officials have told USC that to move forward with the proposal, the university must first address the concerns of the area's existing community.\u003c/p>\n\u003cp>“It is going to change the complexion of the neighborhood, literally,” says Abel Salas, a poet who lives and works out of a warehouse space a few blocks north of the USC expansion site. He and others worry it could displace residents and won’t live up to the promise of job training for young people.\u003c/p>\n\u003cp>“It doesn’t seem realistic to expect people who are among the poorest and least likely to graduate from high school … to suddenly be trained or retrained to have a biotech job, and what’s going to happen to them?”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The university held its first community information meeting on Saturday. If the plan moves forward, it also requires a land deal between USC and L.A. County, which is still being hammered out.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The University of Southern California is working to make East Los Angeles a hub for biotech research.\u003c/p>\n\u003cp>“(W)e’re hoping to develop our biotech industry in order to basically keep our students and stop the brain drain,\" says Martha Escutia, USC’s vice president of government relations.\u003c/p>\n\u003cp>The effort picked up steam in 2012, when the Los Angeles County Board of Supervisors commissioned a \u003ca href=\"http://file.lacounty.gov/SDSInter/bos/bc/217012_REPORTONCONSULTANTEVALUATIONFORAPOTENTIALCOUNTYWIDEBIOTECHNOLOGY.pdf\" target=\"_blank\">master plan\u003c/a> for developing a \u003ca href=\"http://www.latimes.com/opinion/op-ed/la-oe-0226-nikias-los-angeles-biotech-corridor-20150226-story.html\" target=\"_blank\">local biotech industry\u003c/a> that could make L.A. competitive with similar initiatives in San Francisco and San Diego.\u003c/p>\n\u003cp>The quest to develop a biotech center stems in part from the unavailability of local jobs in the field. In 2010, higher education institutions in Los Angeles County graduated more than 5,000 students with bioscience-related degrees. Many, however, have had to leave the region to find work. It took L.A. county nearly a decade, from 2001 to 2010, to add just 4,500 bioscience jobs, according to the master plan. Among the regional impediments for biotech firms is a lack of laboratory and office space close to research universities.\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/285881433&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/285881433'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A biotech hub would expand USC’s existing medical campus in East L.A. and is a high priority for USC president C.L. Max Nikias, who says dozens of biotech startups with roots in USC research have left the region to set up shop.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We are at the dawn of this new technological revolution, which is biotech,\" Nikias says. \"I don't want us to be marginalized or fall behind in this new industrial revolution.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'Why wouldn’t the local community want to receive benefits in terms of jobs, research opportunities for their students; why wouldn’t people want that?'\u003c/aside>\n\u003cp>To that end, he says, USC has recruited dozens of professors in bioscience fields over the past several years. Research institutes on brain science, Alzheimer's treatment and diabetes and obesity are located at the university.\u003c/p>\n\u003cp>USC's proposal for a biotech hub is a partnership with the California Institute of Technology, whose scientists would potentially be able to locate their startups in the area; and the Los Angeles Unified School District. Nikias envisions establishing a training center in the area for high school and community college graduates who want biotech jobs.\u003c/p>\n\u003cp>Officials at USC say the hub could create 3,000 construction and 4,000 permanent jobs that would provide employment opportunities in the largely Latino, low-income neighborhood.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It is going to change the complexion of the neighborhood, literally.'\u003c/aside>\n\u003cp>\"Now why wouldn’t we want to have that in L.A.?\" Escutia says. \"And why wouldn’t the local community want to receive benefits in terms of jobs, research opportunities for their students; why wouldn’t people want that?”\u003c/p>\n\u003cp>But county officials have told USC that to move forward with the proposal, the university must first address the concerns of the area's existing community.\u003c/p>\n\u003cp>“It is going to change the complexion of the neighborhood, literally,” says Abel Salas, a poet who lives and works out of a warehouse space a few blocks north of the USC expansion site. He and others worry it could displace residents and won’t live up to the promise of job training for young people.\u003c/p>\n\u003cp>“It doesn’t seem realistic to expect people who are among the poorest and least likely to graduate from high school … to suddenly be trained or retrained to have a biotech job, and what’s going to happen to them?”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The university held its first community information meeting on Saturday. If the plan moves forward, it also requires a land deal between USC and L.A. County, which is still being hammered out.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Little Evidence for Effectiveness of 'Brain Training' Programs: Study",
"title": "Little Evidence for Effectiveness of 'Brain Training' Programs: Study",
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"content": "\u003cp>Want to be smarter? More focused? Free of memory problems as you age?\u003c/p>\n\u003cp>If so, don't count on brain games to help you.\u003c/p>\n\u003cp>That's the conclusion of an exhaustive evaluation of the scientific literature on brain training games and programs. It was \u003ca href=\"http://psi.sagepub.com/content/current\">published\u003c/a> Monday in the journal \u003cem>Psychological Science in the Public Interest.\u003c/em>\u003c/p>\n\u003cp>\"It's disappointing that the evidence isn't stronger,\" says \u003ca href=\"http://www.psychology.illinois.edu/people/dsimons\">Daniel Simons\u003c/a>, an author of the article and a psychology professor at the University of Illinois at Urbana-Champaign.\u003c/p>\n\u003cp>\"It would be really nice if you could play some games and have it radically change your cognitive abilities,\" Simons says. \"But the studies don't show that on objectively measured real-world outcomes.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The evaluation, done by a team of seven scientists, is a response to a very public disagreement about the effectiveness of brain games, Simons says.\u003c/p>\n\u003cp>In October 2014, more than 70 scientists published an \u003ca href=\"http://longevity3.stanford.edu/blog/2014/10/15/the-consensus-on-the-brain-training-industry-from-the-scientific-community-2/\">open letter\u003c/a> objecting to marketing claims made by brain training companies. Pretty soon, another group, with more than 100 scientists, published a \u003ca href=\"http://www.cognitivetrainingdata.org/the-controversy-does-brain-training-work/response-letter/\">rebuttal\u003c/a> saying brain training has a solid scientific base.\u003c/p>\n\u003cp>\"So you had two consensus statements, each signed by many, many people, that came to essentially opposite conclusions,\" Simons says.\u003c/p>\n\u003cp>In an effort to clarify the issue, Simons and six other scientists reviewed more than 130 studies of brain games and other forms of cognitive training. The evaluation included studies of products from industry giant \u003ca href=\"https://www.lumosity.com/\">Lumosity\u003c/a>, which has been a prominent sponsor of NPR and other public radio programming.\u003c/p>\n\u003cp>\"We went through each paper and tried to look at the kind of evidence it provided,\" Simons says.\u003c/p>\n\u003cp>That meant asking questions like: How big was the study? Did it have an appropriate control group? Do the results support the marketing claims made by companies?\u003c/p>\n\u003cp>The scientists found that \"many of the studies did not really adhere to what we think of as the best practices,\" Simons says.\u003c/p>\n\u003cp>Some of the studies included only a few participants. Others lacked adequate control groups or failed to account for the placebo effect, which causes people to improve on a test simply because they are trying harder or are more confident.\u003c/p>\n\u003cp>There were some good studies, Simons says. And they showed that brain games do help people get better at a specific task.\u003c/p>\n\u003cp>\"You can practice, for example, scanning baggage at an airport and looking for a knife,\" he says. \"And you get really, really good at spotting that knife.\"\u003c/p>\n\u003cp>But there was less evidence that people got better at related tasks, like spotting other suspicious items, Simons says. And there was no strong evidence that practicing a narrow skill led to overall improvements in memory or thinking.\u003c/p>\n\u003cp>That's disappointing, Simons says, because \"what you want to do is be better able to function at work or at school.\"\u003c/p>\n\u003cp>The evaluation got a warm reception from at least some of the scientists who had signed the 2014 letter defending the science behind brain training.\u003c/p>\n\u003cp>\"The evaluation was very even-handed and raised many excellent points,\" says \u003ca href=\"http://www.hopkinsmedicine.org/profiles/results/directory/profile/9783561/george-rebok\">George Rebok\u003c/a>, a psychologist at Johns Hopkins University who has been involved in brain training research for the past 20 years. \"It really helped raise the bar in terms of the level of science that we must aspire to.\"\u003c/p>\n\u003cp>Rebok, who says he has no ties to brain training companies, remains optimistic that the right program of brain exercises can improve mental functioning and delay the effects of aging.\u003c/p>\n\u003cp>One reason brain games haven't shown a clear benefit so far, he says, may be that they don't work the brain hard enough or over a long enough time period.\u003c/p>\n\u003cp>\"It takes mental effort and practice to be able to see results,\" Rebok says. \"If we can implement that long range, I think that there will be a big dividend eventually.\"\u003c/p>\n\u003cp>In the meantime, the brain training industry is facing scrutiny from the Federal Trade Commission.\u003c/p>\n\u003cp>In January, the company behind Lumosity agreed to \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/01/lumosity-pay-2-million-settle-ftc-deceptive-advertising-charges\">pay a $2 million fine\u003c/a> to settle \u003ca href=\"https://www.ftc.gov/system/files/documents/cases/160105lumoslabsstip.pdf\">FTC charges\u003c/a> that it made unfounded claims about its brain training program.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And in May, a smaller brain training company called LearningRx agreed to pay a $200,000 fine to settle \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/05/marketers-one-one-brain-training-programs-settle-ftc-charges\">similar charges\u003c/a>. Even so, the \u003ca href=\"http://www.learningrx.com/\">Learning Rx website\u003c/a> still promises \"A better brain at any age.\"\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=Brain+Game+Claims+Fail+A+Big+Scientific+Test&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Want to be smarter? More focused? Free of memory problems as you age?\u003c/p>\n\u003cp>If so, don't count on brain games to help you.\u003c/p>\n\u003cp>That's the conclusion of an exhaustive evaluation of the scientific literature on brain training games and programs. It was \u003ca href=\"http://psi.sagepub.com/content/current\">published\u003c/a> Monday in the journal \u003cem>Psychological Science in the Public Interest.\u003c/em>\u003c/p>\n\u003cp>\"It's disappointing that the evidence isn't stronger,\" says \u003ca href=\"http://www.psychology.illinois.edu/people/dsimons\">Daniel Simons\u003c/a>, an author of the article and a psychology professor at the University of Illinois at Urbana-Champaign.\u003c/p>\n\u003cp>\"It would be really nice if you could play some games and have it radically change your cognitive abilities,\" Simons says. \"But the studies don't show that on objectively measured real-world outcomes.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The evaluation, done by a team of seven scientists, is a response to a very public disagreement about the effectiveness of brain games, Simons says.\u003c/p>\n\u003cp>In October 2014, more than 70 scientists published an \u003ca href=\"http://longevity3.stanford.edu/blog/2014/10/15/the-consensus-on-the-brain-training-industry-from-the-scientific-community-2/\">open letter\u003c/a> objecting to marketing claims made by brain training companies. Pretty soon, another group, with more than 100 scientists, published a \u003ca href=\"http://www.cognitivetrainingdata.org/the-controversy-does-brain-training-work/response-letter/\">rebuttal\u003c/a> saying brain training has a solid scientific base.\u003c/p>\n\u003cp>\"So you had two consensus statements, each signed by many, many people, that came to essentially opposite conclusions,\" Simons says.\u003c/p>\n\u003cp>In an effort to clarify the issue, Simons and six other scientists reviewed more than 130 studies of brain games and other forms of cognitive training. The evaluation included studies of products from industry giant \u003ca href=\"https://www.lumosity.com/\">Lumosity\u003c/a>, which has been a prominent sponsor of NPR and other public radio programming.\u003c/p>\n\u003cp>\"We went through each paper and tried to look at the kind of evidence it provided,\" Simons says.\u003c/p>\n\u003cp>That meant asking questions like: How big was the study? Did it have an appropriate control group? Do the results support the marketing claims made by companies?\u003c/p>\n\u003cp>The scientists found that \"many of the studies did not really adhere to what we think of as the best practices,\" Simons says.\u003c/p>\n\u003cp>Some of the studies included only a few participants. Others lacked adequate control groups or failed to account for the placebo effect, which causes people to improve on a test simply because they are trying harder or are more confident.\u003c/p>\n\u003cp>There were some good studies, Simons says. And they showed that brain games do help people get better at a specific task.\u003c/p>\n\u003cp>\"You can practice, for example, scanning baggage at an airport and looking for a knife,\" he says. \"And you get really, really good at spotting that knife.\"\u003c/p>\n\u003cp>But there was less evidence that people got better at related tasks, like spotting other suspicious items, Simons says. And there was no strong evidence that practicing a narrow skill led to overall improvements in memory or thinking.\u003c/p>\n\u003cp>That's disappointing, Simons says, because \"what you want to do is be better able to function at work or at school.\"\u003c/p>\n\u003cp>The evaluation got a warm reception from at least some of the scientists who had signed the 2014 letter defending the science behind brain training.\u003c/p>\n\u003cp>\"The evaluation was very even-handed and raised many excellent points,\" says \u003ca href=\"http://www.hopkinsmedicine.org/profiles/results/directory/profile/9783561/george-rebok\">George Rebok\u003c/a>, a psychologist at Johns Hopkins University who has been involved in brain training research for the past 20 years. \"It really helped raise the bar in terms of the level of science that we must aspire to.\"\u003c/p>\n\u003cp>Rebok, who says he has no ties to brain training companies, remains optimistic that the right program of brain exercises can improve mental functioning and delay the effects of aging.\u003c/p>\n\u003cp>One reason brain games haven't shown a clear benefit so far, he says, may be that they don't work the brain hard enough or over a long enough time period.\u003c/p>\n\u003cp>\"It takes mental effort and practice to be able to see results,\" Rebok says. \"If we can implement that long range, I think that there will be a big dividend eventually.\"\u003c/p>\n\u003cp>In the meantime, the brain training industry is facing scrutiny from the Federal Trade Commission.\u003c/p>\n\u003cp>In January, the company behind Lumosity agreed to \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/01/lumosity-pay-2-million-settle-ftc-deceptive-advertising-charges\">pay a $2 million fine\u003c/a> to settle \u003ca href=\"https://www.ftc.gov/system/files/documents/cases/160105lumoslabsstip.pdf\">FTC charges\u003c/a> that it made unfounded claims about its brain training program.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And in May, a smaller brain training company called LearningRx agreed to pay a $200,000 fine to settle \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/05/marketers-one-one-brain-training-programs-settle-ftc-charges\">similar charges\u003c/a>. Even so, the \u003ca href=\"http://www.learningrx.com/\">Learning Rx website\u003c/a> still promises \"A better brain at any age.\"\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=Brain+Game+Claims+Fail+A+Big+Scientific+Test&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "First Automated Insulin System Approved For Type 1 Diabetes",
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"content": "\u003cp>The Food and Drug Administration's approval of a new insulin delivery system for people with Type 1 diabetes is a big deal.\u003c/p>\n\u003cp>With Type 1 diabetes, the pancreas makes little or no insulin so people have to replace it with either multiple daily injections or a pump. In either case, that process involves constant error-prone adjustments, particularly around food and exercise. Over the long term, high blood sugar levels can lead to organ damage, but over-correcting by giving more insulin can cause dangerous low blood sugars that can lead to unconsciousness.\u003c/p>\n\u003cp>The device, Medtronic's MiniMed 670G hybrid closed loop system, is made up of an insulin pump and continuous glucose monitor (CGM), both of which are already on the market separately. The new part involves the communication between the two devices.\u003c/p>\n\u003cp>Medtronic's \u003ca href=\"http://www.npr.org/sections/health-shots/2015/01/30/382172052/diabetes-technology-inches-closer-to-an-artificial-pancreas\">previous system \u003c/a>already had a feature that would shut down the insulin pump if the wearer's blood sugar dropped too low. But the 670G predicts when a person's blood sugar is dropping and prevents the low in the first place, and also corrects high blood sugars.\u003c/p>\n\u003cp>This is the first such machine in the world with that level of automation, and thus it is informally being called the first \"artificial pancreas\" system.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>However, it's called a hybrid rather than a fully closed-loop system because users will still need to signal that they're about to eat and estimate the carbohydrate count of the food so the device can calculate the additional amount of insulin needed. That means there's still the possibility of mistakes. But now if that count is off, the 670G will correct the error automatically.\u003c/p>\n\u003cp>For people with Type 1 diabetes, the new capabilities mean they can both sleep through the night without worrying about their blood sugars dropping too low and can go through their day without having to think about their diabetes all the time, according to Aaron Kowalski, chief mission officer for the JDRF, the organization that funds much of the \"artificial pancreas\" research.\u003c/p>\n\u003cp>\"You get almost normalized overnight blood glucose. For people with Type 1 diabetes, that's massively important,\" he said, adding that the overall 24/7 burden reduction means better quality of life. \"The diabetes isn't gone, but [wearers] can think about it less ...This is a historic milestone.\"\u003c/p>\n\u003cp>And more systems like this are coming.\u003c/p>\n\u003cp>Medtronic, via the Minimed division that it acquired in 2001, was the first to market because it's still the only company that manufactures both the insulin pump and CGM technology. But at least five other partnerships between other manufacturers are now developing closed-loop systems, some using already-available pumps and CGMs, others creating new devices. The systems will likely differ from one another in form, user interface, and in the algorithmic approaches embedded in the communication software, \"so people with diabetes will have more choices,\" Kowalski says, noting that JDRF is \"celebrating Medtronic because it's the first commercial system, but we're supporting the entire field.\"\u003c/p>\n\u003cp>Of course, the field still faces challenges. One of the major technological problems is that insulin deposited just under the skin takes too long to begin working; that's why people still need to signal ahead that they're about to eat. The JDRF is currently funding several initiatives working on making faster-acting insulins.\u003c/p>\n\u003cp>\"The faster the insulin works, the more closed the loop will be,\" Kowalski notes. \"It's not easy, but there's a lot of work going on.\"\u003c/p>\n\u003cp>Wearability is another issue. Some people simply don't want to be strapped to devices, even if it means better diabetes control. So, the JDRF has recently announced new funding for miniaturization of the devices.\u003c/p>\n\u003cp>And of course, there's the problem of access. While insurance coverage for insulin pumps is widely established, this is not the case for the CGM component. Medicare doesn't cover CGM technology, meaning that people now must give up those devices or pay out of pocket when they reach age 65. The JDRF is one of several organizations lobbying to change that, as well as to make sure that all payers recognize both the health and economic advantages of new diabetes technologies.\u003c/p>\n\u003cp>\"This is a priority for us,\" Kowalski says. \"We need to make sure people have access. Not just rich people, but anybody who will benefit.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For now, the 670G, which the FDA gave the nod on Wednesday, is only \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/UCM522974.htm\">approved\u003c/a> for people aged 14 years and older. But Medtronic is studying it in children ages 7-13 with the aim of making it available for them, too.\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=FDA+Approves+The+First+Automated+Insulin+System+For+Type+1+Diabetes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Food and Drug Administration's approval of a new insulin delivery system for people with Type 1 diabetes is a big deal.\u003c/p>\n\u003cp>With Type 1 diabetes, the pancreas makes little or no insulin so people have to replace it with either multiple daily injections or a pump. In either case, that process involves constant error-prone adjustments, particularly around food and exercise. Over the long term, high blood sugar levels can lead to organ damage, but over-correcting by giving more insulin can cause dangerous low blood sugars that can lead to unconsciousness.\u003c/p>\n\u003cp>The device, Medtronic's MiniMed 670G hybrid closed loop system, is made up of an insulin pump and continuous glucose monitor (CGM), both of which are already on the market separately. The new part involves the communication between the two devices.\u003c/p>\n\u003cp>Medtronic's \u003ca href=\"http://www.npr.org/sections/health-shots/2015/01/30/382172052/diabetes-technology-inches-closer-to-an-artificial-pancreas\">previous system \u003c/a>already had a feature that would shut down the insulin pump if the wearer's blood sugar dropped too low. But the 670G predicts when a person's blood sugar is dropping and prevents the low in the first place, and also corrects high blood sugars.\u003c/p>\n\u003cp>This is the first such machine in the world with that level of automation, and thus it is informally being called the first \"artificial pancreas\" system.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, it's called a hybrid rather than a fully closed-loop system because users will still need to signal that they're about to eat and estimate the carbohydrate count of the food so the device can calculate the additional amount of insulin needed. That means there's still the possibility of mistakes. But now if that count is off, the 670G will correct the error automatically.\u003c/p>\n\u003cp>For people with Type 1 diabetes, the new capabilities mean they can both sleep through the night without worrying about their blood sugars dropping too low and can go through their day without having to think about their diabetes all the time, according to Aaron Kowalski, chief mission officer for the JDRF, the organization that funds much of the \"artificial pancreas\" research.\u003c/p>\n\u003cp>\"You get almost normalized overnight blood glucose. For people with Type 1 diabetes, that's massively important,\" he said, adding that the overall 24/7 burden reduction means better quality of life. \"The diabetes isn't gone, but [wearers] can think about it less ...This is a historic milestone.\"\u003c/p>\n\u003cp>And more systems like this are coming.\u003c/p>\n\u003cp>Medtronic, via the Minimed division that it acquired in 2001, was the first to market because it's still the only company that manufactures both the insulin pump and CGM technology. But at least five other partnerships between other manufacturers are now developing closed-loop systems, some using already-available pumps and CGMs, others creating new devices. The systems will likely differ from one another in form, user interface, and in the algorithmic approaches embedded in the communication software, \"so people with diabetes will have more choices,\" Kowalski says, noting that JDRF is \"celebrating Medtronic because it's the first commercial system, but we're supporting the entire field.\"\u003c/p>\n\u003cp>Of course, the field still faces challenges. One of the major technological problems is that insulin deposited just under the skin takes too long to begin working; that's why people still need to signal ahead that they're about to eat. The JDRF is currently funding several initiatives working on making faster-acting insulins.\u003c/p>\n\u003cp>\"The faster the insulin works, the more closed the loop will be,\" Kowalski notes. \"It's not easy, but there's a lot of work going on.\"\u003c/p>\n\u003cp>Wearability is another issue. Some people simply don't want to be strapped to devices, even if it means better diabetes control. So, the JDRF has recently announced new funding for miniaturization of the devices.\u003c/p>\n\u003cp>And of course, there's the problem of access. While insurance coverage for insulin pumps is widely established, this is not the case for the CGM component. Medicare doesn't cover CGM technology, meaning that people now must give up those devices or pay out of pocket when they reach age 65. The JDRF is one of several organizations lobbying to change that, as well as to make sure that all payers recognize both the health and economic advantages of new diabetes technologies.\u003c/p>\n\u003cp>\"This is a priority for us,\" Kowalski says. \"We need to make sure people have access. Not just rich people, but anybody who will benefit.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For now, the 670G, which the FDA gave the nod on Wednesday, is only \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/UCM522974.htm\">approved\u003c/a> for people aged 14 years and older. But Medtronic is studying it in children ages 7-13 with the aim of making it available for them, too.\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=FDA+Approves+The+First+Automated+Insulin+System+For+Type+1+Diabetes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Analysis: Digital Health Companies Aren't Solving the Right Problems",
"title": "Analysis: Digital Health Companies Aren't Solving the Right Problems",
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"content": "\u003cp>Digital health is booming. The market that includes health apps and wearables will increase around \u003cem>1,200 percent\u003c/em> over the next eight years, according to one \u003ca href=\"http://www.digitaljournal.com/pr/3084642\" target=\"_blank\">forecast\u003c/a>.\u003c/p>\n\u003cp>So what's propelling this surge in demand? \"A growing proliferation of chronic diseases, namely diabetes, cancer and heart ailments ... \" the report says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We don’t need an app that counts steps, because that really just tells you that your day doesn’t naturally incorporate the time and space to walk.'\u003c/aside>\n\u003cp>Not only is this trend alarming, said the Robert Wood Johnson Foundation's Stephen Downs at the recent Stanford Medicine X conference, but many of the solutions offered by digital health companies are \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/20/weight-loss-study-finds-fitness-tracker-is-no-help/\" target=\"_blank\">not going to help\u003c/a>.\u003c/p>\n\u003cp>In this age of the Fitbit, Downs said, digital health companies are focused on monitoring the consequences of our \u003ca href=\"http://stateofobesity.org/physical-inactivity/\" target=\"_blank\">notoriously sedentary lifestyles. \u003c/a>But what is really called for from innovators is to stop treating symptoms and start remedying the roots of the problem.\u003c/p>\n\u003cp>“The system needs to be re-engineered!” said Downs, chief technology and strategy officer of RWJF, a philanthropic organization focused on health. \"We don’t need an app that counts steps, because that really just tells you that your day doesn’t naturally incorporate the time and space to walk.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Progress = Inactivity\u003c/strong>\u003c/p>\n\u003cp>Downs is of the opinion that some of our most cherished and widely used inventions have resulted in a kind of apocalypse of inactivity: Automobiles helped create pedestrian-unfriendly suburbs; washing machines provided leisure time -- to watch more TV. And the appearance of the remote control meant we no longer even had to get up to change the channel.\u003c/p>\n\u003cp>Even our thumb muscles have been given the day off since digital assistants like Siri gained the ability to write our text messages, he noted.\u003c/p>\n\u003cp>All these things, combined with an automobile-driven, fast food culture, said Downs, have contributed to a national \u003ca href=\"http://www.diabetes.org/diabetes-basics/statistics/\">diabetes epidemic\u003c/a> and a stunning rise in \u003ca href=\"http://stateofobesity.org/obesity-rates-trends-overview/\" target=\"_blank\">obesity rates\u003c/a>.\u003c/p>\n\u003cp>\u003cb>We Need Stuff Like This \u003c/b>\u003c/p>\n\u003cp>So how to remedy the roots of the unhealthy environments we've created? Downs says engineers and designers in \u003cem>all\u003c/em> industries should be thinking about their products' effects on our health.\u003c/p>\n\u003cp>He cited the \u003ca href=\"http://cp.media.mit.edu/\" target=\"_blank\">Changing Places\u003c/a> group at the Massachusetts Institute of Technology media lab as a project that's attempting to create core solutions that fundamentally change human behavior. One of the lab's initiatives: designing ways to feed people healthier diets through \u003ca href=\"http://web.mit.edu/jiw/www/MITCityFarm/\" target=\"_blank\">urban farms\u003c/a> that make use of city spaces. (Imagine crops growing on the sides of buildings, for instance.)\u003c/p>\n\u003cfigure id=\"attachment_253672\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/bldgs.jpg\">\u003cimg class=\"wp-image-253672 size-medium\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/bldgs-800x581.jpg\" alt=\"Crops grown on the side of a building could help foster urban farming.\" width=\"800\" height=\"581\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs-800x581.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs-400x290.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs-768x558.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs-960x697.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs.jpg 1000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Crops grown on the side of a building could help foster urban farming. \u003ccite>(MIT CityFARM)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The MIT researchers claim their techniques could not only completely eliminate the massive amounts of water used by agriculture, but also render\u003cb> \u003c/b>unnecessary fertilizers and pesticides.\u003c/p>\n\u003cp>Downs also pointed to a food delivery service called \u003ca href=\"https://www.blueapron.com/?cvosrc=search-paid.google.brand30&gclid=CNS2zru1sM8CFQuqaQodXTIFng&utm_campaign=brand30&utm_medium=search-paid&utm_source=google\" target=\"_blank\">Blue Apron\u003c/a> as the kind of upstream innovation that can have a positive effect on health. The company sends a box of fresh food to your doorstep, with all the ingredients and spices to cook a meal at home. Not exactly fast food -- but \u003cem>faster\u003c/em> food with better nutrition.\u003c/p>\n\u003cp>\"This is about finding solutions for people that are more compelling than the patterns that we have established,\" he said.\u003c/p>\n\u003cp>A furniture company like the San Francisco-based \u003ca href=\"http://store.steelcase.com/\" target=\"_blank\">Steelcase\u003c/a> can have an impact, too, Downs said. The company designs chairs, lamps and tables that are intended to inspire movement, remove stress and improve focus.\u003c/p>\n\u003cp>Even ride services such as Uber and Lyft, Downs said, might lead to healthier lifestyles if they influence urban dwellers to ditch their cars altogether -- someone who no longer has a car sitting in their garage may be more inclined to walk or bike.\u003c/p>\n\u003cp>One caveat: Downs said the problem with many of these solutions is they're prohibitively expensive for most people.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"People who are innovating like this really need to think about price points that are available for the masses, not just the well-off folks in Silicon Valley.\"\u003c/p>\n\n",
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"excerpt": "Digital health companies offer a lot of monitoring devices, but they don't address core societal problems that hinder health, says the Robert Woods Johnson Foundation's chief technology officer.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Digital health is booming. The market that includes health apps and wearables will increase around \u003cem>1,200 percent\u003c/em> over the next eight years, according to one \u003ca href=\"http://www.digitaljournal.com/pr/3084642\" target=\"_blank\">forecast\u003c/a>.\u003c/p>\n\u003cp>So what's propelling this surge in demand? \"A growing proliferation of chronic diseases, namely diabetes, cancer and heart ailments ... \" the report says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We don’t need an app that counts steps, because that really just tells you that your day doesn’t naturally incorporate the time and space to walk.'\u003c/aside>\n\u003cp>Not only is this trend alarming, said the Robert Wood Johnson Foundation's Stephen Downs at the recent Stanford Medicine X conference, but many of the solutions offered by digital health companies are \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/20/weight-loss-study-finds-fitness-tracker-is-no-help/\" target=\"_blank\">not going to help\u003c/a>.\u003c/p>\n\u003cp>In this age of the Fitbit, Downs said, digital health companies are focused on monitoring the consequences of our \u003ca href=\"http://stateofobesity.org/physical-inactivity/\" target=\"_blank\">notoriously sedentary lifestyles. \u003c/a>But what is really called for from innovators is to stop treating symptoms and start remedying the roots of the problem.\u003c/p>\n\u003cp>“The system needs to be re-engineered!” said Downs, chief technology and strategy officer of RWJF, a philanthropic organization focused on health. \"We don’t need an app that counts steps, because that really just tells you that your day doesn’t naturally incorporate the time and space to walk.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Progress = Inactivity\u003c/strong>\u003c/p>\n\u003cp>Downs is of the opinion that some of our most cherished and widely used inventions have resulted in a kind of apocalypse of inactivity: Automobiles helped create pedestrian-unfriendly suburbs; washing machines provided leisure time -- to watch more TV. And the appearance of the remote control meant we no longer even had to get up to change the channel.\u003c/p>\n\u003cp>Even our thumb muscles have been given the day off since digital assistants like Siri gained the ability to write our text messages, he noted.\u003c/p>\n\u003cp>All these things, combined with an automobile-driven, fast food culture, said Downs, have contributed to a national \u003ca href=\"http://www.diabetes.org/diabetes-basics/statistics/\">diabetes epidemic\u003c/a> and a stunning rise in \u003ca href=\"http://stateofobesity.org/obesity-rates-trends-overview/\" target=\"_blank\">obesity rates\u003c/a>.\u003c/p>\n\u003cp>\u003cb>We Need Stuff Like This \u003c/b>\u003c/p>\n\u003cp>So how to remedy the roots of the unhealthy environments we've created? Downs says engineers and designers in \u003cem>all\u003c/em> industries should be thinking about their products' effects on our health.\u003c/p>\n\u003cp>He cited the \u003ca href=\"http://cp.media.mit.edu/\" target=\"_blank\">Changing Places\u003c/a> group at the Massachusetts Institute of Technology media lab as a project that's attempting to create core solutions that fundamentally change human behavior. One of the lab's initiatives: designing ways to feed people healthier diets through \u003ca href=\"http://web.mit.edu/jiw/www/MITCityFarm/\" target=\"_blank\">urban farms\u003c/a> that make use of city spaces. (Imagine crops growing on the sides of buildings, for instance.)\u003c/p>\n\u003cfigure id=\"attachment_253672\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/bldgs.jpg\">\u003cimg class=\"wp-image-253672 size-medium\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/bldgs-800x581.jpg\" alt=\"Crops grown on the side of a building could help foster urban farming.\" width=\"800\" height=\"581\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs-800x581.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs-400x290.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs-768x558.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs-960x697.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/bldgs.jpg 1000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Crops grown on the side of a building could help foster urban farming. \u003ccite>(MIT CityFARM)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The MIT researchers claim their techniques could not only completely eliminate the massive amounts of water used by agriculture, but also render\u003cb> \u003c/b>unnecessary fertilizers and pesticides.\u003c/p>\n\u003cp>Downs also pointed to a food delivery service called \u003ca href=\"https://www.blueapron.com/?cvosrc=search-paid.google.brand30&gclid=CNS2zru1sM8CFQuqaQodXTIFng&utm_campaign=brand30&utm_medium=search-paid&utm_source=google\" target=\"_blank\">Blue Apron\u003c/a> as the kind of upstream innovation that can have a positive effect on health. The company sends a box of fresh food to your doorstep, with all the ingredients and spices to cook a meal at home. Not exactly fast food -- but \u003cem>faster\u003c/em> food with better nutrition.\u003c/p>\n\u003cp>\"This is about finding solutions for people that are more compelling than the patterns that we have established,\" he said.\u003c/p>\n\u003cp>A furniture company like the San Francisco-based \u003ca href=\"http://store.steelcase.com/\" target=\"_blank\">Steelcase\u003c/a> can have an impact, too, Downs said. The company designs chairs, lamps and tables that are intended to inspire movement, remove stress and improve focus.\u003c/p>\n\u003cp>Even ride services such as Uber and Lyft, Downs said, might lead to healthier lifestyles if they influence urban dwellers to ditch their cars altogether -- someone who no longer has a car sitting in their garage may be more inclined to walk or bike.\u003c/p>\n\u003cp>One caveat: Downs said the problem with many of these solutions is they're prohibitively expensive for most people.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"People who are innovating like this really need to think about price points that are available for the masses, not just the well-off folks in Silicon Valley.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When Harry Selker was working as a cardiologist in the 1970s, clot-busting drugs were showing great promise against heart attacks. But their lifesaving properties were very time sensitive. \"If you give it within the first hour it has a 47 percent reduction of mortality; if you wait another hour, it has a 28 percent reduction; another hour, 23 percent. And people were taking about 90 minutes to make that decision,\" he recalls. \"So they were losing the opportunity to save patients' lives.\"\u003c/p>\n\u003cp>Selker envisioned a predictive tool, a kind of calculator that would help make the decision faster. He knew the data to create such a tool were already out there, from research on drugs that dissolve blood clots. \"We made mathematical models and they kind of represented that comparison from those data, and that helped us make these predictive instruments. We built them into electrocardiograms,\" Selker says. That helped physicians make better decisions.\u003c/p>\n\u003cp>The EKG-based \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/12118963\">predictive instruments\u003c/a> have helped doctors prescribe clotbusters within the hour, increasing the use of the therapy within one hour, and getting more people treated with either clotbusting drugs or angioplasty.\u003c/p>\n\u003cp>Building on this success, \u003ca href=\"https://www.tuftsmedicalcenter.org/PhysicianDirectory/Harry-Selker.aspx\">Selker \u003c/a>and colleagues at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston, where he is executive director, have gone on to develop other predictive tools, in areas from knee replacement therapy to opioid addiction treatment.\u003c/p>\n\u003cp>Selker grew up in a household in the Seattle area where he was encouraged to tinker. In his office, he proudly shows off the first automobile shock absorber, invented by his grandfather.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And while Selker's own list of patents will attest to his passion for innovation, he's equally passionate about working to ensure those innovations will have an impact.\u003c/p>\n\u003cp>One medical treatment Selker is pursuing right now has never delivered on its early promise for saving lives. It's a cocktail of glucose, insulin and potassium, known by its chemical initials GIK. In studies with baboons and rabbits more than 50 years ago, GIK seemed to actually prevent heart attacks. \"They would clamp off these coronary arteries simulating coronary thrombosis, but keep infusing them with glucose and insulin, then potassium,\" Selker says.\u003c/p>\n\u003cp>When the researchers unclamped the arteries, they found no signs of cardiac arrest, as would be expected. The simple concoction had protected heart muscles against damage. Selker says: \"So it was very encouraging. It was extraordinary, really.\"\u003c/p>\n\u003cp>But there was a problem in translation: In human studies, GIK didn't seem to do much of anything to prevent heart attacks or damage. The research sat on the shelf. But when Selker learned about the research from a colleague and they started to discuss it, he became convinced there were fatal flaws in the human studies, including administering the GIK too late to have an effect. Selker and his colleagues designed a study to test GIK in humans.\u003c/p>\n\u003cp>Paramedics in 13 cities gave people who appeared to be having a heart attack either GIK or a placebo. The GIK didn't keep people from having heart attacks, but those given it were less likely to suffer cardiac arrest or death in the hospital. It also reduced the amount of heart damage by 80 percent. The \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1151528\">results\u003c/a> were published in \u003cem>JAMA \u003c/em>in 2012.\u003c/p>\n\u003cp>Selker says that if additional research supports these findings, many lives could be saved with a simple therapy that costs less than a hundred bucks. But he soon discovered that knowing what needed to be done wasn't enough.\u003c/p>\n\u003cp>\"I thought, pretty much, my work was done and people call me up and say you know, 'when would we get this GIK stuff?' And I realized nobody's making it, nobody's selling it. And so I started talking to the pharmaceutical companies saying, 'You know, would you make this stuff?' And they basically weren't interested.\"\u003c/p>\n\u003cp>GIK is a cocktail of existing off-the-shelf ingredients. A company could invest in the additional research and work to get it out to patients, but there'd be no big payoff. But Selker refuses to be deterred.\u003c/p>\n\u003cp>He is now in dialogue with the Food and Drug Administration about the details of a definitive clinical trial to determine the effectiveness of GIK in acute coronary emergencies. And like so many times before, he's continuing to reach across professional boundaries, working with policy experts, statistical modelers, anyone who can push the process forward.\u003c/p>\n\u003cp>\"If you're going to try to improve things, you have to work on all angles, you have to work in all disciplines,\" Selker says. \"You can't just work in biology; that would never get you anywhere.\"\u003c/p>\n\u003cp>His happiest moments in research, he says, have been sitting down with people who have ideas he never could have imagined, where he gets to push and prod, challenging them to figure out how to put those ideas to use.\u003c/p>\n\u003cp>\"So working across disciplines and personalities and in different perspectives; that's the good stuff for me. Now really that makes a great day.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Selker is hopeful that the next clinical trial for GIK will take place by early next year, moving one step closer to a tested treatment that could save lives.\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=This+Doctor+Is+Trying+To+Stop+Heart+Attacks+In+Their+Tracks&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And while Selker's own list of patents will attest to his passion for innovation, he's equally passionate about working to ensure those innovations will have an impact.\u003c/p>\n\u003cp>One medical treatment Selker is pursuing right now has never delivered on its early promise for saving lives. It's a cocktail of glucose, insulin and potassium, known by its chemical initials GIK. In studies with baboons and rabbits more than 50 years ago, GIK seemed to actually prevent heart attacks. \"They would clamp off these coronary arteries simulating coronary thrombosis, but keep infusing them with glucose and insulin, then potassium,\" Selker says.\u003c/p>\n\u003cp>When the researchers unclamped the arteries, they found no signs of cardiac arrest, as would be expected. The simple concoction had protected heart muscles against damage. Selker says: \"So it was very encouraging. It was extraordinary, really.\"\u003c/p>\n\u003cp>But there was a problem in translation: In human studies, GIK didn't seem to do much of anything to prevent heart attacks or damage. The research sat on the shelf. But when Selker learned about the research from a colleague and they started to discuss it, he became convinced there were fatal flaws in the human studies, including administering the GIK too late to have an effect. Selker and his colleagues designed a study to test GIK in humans.\u003c/p>\n\u003cp>Paramedics in 13 cities gave people who appeared to be having a heart attack either GIK or a placebo. The GIK didn't keep people from having heart attacks, but those given it were less likely to suffer cardiac arrest or death in the hospital. It also reduced the amount of heart damage by 80 percent. The \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=1151528\">results\u003c/a> were published in \u003cem>JAMA \u003c/em>in 2012.\u003c/p>\n\u003cp>Selker says that if additional research supports these findings, many lives could be saved with a simple therapy that costs less than a hundred bucks. But he soon discovered that knowing what needed to be done wasn't enough.\u003c/p>\n\u003cp>\"I thought, pretty much, my work was done and people call me up and say you know, 'when would we get this GIK stuff?' And I realized nobody's making it, nobody's selling it. And so I started talking to the pharmaceutical companies saying, 'You know, would you make this stuff?' And they basically weren't interested.\"\u003c/p>\n\u003cp>GIK is a cocktail of existing off-the-shelf ingredients. A company could invest in the additional research and work to get it out to patients, but there'd be no big payoff. But Selker refuses to be deterred.\u003c/p>\n\u003cp>He is now in dialogue with the Food and Drug Administration about the details of a definitive clinical trial to determine the effectiveness of GIK in acute coronary emergencies. And like so many times before, he's continuing to reach across professional boundaries, working with policy experts, statistical modelers, anyone who can push the process forward.\u003c/p>\n\u003cp>\"If you're going to try to improve things, you have to work on all angles, you have to work in all disciplines,\" Selker says. \"You can't just work in biology; that would never get you anywhere.\"\u003c/p>\n\u003cp>His happiest moments in research, he says, have been sitting down with people who have ideas he never could have imagined, where he gets to push and prod, challenging them to figure out how to put those ideas to use.\u003c/p>\n\u003cp>\"So working across disciplines and personalities and in different perspectives; that's the good stuff for me. Now really that makes a great day.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Selker is hopeful that the next clinical trial for GIK will take place by early next year, moving one step closer to a tested treatment that could save lives.\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=This+Doctor+Is+Trying+To+Stop+Heart+Attacks+In+Their+Tracks&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When 15-year-old Billy Ellsworth stepped up to the microphone at a Food and Drug Administration public meeting in April, he had no way to know he was part of a historic shift in how the government considers the desires of patients and their advocates in evaluating new drugs.\u003c/p>\n\u003cp>Ellsworth has Duchenne muscular dystrophy, a muscle-wasting disease, that mainly affects boys. And he was taking an experimental drug that the FDA was trying to decide whether to approve.\u003c/p>\n\u003cp>\"I'm going to beat this bloody disease but I need your help,\" Billy told the scientists weighing the evidence about the drug. \"So please help me and my friends and do the right thing. FDA, please don't let me die early.\"\u003c/p>\n\u003cp>Applause swelled from the overflow crowd.\u003c/p>\n\u003cp>His testimony and other pleas like it during the 10-hour hearing clearly affected some of the scientists sitting in judgment of the experimental drug called eteplirsen. But when the scientists turned their attention to the slim evidence before them, they ultimately voted that drugmaker \u003ca href=\"https://www.sarepta.com/\">Sarepta\u003c/a> had not shown that the experimental drug was effective.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Just 12 boys had been involved in the key study, and just about everybody agreed that the research was deeply flawed. But parents of some of those boys were convinced that the drug was in fact helping delay the progression of a disease that ultimately proves fatal.\u003c/p>\n\u003cp>\"We came away really heartbroken in many ways,\" said Pat Furlong, a longtime advocate who founded \u003ca href=\"http://www.parentprojectmd.org/\">Parent Project Muscular Dystrophy\u003c/a> and who had lost two sons to the disease.\u003c/p>\n\u003cp>One similar drug had previously been rejected by the FDA, and two others were turned away before they could even get through the door. There was no approved drug to stop the progression of this disease.\u003c/p>\n\u003cp>But that wasn't the end of the story.\u003c/p>\n\u003cp>Times are changing at the FDA and other federal agencies. In recent years, legislation and regulation has pushed for a greater patient voice in decisions. The FDA's job wasn't simply to look at the science, as it has done for many years. They have \"to look to what is meaningful benefit on the part of the patients,\" Furlong said. \"What do the patients value?\"\u003c/p>\n\u003cp>In this case, the parents saw real promise in this drug, despite the results from the flawed study. They also noted that the drug appears to be safe, so there wasn't much risk. And the research did show that boys on the drug were producing a small amount of a potentially helpful protein called dystrophin, which could be a sign that the drug provides some benefit.\u003c/p>\n\u003cp>That was all part of the FDA's thinking when on Monday \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm521263.htm\">it approved\u003c/a> eteplirsen, brand name Exondys 51, on a provisional basis. A \u003ca href=\"http://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/206488_summary%20review_Redacted.pdf\">letter\u003c/a> written by FDA Commissioner Robert Califf laid out in remarkably frank terms the heated internal debate at the agency, which \u003ca href=\"https://www.statnews.com/pharmalot/2016/09/14/fda-sarepta-farkas-duchenne/\">may have led to the departure\u003c/a> of one key scientist who was opposed to approving the drug.\u003c/p>\n\u003cp>\"It is inevitable that in some of these situations, highly qualified experts will disagree,\" Califf wrote, and he praised Dr. Janet Woodcock, the head of the FDA division that reviews new drugs, who made the call \"in the face of profound changes in science and social interactions related to drugs.\"\u003c/p>\n\u003cp>Califf said Woodcock ultimately made a scientific judgment call, anchored on the observation that the drug does prompt patients to produce at least a small amount of dystrophin.\u003c/p>\n\u003cp>Yet the role of advocacy here was inescapable. It is, after all, the patients who face the risks and the benefits.\u003c/p>\n\u003cp>\"You can look at this as being a potentially damaging precedent, and on the other hand you can look of this as being an innovative precedent, that could bring good things and earlier access to medicines,\" Eric Hoffman told NPR.\u003c/p>\n\u003cp>Hoffman and Louis Kunkel \u003ca href=\"http://www.cell.com/cell/abstract/0092-8674(87)90579-4?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2F0092867487905794%3Fshowall%3Dtrue\">discovered the dystrophin gene in 1987\u003c/a>. Hoffman is now CEO of ReveraGen, a company working on a drug for the disease, as well as associate dean of research at the University of Binghamton's pharmacy school in New York.\u003c/p>\n\u003cp>The FDA decision approves the drug on an accelerated basis, but that approval is contingent on follow-up studies and it can be withdrawn. In other diseases, provisional approvals have been reversed after follow-up studies failed to show the drugs were effective. (Avastin for advanced breast cancer is \u003ca href=\"http://www.npr.org/sections/health-shots/2011/11/18/142503630/fda-pulls-approval-of-avastin-for-advanced-breast-cancer\">a notable example\u003c/a>, despite pleas from patient groups to keep the approval intact).\u003c/p>\n\u003cp>The Sarepta drug addresses just one genetic mutation in muscular dystrophy, and that particular flaw only affects about 1,500 boys in the entire United States. Drugmaker Sarepta plans to use the same approach now to target other mutations related to the disease, and to use those study results to comply with the FDA's requirement for more and better studies.\u003c/p>\n\u003cp>In the meantime, Sarepta can start charging $300,000 per patient per year for treatment with eteplirsen.\u003c/p>\n\u003cp>\"Yes, there was a lot of pressure,\" Dr. Edward Kaye, CEO of Sarepta said, \"but I think the FDA demonstrated the flexibility they are allowed under the law. It took a lot of courage for them to do this. It's always easy to take the safe path and say, just give us more data.\"\u003c/p>\n\u003cp>Advocate Pat Furlong agreed. \"I think the important aspect of this is maybe a new social contract,\" she said. Since the drug is apparently safe and possibly useful, parents wanted to make the drug available while the questions about usefulness and value are fully answered. \"And at the end of five years we can reevaluate whether this really hits its mark in terms of the healthcare cost and the benefit to patients,\" she said.\u003c/p>\n\u003cp>More than a dozen potential drugs for this disease are in the pipeline now, and at the very least they now have a standard against which they can be judged.\u003c/p>\n\u003cp>The decision about eteplirsen would have been considerably easier, for patients and scientists alike, if the company had conducted its trials carefully and rigorously.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Considering that a substantially flawed development program contributed to the difficulty of coming to resolution in this case, we must redouble our efforts to ... use methods that will produce high-quality evidence from the outset,\" Califf wrote.\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=Controversy+Continues+Over+Muscular+Dystrophy+Drug%2C+Despite+FDA+Approval&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When 15-year-old Billy Ellsworth stepped up to the microphone at a Food and Drug Administration public meeting in April, he had no way to know he was part of a historic shift in how the government considers the desires of patients and their advocates in evaluating new drugs.\u003c/p>\n\u003cp>Ellsworth has Duchenne muscular dystrophy, a muscle-wasting disease, that mainly affects boys. And he was taking an experimental drug that the FDA was trying to decide whether to approve.\u003c/p>\n\u003cp>\"I'm going to beat this bloody disease but I need your help,\" Billy told the scientists weighing the evidence about the drug. \"So please help me and my friends and do the right thing. FDA, please don't let me die early.\"\u003c/p>\n\u003cp>Applause swelled from the overflow crowd.\u003c/p>\n\u003cp>His testimony and other pleas like it during the 10-hour hearing clearly affected some of the scientists sitting in judgment of the experimental drug called eteplirsen. But when the scientists turned their attention to the slim evidence before them, they ultimately voted that drugmaker \u003ca href=\"https://www.sarepta.com/\">Sarepta\u003c/a> had not shown that the experimental drug was effective.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Just 12 boys had been involved in the key study, and just about everybody agreed that the research was deeply flawed. But parents of some of those boys were convinced that the drug was in fact helping delay the progression of a disease that ultimately proves fatal.\u003c/p>\n\u003cp>\"We came away really heartbroken in many ways,\" said Pat Furlong, a longtime advocate who founded \u003ca href=\"http://www.parentprojectmd.org/\">Parent Project Muscular Dystrophy\u003c/a> and who had lost two sons to the disease.\u003c/p>\n\u003cp>One similar drug had previously been rejected by the FDA, and two others were turned away before they could even get through the door. There was no approved drug to stop the progression of this disease.\u003c/p>\n\u003cp>But that wasn't the end of the story.\u003c/p>\n\u003cp>Times are changing at the FDA and other federal agencies. In recent years, legislation and regulation has pushed for a greater patient voice in decisions. The FDA's job wasn't simply to look at the science, as it has done for many years. They have \"to look to what is meaningful benefit on the part of the patients,\" Furlong said. \"What do the patients value?\"\u003c/p>\n\u003cp>In this case, the parents saw real promise in this drug, despite the results from the flawed study. They also noted that the drug appears to be safe, so there wasn't much risk. And the research did show that boys on the drug were producing a small amount of a potentially helpful protein called dystrophin, which could be a sign that the drug provides some benefit.\u003c/p>\n\u003cp>That was all part of the FDA's thinking when on Monday \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm521263.htm\">it approved\u003c/a> eteplirsen, brand name Exondys 51, on a provisional basis. A \u003ca href=\"http://www.accessdata.fda.gov/drugsatfda_docs/nda/2016/206488_summary%20review_Redacted.pdf\">letter\u003c/a> written by FDA Commissioner Robert Califf laid out in remarkably frank terms the heated internal debate at the agency, which \u003ca href=\"https://www.statnews.com/pharmalot/2016/09/14/fda-sarepta-farkas-duchenne/\">may have led to the departure\u003c/a> of one key scientist who was opposed to approving the drug.\u003c/p>\n\u003cp>\"It is inevitable that in some of these situations, highly qualified experts will disagree,\" Califf wrote, and he praised Dr. Janet Woodcock, the head of the FDA division that reviews new drugs, who made the call \"in the face of profound changes in science and social interactions related to drugs.\"\u003c/p>\n\u003cp>Califf said Woodcock ultimately made a scientific judgment call, anchored on the observation that the drug does prompt patients to produce at least a small amount of dystrophin.\u003c/p>\n\u003cp>Yet the role of advocacy here was inescapable. It is, after all, the patients who face the risks and the benefits.\u003c/p>\n\u003cp>\"You can look at this as being a potentially damaging precedent, and on the other hand you can look of this as being an innovative precedent, that could bring good things and earlier access to medicines,\" Eric Hoffman told NPR.\u003c/p>\n\u003cp>Hoffman and Louis Kunkel \u003ca href=\"http://www.cell.com/cell/abstract/0092-8674(87)90579-4?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2F0092867487905794%3Fshowall%3Dtrue\">discovered the dystrophin gene in 1987\u003c/a>. Hoffman is now CEO of ReveraGen, a company working on a drug for the disease, as well as associate dean of research at the University of Binghamton's pharmacy school in New York.\u003c/p>\n\u003cp>The FDA decision approves the drug on an accelerated basis, but that approval is contingent on follow-up studies and it can be withdrawn. In other diseases, provisional approvals have been reversed after follow-up studies failed to show the drugs were effective. (Avastin for advanced breast cancer is \u003ca href=\"http://www.npr.org/sections/health-shots/2011/11/18/142503630/fda-pulls-approval-of-avastin-for-advanced-breast-cancer\">a notable example\u003c/a>, despite pleas from patient groups to keep the approval intact).\u003c/p>\n\u003cp>The Sarepta drug addresses just one genetic mutation in muscular dystrophy, and that particular flaw only affects about 1,500 boys in the entire United States. Drugmaker Sarepta plans to use the same approach now to target other mutations related to the disease, and to use those study results to comply with the FDA's requirement for more and better studies.\u003c/p>\n\u003cp>In the meantime, Sarepta can start charging $300,000 per patient per year for treatment with eteplirsen.\u003c/p>\n\u003cp>\"Yes, there was a lot of pressure,\" Dr. Edward Kaye, CEO of Sarepta said, \"but I think the FDA demonstrated the flexibility they are allowed under the law. It took a lot of courage for them to do this. It's always easy to take the safe path and say, just give us more data.\"\u003c/p>\n\u003cp>Advocate Pat Furlong agreed. \"I think the important aspect of this is maybe a new social contract,\" she said. Since the drug is apparently safe and possibly useful, parents wanted to make the drug available while the questions about usefulness and value are fully answered. \"And at the end of five years we can reevaluate whether this really hits its mark in terms of the healthcare cost and the benefit to patients,\" she said.\u003c/p>\n\u003cp>More than a dozen potential drugs for this disease are in the pipeline now, and at the very least they now have a standard against which they can be judged.\u003c/p>\n\u003cp>The decision about eteplirsen would have been considerably easier, for patients and scientists alike, if the company had conducted its trials carefully and rigorously.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Considering that a substantially flawed development program contributed to the difficulty of coming to resolution in this case, we must redouble our efforts to ... use methods that will produce high-quality evidence from the outset,\" Califf wrote.\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=Controversy+Continues+Over+Muscular+Dystrophy+Drug%2C+Despite+FDA+Approval&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "U.N. Takes 'Historic' Action Against Antibiotic Resistance",
"title": "U.N. Takes 'Historic' Action Against Antibiotic Resistance",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Historic. A possible turning point.\u003c/p>\n\u003cp>These are the words health researchers are using to describe a declaration passed Wednesday by the U.N. General Assembly aiming to slow down the spread of superbugs — bacteria that have become resistant to antibiotics.\u003c/p>\n\u003cp>\"I think the declaration will have very strong implications,\" says the \u003ca href=\"http://www.who.int/en/\">World Health Organization's\u003c/a> Dr. Keiji Fukuda. \"What it will convey is that there's recognition that we have a big problem and there's a commitment to do something about it.\"\u003c/p>\n\u003cp>Every year, more than 2 million Americans get sick with antibiotic-resistant infections, and tens of thousands die as a result, \u003ca href=\"http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf\">says\u003c/a> the Centers for Disease Control and Prevention. Common diseases, like urinary tract infections and pneumonia, are becoming harder and harder to treat. And new superbugs are \u003ca href=\"http://www.npr.org/sections/health-shots/2016/05/26/479639936/germ-resistant-to-antibiotic-of-last-resort-appears-in-u-s\">cropping up\u003c/a> — even here in the U.S. — that are resistant to last-resort drugs.\u003c/p>\n\u003cp>Doctors have been warning about this problem for decades. But in the past year or so, another group of researchers has started taking interest in superbugs: economists. And they quickly realized the problem goes way beyond health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Antibiotic resistance has immense economic consequences and immense implications for food,\" Fukuda says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There's recognition that we have a big problem and there's a commitment to do something about it.'\u003ccite>Dr. Keiji Fukuda, World Health Organization\u003c/cite>\u003c/aside>\n\u003cp>A recent \u003ca href=\"http://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf\">report\u003c/a> from the U.K. government found that antibiotic-resistant bacteria could cost the world $100 trillion by 2050 if nothing is done about it. The World Bank \u003ca href=\"http://www.worldbank.org/en/news/press-release/2016/09/18/by-2050-drug-resistant-infections-could-cause-global-economic-damage-on-par-with-2008-financial-crisis\">predicts\u003c/a> drug-resistant infections could damage the economy as much as — or even more than — the 2008 financial crisis. And annual global GDP could drop by 1 to 4 percent, the agency says.\u003c/p>\n\u003cp>On top of that, farmers around the world have come to rely on antibiotics to raise animals. The drugs make pigs, cows and chickens grow fatter more quickly — and keeps them healthy in densely packed quarters.\u003c/p>\n\u003cp>\"If we lose that ability we begin to perhaps lose the ability to have adequate food supplies in the world,\" Fukuda says.\u003c/p>\n\u003cp>And that's why world leaders are now getting involved. The U.N.'s declaration requires countries to come up with a two-year a plan to protect the potency of antibiotics. Countries need to create ways to monitor the use of antibiotics in medicine and agriculture, start curbing that use and begin developing new antibiotics that work.\u003c/p>\n\u003cfigure id=\"attachment_250257\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-250257\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Staph.-aureus-800x541.jpg\" alt=\"Staphylococcus Aureus in biofilm, magnified.\" width=\"800\" height=\"541\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-800x541.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-400x270.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-768x519.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-960x649.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Staphylococcus Aureus in biofilm, magnified. \u003ccite>(Janice Carr/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After two years, the U.N.'s secretary-general will assess each country's plan and check to make sure each is making progress.\u003c/p>\n\u003cp>\"I think this is the first realistic chance, in our lifetime, to turn this around,\" Fukuda says.\u003c/p>\n\u003cp>And there's precedent for this optimism.\u003c/p>\n\u003cp>Back in 2001, the U.N. made a \u003ca href=\"http://www.un.org/ga/aids/coverage/FinalDeclarationHIVAIDS.html\">similar declaration\u003c/a> about the HIV pandemic. And that declaration had a big impact on curbing the spread of HIV around the world, says \u003ca href=\"http://www.cddep.org/profile/ramanan_laxminarayan#sthash.UiH1YYRk.dpbs\">Ramanan Laxminarayan\u003c/a>, who directs the Center for Disease Dynamics, Economics & Policy in Washington, D.C.\u003c/p>\n\u003cp>\u003cem>\"\u003c/em>The declaration made countries take responsibility for the HIV burden,\" he says. People were willing to start talking about and change their attitudes on stigma. And last but not least, the declaration made sure that lots of money went towards both treatment and prevention.\"\u003c/p>\n\u003cp>He says there are a few weaknesses in the U.N.'s new plan on antibiotic-resistant bacteria. For example, there are no hardcore targets for reducing antibiotic use by a certain amount in two years.\u003c/p>\n\u003cp>But he thinks the declaration could have the same impact on fighting antibiotic-resistant bacteria as the previous one had on fighting HIV. Since 2004, there \u003ca href=\"http://www.npr.org/sections/goatsandsoda/2016/09/15/493760787/why-the-u-s-is-pledging-4-3-billion-to-the-global-fund\">has been\u003c/a> a 45 percent drop in AIDS-related deaths in countries supported by global HIV campaigns.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Am I optimistic? I certainly am,\" he says. \"In fact, we don't have a choice. We have to do better than we're doing right now because tens of thousands of people are now dying around the world, particularly newborns. And this is surely getting worse year by year.\"\u003c/p>\n\n",
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"excerpt": "An unprecedented U.N. declaration requires countries to come up with a two-year plan to protect the potency of antibiotics.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Historic. A possible turning point.\u003c/p>\n\u003cp>These are the words health researchers are using to describe a declaration passed Wednesday by the U.N. General Assembly aiming to slow down the spread of superbugs — bacteria that have become resistant to antibiotics.\u003c/p>\n\u003cp>\"I think the declaration will have very strong implications,\" says the \u003ca href=\"http://www.who.int/en/\">World Health Organization's\u003c/a> Dr. Keiji Fukuda. \"What it will convey is that there's recognition that we have a big problem and there's a commitment to do something about it.\"\u003c/p>\n\u003cp>Every year, more than 2 million Americans get sick with antibiotic-resistant infections, and tens of thousands die as a result, \u003ca href=\"http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf\">says\u003c/a> the Centers for Disease Control and Prevention. Common diseases, like urinary tract infections and pneumonia, are becoming harder and harder to treat. And new superbugs are \u003ca href=\"http://www.npr.org/sections/health-shots/2016/05/26/479639936/germ-resistant-to-antibiotic-of-last-resort-appears-in-u-s\">cropping up\u003c/a> — even here in the U.S. — that are resistant to last-resort drugs.\u003c/p>\n\u003cp>Doctors have been warning about this problem for decades. But in the past year or so, another group of researchers has started taking interest in superbugs: economists. And they quickly realized the problem goes way beyond health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Antibiotic resistance has immense economic consequences and immense implications for food,\" Fukuda says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There's recognition that we have a big problem and there's a commitment to do something about it.'\u003ccite>Dr. Keiji Fukuda, World Health Organization\u003c/cite>\u003c/aside>\n\u003cp>A recent \u003ca href=\"http://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf\">report\u003c/a> from the U.K. government found that antibiotic-resistant bacteria could cost the world $100 trillion by 2050 if nothing is done about it. The World Bank \u003ca href=\"http://www.worldbank.org/en/news/press-release/2016/09/18/by-2050-drug-resistant-infections-could-cause-global-economic-damage-on-par-with-2008-financial-crisis\">predicts\u003c/a> drug-resistant infections could damage the economy as much as — or even more than — the 2008 financial crisis. And annual global GDP could drop by 1 to 4 percent, the agency says.\u003c/p>\n\u003cp>On top of that, farmers around the world have come to rely on antibiotics to raise animals. The drugs make pigs, cows and chickens grow fatter more quickly — and keeps them healthy in densely packed quarters.\u003c/p>\n\u003cp>\"If we lose that ability we begin to perhaps lose the ability to have adequate food supplies in the world,\" Fukuda says.\u003c/p>\n\u003cp>And that's why world leaders are now getting involved. The U.N.'s declaration requires countries to come up with a two-year a plan to protect the potency of antibiotics. Countries need to create ways to monitor the use of antibiotics in medicine and agriculture, start curbing that use and begin developing new antibiotics that work.\u003c/p>\n\u003cfigure id=\"attachment_250257\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-250257\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Staph.-aureus-800x541.jpg\" alt=\"Staphylococcus Aureus in biofilm, magnified.\" width=\"800\" height=\"541\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-800x541.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-400x270.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-768x519.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus-960x649.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Staph.-aureus.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Staphylococcus Aureus in biofilm, magnified. \u003ccite>(Janice Carr/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>After two years, the U.N.'s secretary-general will assess each country's plan and check to make sure each is making progress.\u003c/p>\n\u003cp>\"I think this is the first realistic chance, in our lifetime, to turn this around,\" Fukuda says.\u003c/p>\n\u003cp>And there's precedent for this optimism.\u003c/p>\n\u003cp>Back in 2001, the U.N. made a \u003ca href=\"http://www.un.org/ga/aids/coverage/FinalDeclarationHIVAIDS.html\">similar declaration\u003c/a> about the HIV pandemic. And that declaration had a big impact on curbing the spread of HIV around the world, says \u003ca href=\"http://www.cddep.org/profile/ramanan_laxminarayan#sthash.UiH1YYRk.dpbs\">Ramanan Laxminarayan\u003c/a>, who directs the Center for Disease Dynamics, Economics & Policy in Washington, D.C.\u003c/p>\n\u003cp>\u003cem>\"\u003c/em>The declaration made countries take responsibility for the HIV burden,\" he says. People were willing to start talking about and change their attitudes on stigma. And last but not least, the declaration made sure that lots of money went towards both treatment and prevention.\"\u003c/p>\n\u003cp>He says there are a few weaknesses in the U.N.'s new plan on antibiotic-resistant bacteria. For example, there are no hardcore targets for reducing antibiotic use by a certain amount in two years.\u003c/p>\n\u003cp>But he thinks the declaration could have the same impact on fighting antibiotic-resistant bacteria as the previous one had on fighting HIV. Since 2004, there \u003ca href=\"http://www.npr.org/sections/goatsandsoda/2016/09/15/493760787/why-the-u-s-is-pledging-4-3-billion-to-the-global-fund\">has been\u003c/a> a 45 percent drop in AIDS-related deaths in countries supported by global HIV campaigns.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Am I optimistic? I certainly am,\" he says. \"In fact, we don't have a choice. We have to do better than we're doing right now because tens of thousands of people are now dying around the world, particularly newborns. And this is surely getting worse year by year.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>My mother swears I learned to read by watching \u003cem>The Electric Company\u003c/em> on TV, so maybe that's why I was initially a bit lax when it came to my daughter and screen time.\u003c/p>\n\u003cp>But after realizing she would be perfectly content to spend every free minute switching between the PBS Kids app and \u003ca href=\"http://www.npr.org/templates/transcript/transcript.php?storyId=348241139\">toy unboxing videos\u003c/a> on YouTube, my husband and I drew several lines in the sand and drastically limited her screen use by both time and content.\u003c/p>\n\u003cp>She's only 4, which means that we still face years of decisions surrounding smartphones, Minecraft, Snapchat and the yet-to-be developed apps, games and devices that will be competing for kids' attention in the years to come. And it's not only her I'm worried about; my own habits of constantly checking email after 6:30 p.m. and reading political Facebook posts at any hour make me anxious.\u003c/p>\n\u003cp>In short, like many parents, I'm confused.\u003c/p>\n\u003cp>Most families have accepted digital technology into their homes, but many of us are unclear on how to use it wisely. And we worry about the mental and physical effects that excess tech may be having on our kids and ourselves. \u003ca href=\"http://www.familiesmanagingmedia.com/club-unplug-for-moms/about-us/\">Melanie Hempe\u003c/a>, founder and executive director of the nonprofit Families Managing Media in Charlotte, N.C., says she is concerned that overuse of digital technology isolates, rather than brings together, parents and kids both emotionally and physically. It also takes them away from activities that are shown to benefit their bodies and brains, like playing outside with a friend or reading a book. Here are some guiding principles for parenting in the digital age from conversations with Hempe and other experts:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Be aware that not all tech is the same. \u003c/strong>Rather than making rules based strictly on screen time, figure out what your kids are actually doing when they're on the computer or their phone, says \u003ca href=\"http://www.raisingdigitalnatives.com/about/\">Devorah Heitner\u003c/a>, who founded \u003ca href=\"http://www.raisingdigitalnatives.com/\">Raising Digital Natives\u003c/a> and is the author of \u003cem>Screenwise: Helping Kids Thrive (and Survive) in Their Digital World\u003c/em>. Ask them to show you exactly which sites they visit and how they spend their time. They might be doing homework, composing music or writing a novel. Or they might be playing a first-person shooter game or following the Kardashians' every move on Instagram. Your limits on their use are likely to vary accordingly.\u003c/p>\n\u003cp>If you're concerned about compulsive use, current research suggests that online games seem to be the technology most likely to \"potentially result in problems,\" says \u003ca href=\"http://www4.ntu.ac.uk/apps/staff_profiles/staff_directory/9925a18a-4fcb-4e32-aa68-b970f37b8f9d-0/26/profile.aspx?deptcode=SOC&deptTitle=School%20of%20Social%20Sciences&page=6\">Daria Kuss\u003c/a>, a psychologist and member of the International Gaming Research Unit at Nottingham Trent University in the U.K. \"They're highly interactive and can engage players to such an extent that they easily forget about the time and their environment.\" (\u003ca href=\"http://www.dsm5.org/Documents/Internet%20Gaming%20Disorder%20Fact%20Sheet.pdf\">Internet gaming disorder\u003c/a> is identified in the current \u003cem>Diagnostic and Statistical Manual,\u003c/em> the \u003cem>DSM-5,\u003c/em> as a condition that warrants further study.) That doesn't mean your kid can't game, but it does mean you might want to be more alert to the potential for problems if that's his main online activity.\u003c/p>\n\u003cp>\u003cstrong>Think about the role tech plays in your family life.\u003c/strong> \"You should be focused on your values and what you think is important,\" says Hempe. Does everyone sit around the living room watching their own shows on their own iPads? Maybe it's time to institute family game or movie night. Can your children name three things they like to do as much as or more than an online activity? If not, maybe it's time to help them broaden their horizons. Do you spend more time posting witty remarks on Twitter than saying them out loud to your spouse? Schedule a regular tech-free date night.\u003c/p>\n\u003cp>\u003cstrong>Model good behavior, online and off.\u003c/strong> \"We've fallen into this mental sinkhole where we get a communication and feel we have to respond to it,\" says \u003ca href=\"http://drlarryrosen.com/\">Larry Rosen\u003c/a>, a psychologist and professor emeritus at California State University, Dominguez Hills. That didn't happen overnight, but by now many people feel compelled to check social media constantly and to read and respond to emails and texts within minutes.\u003c/p>\n\u003cp>\"We act out of this creeping anxiety of not being current,\" says Rosen, who is co-author of \u003cem>The Distracted Mind: Ancient Brains in a High-Tech World\u003c/em>. And if your kids see you drop everything to respond to an email during dinner, they're going to get the idea that it's OK to drop everything and respond to a text during their homework.\u003c/p>\n\u003cp>Rosen suggests weaning yourself by taking increasingly long tech breaks during the day, starting at one minute and working up to 30 minutes. And help kids with their own connectivity anxiety by telling them they're not bad friends if they aren't immediately answering a late-night text, says Heitner. \"Model boundaries, and model being unplugged,\" she says.\u003c/p>\n\u003cp>Also, show your kids when and how to take your communications offline. \"Show you need to be able to go to someone face to face to resolve relationship difficulties,\" says Heitner. \"Show them how to move away from an Instagram comment to 'I'm sorry I hurt your feelings.' \"\u003c/p>\n\u003cp>\u003cstrong>Have tech-free zones and times.\u003c/strong> One way to help everyone curb overuse is to create tech-free zones, says Rosen. Those can be geographical, like banning technology at the kitchen table or bathroom. Removing smartphones and tablets from the bedroom is also helpful — at the very least, take out the devices a few hours before bedtime, since for a variety of reasons, they seem to contribute to poor sleep.\u003c/p>\n\u003cp>One \u003ca href=\"http://www.smrv-journal.com/article/S1087-0792(14)00081-1/abstract\">2014 review of research\u003c/a> found an association between more screen time and later bedtimes and shorter sleep lengths in kids and teens. And a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/26791323\">study published this year\u003c/a> found that young adults who reported greater social media use also had greater odds of a sleep disturbance.\u003c/p>\n\u003cp>You can also carve out time or situations where no tech is permitted. \u003ca href=\"http://www.steelcounseling.com/\">Ann Steel\u003c/a>, a licensed mental health counselor and former practicing physician in Seattle who sees a lot of patients with technology dependence, suggests one family tech-free day a week. Or require everyone to turn devices off during family dinners or car rides.\u003c/p>\n\u003cp>\u003cstrong>Let them learn for themselves.\u003c/strong> Heitner is a firm believer in allowing your kids to come to their own conclusions about tech when at all possible. That may mean allowing them to face the natural consequences of staying up late chatting online the night before a test. Or it could be letting them figure out for themselves the benefits of being unplugged during \u003ca href=\"http://www.npr.org/2016/08/11/489661961/summer-camps-struggle-to-enforce-bans-on-screen-time\">tech-free periods like sleepaway camp\u003c/a>. But on the other hand, you know your kids, and it's perfectly fine to step in and curb their technology adoption if you think they can't handle it. \"If you think your kid is too immature to get a phone, don't discount that,\" she says.\u003c/p>\n\u003cp>\u003cstrong>Keep an eye out for signs of serious trouble.\u003c/strong> \"There's a continuum of behavior,\" says Heitner. Just because you have a hard time tearing your child away from Minecraft doesn't mean he's \"addicted.\" But in some cases kids can have serious issues with technology — whether it's gaming, social media or something else — that require professional help. If your kid is using tech to the exclusion of things like sleeping, friends and school and can't change his or her ways, Steel says, it may be time to seek out therapy.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Katherine Hobson is a freelance health and science writer based in Brooklyn, N.Y. She's on Twitter:\u003c/em> \u003ca href=\"https://twitter.com/katherinehobson\">@katherinehobson\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Trying+To+Get+The+Kids+To+Put+Down+Those+Phones%3F+Here%27s+Help&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>My mother swears I learned to read by watching \u003cem>The Electric Company\u003c/em> on TV, so maybe that's why I was initially a bit lax when it came to my daughter and screen time.\u003c/p>\n\u003cp>But after realizing she would be perfectly content to spend every free minute switching between the PBS Kids app and \u003ca href=\"http://www.npr.org/templates/transcript/transcript.php?storyId=348241139\">toy unboxing videos\u003c/a> on YouTube, my husband and I drew several lines in the sand and drastically limited her screen use by both time and content.\u003c/p>\n\u003cp>She's only 4, which means that we still face years of decisions surrounding smartphones, Minecraft, Snapchat and the yet-to-be developed apps, games and devices that will be competing for kids' attention in the years to come. And it's not only her I'm worried about; my own habits of constantly checking email after 6:30 p.m. and reading political Facebook posts at any hour make me anxious.\u003c/p>\n\u003cp>In short, like many parents, I'm confused.\u003c/p>\n\u003cp>Most families have accepted digital technology into their homes, but many of us are unclear on how to use it wisely. And we worry about the mental and physical effects that excess tech may be having on our kids and ourselves. \u003ca href=\"http://www.familiesmanagingmedia.com/club-unplug-for-moms/about-us/\">Melanie Hempe\u003c/a>, founder and executive director of the nonprofit Families Managing Media in Charlotte, N.C., says she is concerned that overuse of digital technology isolates, rather than brings together, parents and kids both emotionally and physically. It also takes them away from activities that are shown to benefit their bodies and brains, like playing outside with a friend or reading a book. Here are some guiding principles for parenting in the digital age from conversations with Hempe and other experts:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Be aware that not all tech is the same. \u003c/strong>Rather than making rules based strictly on screen time, figure out what your kids are actually doing when they're on the computer or their phone, says \u003ca href=\"http://www.raisingdigitalnatives.com/about/\">Devorah Heitner\u003c/a>, who founded \u003ca href=\"http://www.raisingdigitalnatives.com/\">Raising Digital Natives\u003c/a> and is the author of \u003cem>Screenwise: Helping Kids Thrive (and Survive) in Their Digital World\u003c/em>. Ask them to show you exactly which sites they visit and how they spend their time. They might be doing homework, composing music or writing a novel. Or they might be playing a first-person shooter game or following the Kardashians' every move on Instagram. Your limits on their use are likely to vary accordingly.\u003c/p>\n\u003cp>If you're concerned about compulsive use, current research suggests that online games seem to be the technology most likely to \"potentially result in problems,\" says \u003ca href=\"http://www4.ntu.ac.uk/apps/staff_profiles/staff_directory/9925a18a-4fcb-4e32-aa68-b970f37b8f9d-0/26/profile.aspx?deptcode=SOC&deptTitle=School%20of%20Social%20Sciences&page=6\">Daria Kuss\u003c/a>, a psychologist and member of the International Gaming Research Unit at Nottingham Trent University in the U.K. \"They're highly interactive and can engage players to such an extent that they easily forget about the time and their environment.\" (\u003ca href=\"http://www.dsm5.org/Documents/Internet%20Gaming%20Disorder%20Fact%20Sheet.pdf\">Internet gaming disorder\u003c/a> is identified in the current \u003cem>Diagnostic and Statistical Manual,\u003c/em> the \u003cem>DSM-5,\u003c/em> as a condition that warrants further study.) That doesn't mean your kid can't game, but it does mean you might want to be more alert to the potential for problems if that's his main online activity.\u003c/p>\n\u003cp>\u003cstrong>Think about the role tech plays in your family life.\u003c/strong> \"You should be focused on your values and what you think is important,\" says Hempe. Does everyone sit around the living room watching their own shows on their own iPads? Maybe it's time to institute family game or movie night. Can your children name three things they like to do as much as or more than an online activity? If not, maybe it's time to help them broaden their horizons. Do you spend more time posting witty remarks on Twitter than saying them out loud to your spouse? Schedule a regular tech-free date night.\u003c/p>\n\u003cp>\u003cstrong>Model good behavior, online and off.\u003c/strong> \"We've fallen into this mental sinkhole where we get a communication and feel we have to respond to it,\" says \u003ca href=\"http://drlarryrosen.com/\">Larry Rosen\u003c/a>, a psychologist and professor emeritus at California State University, Dominguez Hills. That didn't happen overnight, but by now many people feel compelled to check social media constantly and to read and respond to emails and texts within minutes.\u003c/p>\n\u003cp>\"We act out of this creeping anxiety of not being current,\" says Rosen, who is co-author of \u003cem>The Distracted Mind: Ancient Brains in a High-Tech World\u003c/em>. And if your kids see you drop everything to respond to an email during dinner, they're going to get the idea that it's OK to drop everything and respond to a text during their homework.\u003c/p>\n\u003cp>Rosen suggests weaning yourself by taking increasingly long tech breaks during the day, starting at one minute and working up to 30 minutes. And help kids with their own connectivity anxiety by telling them they're not bad friends if they aren't immediately answering a late-night text, says Heitner. \"Model boundaries, and model being unplugged,\" she says.\u003c/p>\n\u003cp>Also, show your kids when and how to take your communications offline. \"Show you need to be able to go to someone face to face to resolve relationship difficulties,\" says Heitner. \"Show them how to move away from an Instagram comment to 'I'm sorry I hurt your feelings.' \"\u003c/p>\n\u003cp>\u003cstrong>Have tech-free zones and times.\u003c/strong> One way to help everyone curb overuse is to create tech-free zones, says Rosen. Those can be geographical, like banning technology at the kitchen table or bathroom. Removing smartphones and tablets from the bedroom is also helpful — at the very least, take out the devices a few hours before bedtime, since for a variety of reasons, they seem to contribute to poor sleep.\u003c/p>\n\u003cp>One \u003ca href=\"http://www.smrv-journal.com/article/S1087-0792(14)00081-1/abstract\">2014 review of research\u003c/a> found an association between more screen time and later bedtimes and shorter sleep lengths in kids and teens. And a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/26791323\">study published this year\u003c/a> found that young adults who reported greater social media use also had greater odds of a sleep disturbance.\u003c/p>\n\u003cp>You can also carve out time or situations where no tech is permitted. \u003ca href=\"http://www.steelcounseling.com/\">Ann Steel\u003c/a>, a licensed mental health counselor and former practicing physician in Seattle who sees a lot of patients with technology dependence, suggests one family tech-free day a week. Or require everyone to turn devices off during family dinners or car rides.\u003c/p>\n\u003cp>\u003cstrong>Let them learn for themselves.\u003c/strong> Heitner is a firm believer in allowing your kids to come to their own conclusions about tech when at all possible. That may mean allowing them to face the natural consequences of staying up late chatting online the night before a test. Or it could be letting them figure out for themselves the benefits of being unplugged during \u003ca href=\"http://www.npr.org/2016/08/11/489661961/summer-camps-struggle-to-enforce-bans-on-screen-time\">tech-free periods like sleepaway camp\u003c/a>. But on the other hand, you know your kids, and it's perfectly fine to step in and curb their technology adoption if you think they can't handle it. \"If you think your kid is too immature to get a phone, don't discount that,\" she says.\u003c/p>\n\u003cp>\u003cstrong>Keep an eye out for signs of serious trouble.\u003c/strong> \"There's a continuum of behavior,\" says Heitner. Just because you have a hard time tearing your child away from Minecraft doesn't mean he's \"addicted.\" But in some cases kids can have serious issues with technology — whether it's gaming, social media or something else — that require professional help. If your kid is using tech to the exclusion of things like sleeping, friends and school and can't change his or her ways, Steel says, it may be time to seek out therapy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Katherine Hobson is a freelance health and science writer based in Brooklyn, N.Y. She's on Twitter:\u003c/em> \u003ca href=\"https://twitter.com/katherinehobson\">@katherinehobson\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Trying+To+Get+The+Kids+To+Put+Down+Those+Phones%3F+Here%27s+Help&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Lipedema: The Fat Disorder That Millions Have But No One Has Heard Of",
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"content": "\u003cp>In college Judy Maggiore remembers looking in the mirror, perplexed by her body’s disproportion.\u003c/p>\n\u003cp>\"I was skinny. I was a stick. The upper part of my body was really, really thin. You could see my ribs!\" exclaims Maggiore. \"But from the waist down, it was like there were two of me or something.\"\u003c/p>\n\u003cp>Tree trunk-like legs and a slim upper body are the signature characteristic of a lipedema patient. You can starve yourself and exercise for hours a day and the fat will not regress. But Maggiore didn’t know that at the time. She swore off bathing suits and hit the gym fanatically.\u003c/p>\n\u003cp>Even though she was mystified by her body, she didn't consider going to the doctor. \"Clearly, there was something wrong with me. I wasn’t eating the right things. I wasn’t exercising correctly.\"\u003c/p>\n\u003cfigure id=\"attachment_244616\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-244616 size-medium\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/IMG_0761-800x600.jpg\" alt=\"Judy Maggiore eats a salad everyday for lunch. \" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Judy Maggiore eats a salad every day for lunch. \u003ccite>(Lesley McClurg/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yet she tried every diet imaginable, from Atkins to Weight Watchers to Jenny Craig. Nothing worked.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Finally, last year -- when she was 68 years old -- a lymphatic specialist shocked her with a diagnosis of lipedema.\u003c/p>\n\u003cp>\"I was like, 'Whoa!'\" exclaims Maggiore. \"I’ve never heard that before. They have a name for it and it’s not my fault!\"\u003c/p>\n\u003cp>\u003cstrong>Tricky Diagnosis\u003c/strong>\u003c/p>\n\u003cp>Lipedema is a lymphatic disease that is thought to affect 10 to 17 million people in America, mostly women. Exact patient estimates are not available because it’s hard to diagnose. In fact, many lipedema patients don’t even know they have it. Neither do their physicians, who often assume their patients are obese. Plus, doctors often confuse lipedema with lymphedema -- a prevalent lymphatic disease that presents similar symptoms. Maggiore says every doctor she saw throughout her life told her she needed to lose weight.\u003c/p>\n\u003cp>There isn’t a standard exam like a blood or urine test for lipedema. Instead, doctors use physical clues, like the unusual texture of the skin. It starts to feel like sand, then pebbles, and then small stones. The fat cells keep enlarging and increasing.\u003c/p>\n\u003cp>\"It’s like being wrapped in bubble wrap,\" says Maggiore.\u003cb>\u003cbr>\n\u003c/b>\u003c/p>\n\u003cp>The causes are mysterious too, although early \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/20358611\" target=\"_blank\">studies\u003c/a> suggest lipedema is a genetic condition in women. It seems the disease is hormonally triggered, as the onset is usually around puberty, and symptoms worsen during childbirth and menopause.\u003c/p>\n\u003cp>\"We just have the earliest clues about where to look and what to think about,\" says \u003ca href=\"https://med.stanford.edu/profiles/stanley-rockson\" target=\"_blank\">Dr. Stanley Rockson\u003c/a>, a professor and researcher at Stanford University.\u003c/p>\n\u003cp>Usually fat cells increase when you overeat, and then decrease when you diet -- but something goes awry in lipedema patients. Rockson uses the metaphor of a bank to illustrate how cells in lipedema patients work.\u003c/p>\n\u003cp>\"They’re a very unusual bank, because they accept deposits but no withdrawals,\" says Rockson. \"So once they accumulate material, it never comes out again.\"\u003c/p>\n\u003cp>Rockson is one of only a handful of lipedema specialists in the world trying to understand the disease's pathology. In a current study, he’s analyzing tissue samples from the legs and abdomen to better understand why subcutaneous fat accumulates primarily in the lower body. He’s also testing anti-inflammatory drugs that have worked on other lymphatic diseases to reduce pain. And he's one of the founders of an \u003ca href=\"http://lymphaticnetwork.org/\" target=\"_blank\">international registry\u003c/a> collecting the medical records of patients who suffer from lymphatic diseases. He hopes the research will eventually lead to treatments for the disease. As of now, doctors have few options for patients.\u003c/p>\n\u003cp>\u003cstrong>Liposuction Offers Some Hope\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The only long-term treatment is liposuction, and Judy Maggiore is terrified of surgery. But some women don’t have a choice.\u003c/p>\n\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/WPwhWfFhlYc?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen>\u003c/iframe>\u003cbr>\n\u003csmall>\u003cem>VIDEO: Marlene Simpson's liposuction surgery to treat lipedema, conducted by Dr. David Amron.\u003c/em>\u003c/small>\u003c/p>\n\u003cp>When Marlene Simpson’s scale topped three hundred pounds, she was desperate for thinner legs. She wasn't sleeping, which lead to exhaustion and made functioning at work nearly impossible.\u003c/p>\n\u003cp>But her initial appointment with a plastic surgeon was devastating. The physician denied her self-diagnosis. \"He told me that I shouldn’t believe what I see on the Internet,\" says Simpson.\u003c/p>\n\u003cp>But she didn't give up. More Internet research led her to \u003ca href=\"http://www.amronmd.com/about/meet-dr-amron/\" target=\"_blank\">Dr. David Amron\u003c/a>, a Beverly Hills surgeon. She booked a flight as soon as possible. After two surgeries, Simpson’s legs were 24 pounds lighter.\u003c/p>\n\u003cfigure id=\"attachment_244610\" class=\"wp-caption aligncenter\" style=\"max-width: 634px\">\u003cimg class=\"size-medium wp-image-244610\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Marlene-Simpson-Legs-634x600.jpg\" alt=\"Marlene Simpson's legs before and after liposuction surgery to treat her lipedema. \" width=\"634\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlene-Simpson-Legs-634x600.jpg 634w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlene-Simpson-Legs-400x378.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlene-Simpson-Legs-768x726.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlene-Simpson-Legs.jpg 774w\" sizes=\"(max-width: 634px) 100vw, 634px\">\u003cfigcaption class=\"wp-caption-text\">Marlene Simpson's legs before and after liposuction surgery to treat her lipedema.\u003c/figcaption>\u003c/figure>\n\u003cp>When she returned home to Sacramento, she felt like a new person.\u003c/p>\n\u003cp>\"It wasn’t ‘til I had surgery that I just realized that I was in a lot of pain,\" says Simpson.\u003c/p>\n\u003cp>Simpson's pain is caused by all the extra weight pressing on her nerves and lymph vessels. Over time, lipedema can be debilitating because blood clots, skin ulcers and recurrent infections can develop.\u003c/p>\n\u003cp>\u003cstrong>A Medical Unknown\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>But the relief put Simpson back $21,000 because her insurance denied the procedure. The company claims that liposuction is a cosmetic procedure, and it is not a recognized treatment for lipedema.\u003c/p>\n\u003cp>But Amron says liposuction \u003ci>does\u003c/i> work. If patients continue to diet and exercise, he swears the fat should not come back.\u003c/p>\n\u003cfigure id=\"attachment_244641\" class=\"wp-caption aligncenter\" style=\"max-width: 600px\">\u003cimg class=\"size-medium wp-image-244641\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Marlenes-fat-600x600.jpg\" alt=\"The fat that was removed from Marlene Simpson's legs during liposuction surgery. \" width=\"600\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-600x600.jpg 600w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-400x400.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-1180x1180.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-1920x1920.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-150x150.jpg 150w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat.jpg 2048w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003cfigcaption class=\"wp-caption-text\">The fat removed from Marlene Simpson's legs during liposuction surgery.\u003c/figcaption>\u003c/figure>\n\u003cp>Ninety percent of Dr. Amron’s clientele have lipedema. They come to him for liposuction.\u003c/p>\n\u003cp>\"They found their way to me about ten years ago when I started doing lipedema patients, and I’d never even heard of the condition,\" says Amron\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Ignored by the Medical Community\u003c/strong>\u003c/p>\n\u003cp>In fact, most doctors haven’t heard of lipedema. A 2004 Stanford University \u003ca href=\"http://www.journaloflymphoedema.com/media/journals/_/1108/files/jol6-1-44-9.pdf\" target=\"_blank\">study\u003c/a> showed that most U.S. medical schools spend less than 30 minutes teaching the entire lymphatic system.\u003c/p>\n\u003cp>\"So, not surprisingly, doctors don’t know a lot about these diseases or the underlying conditions,\" says Rockson. \"If you poll 100 physicians off the street, you might find one that knows the term lipedema, and that one might not have much to say about it other than a recognition of the name.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>One of his patients, Judy Maggiore, hopes to someday benefit from his research. In the meantime, her daily lunch is a bowl filled with vegetables, and even though she usually skips dinner, the flab on her legs continues to thicken, causing chronic pain. She savors each bite slowly, in hopes of keeping fat cells at bay.\u003c/p>\n\n",
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"excerpt": "Millions of women are suffering from a disease that poses as obesity. Most patients don’t know they have it, and doctors haven’t heard of it. Plus, dieting doesn’t work because the patients have abnormal fat cells that never go away. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In college Judy Maggiore remembers looking in the mirror, perplexed by her body’s disproportion.\u003c/p>\n\u003cp>\"I was skinny. I was a stick. The upper part of my body was really, really thin. You could see my ribs!\" exclaims Maggiore. \"But from the waist down, it was like there were two of me or something.\"\u003c/p>\n\u003cp>Tree trunk-like legs and a slim upper body are the signature characteristic of a lipedema patient. You can starve yourself and exercise for hours a day and the fat will not regress. But Maggiore didn’t know that at the time. She swore off bathing suits and hit the gym fanatically.\u003c/p>\n\u003cp>Even though she was mystified by her body, she didn't consider going to the doctor. \"Clearly, there was something wrong with me. I wasn’t eating the right things. I wasn’t exercising correctly.\"\u003c/p>\n\u003cfigure id=\"attachment_244616\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-244616 size-medium\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/IMG_0761-800x600.jpg\" alt=\"Judy Maggiore eats a salad everyday for lunch. \" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/IMG_0761-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Judy Maggiore eats a salad every day for lunch. \u003ccite>(Lesley McClurg/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yet she tried every diet imaginable, from Atkins to Weight Watchers to Jenny Craig. Nothing worked.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Finally, last year -- when she was 68 years old -- a lymphatic specialist shocked her with a diagnosis of lipedema.\u003c/p>\n\u003cp>\"I was like, 'Whoa!'\" exclaims Maggiore. \"I’ve never heard that before. They have a name for it and it’s not my fault!\"\u003c/p>\n\u003cp>\u003cstrong>Tricky Diagnosis\u003c/strong>\u003c/p>\n\u003cp>Lipedema is a lymphatic disease that is thought to affect 10 to 17 million people in America, mostly women. Exact patient estimates are not available because it’s hard to diagnose. In fact, many lipedema patients don’t even know they have it. Neither do their physicians, who often assume their patients are obese. Plus, doctors often confuse lipedema with lymphedema -- a prevalent lymphatic disease that presents similar symptoms. Maggiore says every doctor she saw throughout her life told her she needed to lose weight.\u003c/p>\n\u003cp>There isn’t a standard exam like a blood or urine test for lipedema. Instead, doctors use physical clues, like the unusual texture of the skin. It starts to feel like sand, then pebbles, and then small stones. The fat cells keep enlarging and increasing.\u003c/p>\n\u003cp>\"It’s like being wrapped in bubble wrap,\" says Maggiore.\u003cb>\u003cbr>\n\u003c/b>\u003c/p>\n\u003cp>The causes are mysterious too, although early \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/20358611\" target=\"_blank\">studies\u003c/a> suggest lipedema is a genetic condition in women. It seems the disease is hormonally triggered, as the onset is usually around puberty, and symptoms worsen during childbirth and menopause.\u003c/p>\n\u003cp>\"We just have the earliest clues about where to look and what to think about,\" says \u003ca href=\"https://med.stanford.edu/profiles/stanley-rockson\" target=\"_blank\">Dr. Stanley Rockson\u003c/a>, a professor and researcher at Stanford University.\u003c/p>\n\u003cp>Usually fat cells increase when you overeat, and then decrease when you diet -- but something goes awry in lipedema patients. Rockson uses the metaphor of a bank to illustrate how cells in lipedema patients work.\u003c/p>\n\u003cp>\"They’re a very unusual bank, because they accept deposits but no withdrawals,\" says Rockson. \"So once they accumulate material, it never comes out again.\"\u003c/p>\n\u003cp>Rockson is one of only a handful of lipedema specialists in the world trying to understand the disease's pathology. In a current study, he’s analyzing tissue samples from the legs and abdomen to better understand why subcutaneous fat accumulates primarily in the lower body. He’s also testing anti-inflammatory drugs that have worked on other lymphatic diseases to reduce pain. And he's one of the founders of an \u003ca href=\"http://lymphaticnetwork.org/\" target=\"_blank\">international registry\u003c/a> collecting the medical records of patients who suffer from lymphatic diseases. He hopes the research will eventually lead to treatments for the disease. As of now, doctors have few options for patients.\u003c/p>\n\u003cp>\u003cstrong>Liposuction Offers Some Hope\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The only long-term treatment is liposuction, and Judy Maggiore is terrified of surgery. But some women don’t have a choice.\u003c/p>\n\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/WPwhWfFhlYc?feature=oembed\" frameborder=\"0\" allow=\"autoplay; encrypted-media\" allowfullscreen>\u003c/iframe>\u003cbr>\n\u003csmall>\u003cem>VIDEO: Marlene Simpson's liposuction surgery to treat lipedema, conducted by Dr. David Amron.\u003c/em>\u003c/small>\u003c/p>\n\u003cp>When Marlene Simpson’s scale topped three hundred pounds, she was desperate for thinner legs. She wasn't sleeping, which lead to exhaustion and made functioning at work nearly impossible.\u003c/p>\n\u003cp>But her initial appointment with a plastic surgeon was devastating. The physician denied her self-diagnosis. \"He told me that I shouldn’t believe what I see on the Internet,\" says Simpson.\u003c/p>\n\u003cp>But she didn't give up. More Internet research led her to \u003ca href=\"http://www.amronmd.com/about/meet-dr-amron/\" target=\"_blank\">Dr. David Amron\u003c/a>, a Beverly Hills surgeon. She booked a flight as soon as possible. After two surgeries, Simpson’s legs were 24 pounds lighter.\u003c/p>\n\u003cfigure id=\"attachment_244610\" class=\"wp-caption aligncenter\" style=\"max-width: 634px\">\u003cimg class=\"size-medium wp-image-244610\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Marlene-Simpson-Legs-634x600.jpg\" alt=\"Marlene Simpson's legs before and after liposuction surgery to treat her lipedema. \" width=\"634\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlene-Simpson-Legs-634x600.jpg 634w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlene-Simpson-Legs-400x378.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlene-Simpson-Legs-768x726.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlene-Simpson-Legs.jpg 774w\" sizes=\"(max-width: 634px) 100vw, 634px\">\u003cfigcaption class=\"wp-caption-text\">Marlene Simpson's legs before and after liposuction surgery to treat her lipedema.\u003c/figcaption>\u003c/figure>\n\u003cp>When she returned home to Sacramento, she felt like a new person.\u003c/p>\n\u003cp>\"It wasn’t ‘til I had surgery that I just realized that I was in a lot of pain,\" says Simpson.\u003c/p>\n\u003cp>Simpson's pain is caused by all the extra weight pressing on her nerves and lymph vessels. Over time, lipedema can be debilitating because blood clots, skin ulcers and recurrent infections can develop.\u003c/p>\n\u003cp>\u003cstrong>A Medical Unknown\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>But the relief put Simpson back $21,000 because her insurance denied the procedure. The company claims that liposuction is a cosmetic procedure, and it is not a recognized treatment for lipedema.\u003c/p>\n\u003cp>But Amron says liposuction \u003ci>does\u003c/i> work. If patients continue to diet and exercise, he swears the fat should not come back.\u003c/p>\n\u003cfigure id=\"attachment_244641\" class=\"wp-caption aligncenter\" style=\"max-width: 600px\">\u003cimg class=\"size-medium wp-image-244641\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/09/Marlenes-fat-600x600.jpg\" alt=\"The fat that was removed from Marlene Simpson's legs during liposuction surgery. \" width=\"600\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-600x600.jpg 600w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-400x400.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-1180x1180.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-1920x1920.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat-150x150.jpg 150w, https://ww2.kqed.org/app/uploads/sites/13/2016/09/Marlenes-fat.jpg 2048w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003cfigcaption class=\"wp-caption-text\">The fat removed from Marlene Simpson's legs during liposuction surgery.\u003c/figcaption>\u003c/figure>\n\u003cp>Ninety percent of Dr. Amron’s clientele have lipedema. They come to him for liposuction.\u003c/p>\n\u003cp>\"They found their way to me about ten years ago when I started doing lipedema patients, and I’d never even heard of the condition,\" says Amron\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Ignored by the Medical Community\u003c/strong>\u003c/p>\n\u003cp>In fact, most doctors haven’t heard of lipedema. A 2004 Stanford University \u003ca href=\"http://www.journaloflymphoedema.com/media/journals/_/1108/files/jol6-1-44-9.pdf\" target=\"_blank\">study\u003c/a> showed that most U.S. medical schools spend less than 30 minutes teaching the entire lymphatic system.\u003c/p>\n\u003cp>\"So, not surprisingly, doctors don’t know a lot about these diseases or the underlying conditions,\" says Rockson. \"If you poll 100 physicians off the street, you might find one that knows the term lipedema, and that one might not have much to say about it other than a recognition of the name.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One of his patients, Judy Maggiore, hopes to someday benefit from his research. In the meantime, her daily lunch is a bowl filled with vegetables, and even though she usually skips dinner, the flab on her legs continues to thicken, causing chronic pain. She savors each bite slowly, in hopes of keeping fat cells at bay.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Dr. Lorraine Page, believe it or not, makes house calls.\u003c/p>\n\u003cp>One place she visits is the home of Ann Caponio, a one-bedroom apartment in Half Moon Bay, California. You can tell a knitter lives there: baskets of wool and hanks of yarn adorn the room, and in the corner sits a wooden spinning wheel.\u003c/p>\n\u003caside class=\"pullquote alignright\">A new model gains in popularity: no insurance but unlimited doctor visits are provided for a monthly fee.\u003c/aside>\n\u003cp>But arthritis has put an end to that hobby. And for a while, Caponio, 69, wasn't even getting out.\u003c/p>\n\u003cp>\"I kind of stopped going downtown,\" she says, in her Midland, Texas twang, a holdover from childhood. \"Omigod those stairs.\"\u003c/p>\n\u003cp>She's talking about a steep, 17-step staircase leading to her front door. Three hip replacements left negotiating them a dangerous proposition.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"I tend to fall. And I fell on those damned stairs once.\"\u003c/p>\n\u003cp>And that's where Lorraine Page enters the picture.\u003c/p>\n\u003cp>Besides the house calls, Page provides a little more than Caponio might expect from a primary care doc available through Medicare. Page, for instance, has aided her patient with a number of safety issues, including helping her find someone to rig up a chairlift on those stairs. Now, she can sit on a seat at the top and glide to the bottom.\u003c/p>\n\u003cp>\"It opens up a whole new world for me,\" Caponio says.\u003c/p>\n\u003cp>\u003cstrong>A Different Model\u003c/strong>\u003c/p>\n\u003cp>A whole new world is what Dr. Page herself has been experiencing, ever since she left the traditional clinic setting to try something different. She does have a small office, but prefers to visit most of her patients in their homes.\u003c/p>\n\u003caside class=\"pullquote alignright\">When they learn they can get off the production line, 'Doctors will be in mass exodus.'\u003ccite>Dr. Pamela Wible\u003c/cite>\u003c/aside>\n\u003cp>She's one of a growing number of doctors who have cut loose from what she calls the \"assembly-line, volume approach\" that most of her colleagues have experienced. These breakaway docs are now using a health care delivery model called direct primary care. Page has cut back on the number of patients she sees, and spends more time with the ones she does. She doesn't take insurance and deals mostly in cash. Page charges each time she sees a patient, but most direct primary care doctors bill a monthly fee for unlimited visits.\u003c/p>\n\u003cp>In her previous practice, Page says, the pressure to see more patients in less time wore her down, as did the need for an army of support staff to process the copious paperwork required by insurance companies.\u003c/p>\n\u003cp>\"At our office, we had six full-time doctors. And we had seven full-time insurance people. So [that's] more than one full-time person trying to get reimbursement for patients I was seeing.\"\u003c/p>\n\u003cp>The benefits of leaving that bureaucratic load behind includes more time with patients but shorter days as her total load has been reduced. And she's doing the kind of family-care medicine for which she was trained.\u003c/p>\n\u003cp>\"And I enjoy it a lot more,\" Page says. \"Let's not minimize that.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"vPRJXQNXVX11c9sC2BeSG7GGPJpZybhw\"]\u003c/p>\n\u003cp>\u003cstrong>What Doctors Want\u003c/strong>\u003c/p>\n\u003cp>A 2012 \u003ca href=\"http://www.medscape.com/features/slideshow/compensation/2012/public\" target=\"_blank\">Medscape study\u003c/a> found that 46 percent of primary care physicians showed such dissatisfaction with their careers, they wouldn't pursue medicine if they could choose again. Another\u003ca href=\"http://www.physiciansfoundation.org/healthcare-research/a-survey-of-americas-physicians-practice-patterns-and-perspectives\" target=\"_blank\"> study\u003c/a>, from the Physicians Foundation, found 60 percent of primary care doctors would not recommend a career in medicine. Just six percent described the morale of their colleagues as positive.\u003c/p>\n\u003cp>Overall, says Wanda Filer, president of the American Academy of Family Physicians, primary care doctors feel overworked and ineffective. \"Most patients are just rushed out the door,\" she says. \"That's not what doctors want to do. This new model of care gets the physician and the patient out of that hamster-wheel model.\"\u003c/p>\n\u003cp>Filer says about three percent of the organization's 69,000 primary care doctors have made the move to direct primary care in the past couple of years, and that number is increasing rapidly as other physicians see it succeed.\u003c/p>\n\u003cp>In fact, Filer says, her organization has taken the unusual step of convening informational seminars for the large number of family doctors who have expressed interest in getting off the grid and starting a kinder, gentler practice.\u003c/p>\n\u003cp>\u003cb>Cash and Care\u003c/b>\u003c/p>\n\u003cfigure id=\"attachment_220077\" class=\"wp-caption alignright\" style=\"max-width: 357px\">\u003cimg class=\"wp-image-220077\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/08/emiliescott1-885x1180.jpg\" alt=\"Dr. Emilie Scott of Irvine, Calif.\" width=\"357\" height=\"476\">\u003cfigcaption class=\"wp-caption-text\">Dr. Emilie Scott of Irvine, Calif., says the direct primary care model has put 'the heart back in medicine' for her. (David Gorn/KQED) \u003ccite>(David Gorn/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While direct primary care has some similarities to \u003ca href=\"http://www.healthline.com/health-news/the-future-of-healthcare-could-be-in-concierge-medicine-063015\" target=\"_blank\">concierge medicine\u003c/a>, it differs in that direct primary care rejects insurance. And, because concierge medicine sprang from wealthy patients’ desire for greater access to their doctors, patients can \u003ca href=\"http://www.wsj.com/articles/SB10001424052702303471004579165470633112630\" target=\"_blank\">pay up to thousands of dollars a month\u003c/a> for same-day appointments, round-the-clock phone access, house calls and other services.\u003c/p>\n\u003cp>In contrast, direct primary care doctors charge a relatively small monthly fee. While that can be an extra cost for those who also need insurance to cover more serious medical problems, many patients have high-deductible plans, making the monthly expense of direct primary care a good deal, especially for those who go to the doctor a lot.\u003c/p>\n\u003cp>For doctors, the main idea behind direct primary care is to simplify -- scale down, deal mostly in cash and focus on taking better care of fewer patients. This includes a good deal of listening and analysis of how a patient's current environment or life situation may be affecting their health.\u003c/p>\n\u003cp>This type of service \u003ca href=\"http://www.kevinmd.com/blog/2011/07/direct-primary-care-reduces-primary-care-costs.html\" target=\"_blank\">took off as a movement\u003c/a> in 2011, and the model was first evaluated in a 2013 \u003ca href=\"http://www.chcf.org/publications/2013/04/retainer-direct-primary-care\" target=\"_blank\">study\u003c/a> by the California Health Care Foundation. It's gaining significant traction, says Laurence Baker, the chair of Stanford University's Department of Health Research and Policy.\u003c/p>\n\u003cp>\"Absolutely it's a growing segment of primary care,\" he says. \"The model we have is challenged in a lot of ways, the longer a patient waits to see a doctor, the shorter time spent with the doctor. So we have to think about what else we can do to change that.\u003c/p>\n\u003cp>\"I would be surprised if it took over the world,\" Baker added, \"But I certainly wouldn't be surprised if it grew substantially more in the next few years.\"\u003c/p>\n\u003cp>\u003cstrong>'Doctors Will Be in Mass Exodus'\u003c/strong>\u003c/p>\n\u003cp>The reason doctors need to see so many patients in rapid succession is because of huge overhead, says Pamela Wible, a physician in Eugene, Ore., who helps doctors set up their ideal practice using the direct primary care model. In fact, she says, most doctors see just a small fraction of gross earnings.\u003c/p>\n\u003cp>But the kind of streamlined operation found in direct primary care allows doctors to keep a greater share of the money coming in, she says, even if they make less overall than in a traditional practice.\u003c/p>\n\u003cp>\"My expenses are so low, they're now about 10 percent of my practice,\" Wible says. \"And it used to be 74 percent.\"\u003c/p>\n\u003cp>Wible says the direct primary care model has at its heart the relationship between doctor and patient. She says doctors \"will be in mass exodus\" once they learn they can run their practice differently and \"get off the production line.\"\u003c/p>\n\u003cp>Dr. Emilie Scott did just that, in March. She had worked in an academic medical setting for many years, then in a large group practice for another five before venturing out on her own.\u003c/p>\n\u003cp>There are no waiting room magazines in her tiny Irvine medical office, because there is no waiting room. And that's because there is no waiting.\u003c/p>\n\u003cp>She charges her patients $59 per month. Just five months in, she says, her practice is already breaking even.\u003c/p>\n\u003cp>\"For me, it puts the heart back in medicine,\" Scott says, grinning. In the past, \"I had to see patients in a rapid style, trying to get patients out the door. It wears on you.\"\u003c/p>\n\u003cp>She understands the fear some doctors have of taking the leap, in part because of the massive debt they've incurred from medical school. But, she says, \"The point here isn't to become a millionaire. You make a good living, and you can practice in line with your values.\"\u003c/p>\n\u003cp>Scott said some of her patients are surprised at how little her service costs.\u003c/p>\n\u003cp>\"I had one woman who said she couldn't afford it but said she'd listen, and then I explained it, and she was like, 'Are we on Candid Camera or something? What's the catch?'\"\u003c/p>\n\u003cp>\u003cstrong>Shrinking the Physician Pool?\u003c/strong>\u003c/p>\n\u003cp>Janet Coffman, a health policy professor at the University of California, San Francisco, says she doesn't expect direct primary care to explode on the medical scene. Rather, she believes it will make slow and steady inroads. She doesn't think insurance companies will fight the model, even though it cuts them out of the medical care delivery system.\u003c/p>\n\u003cp>But one major effect direct primary care could have, she said, is to further shrink the already inadequate pool of primary care physicians.\u003c/p>\n\u003cp>\"If I were an insurance company, I think I'd be more concerned about recruiting and keeping PCPs because of this,\" Coffman says.\u003c/p>\n\u003cp>Betsy Imholz, director of special projects for Consumers Union, agrees that could be a concern if direct primary care catches on.\u003c/p>\n\u003cp>“Primary care is one of the least lucrative areas for doctors to go into,” Imholz says, “and therefore sometimes difficult for insurers to get sufficient numbers of.”\u003c/p>\n\u003cp>Imholz sees some other potential problems with the model. While she understands why both doctors and patients are attracted to direct primary care — “the old \u003ca href=\"https://www.youtube.com/watch?v=Y10VEkyKd3w\" target=\"_blank\">Marcus Welby\u003c/a> model,” as she puts it — she thinks it’s a move in the opposite direction of the current push for an integrated health care system. Ideally, doctors would have access to patients’ electronic health records, and \u003ca href=\"http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2014/rwjf409988\" target=\"_blank\">all-payer claims databases\u003c/a>, at least \u003ca href=\"http://www.commondreams.org/newswire/2016/08/03/all-six-states-keep-consumers-dark-cost-medical-procedures\" target=\"_blank\">theoretically\u003c/a>, would allow purchasers of insurance to compare costs.\u003c/p>\n\u003cp>“It goes against this coordinated care model that the Affordable Care Act and the U.S. is coming to,” she says, “having things not fragmented but coordinated [in a way that] enables us to check, make quality assessments.”\u003c/p>\n\u003cp>Imholz is also concerned this type of practice could attract healthier people, who might see direct primary care as a substitute for insurance rather than an extra. And that could deprive the ACA \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/03/30/theyre-sicker-plus-aca-enrollees-cost-more-in-care-major-insurer-finds/\" target=\"_blank\">risk pool \u003c/a>of the very type of patients \u003ca href=\"http://www.newsweek.com/obamacare-premiums-rise-10-percent-2017-490268\" target=\"_blank\">needed to keep cost increases manageable\u003c/a>.\u003c/p>\n\u003cp>Consumers in California, Imholz said, should also keep in mind a little-known benefit of the plans offered on the state’s health care exchange, Covered California: those plans are required to offer three visits outside of the deductible, costing only a co-pay.\u003c/p>\n\u003cp>Ultimately, she says, if patients do want to go the route of direct primary care, they should create their own \u003ca href=\"https://www.healthit.gov/providers-professionals/faqs/what-personal-health-record\" target=\"_blank\">personal health record\u003c/a> for each visit, in case at some point they need to visit a specialist for a serious health problem.\u003c/p>\n\u003cp>As to whether direct primary care will positively impact patients' health, Laurence Baker says it's not clear whether or not the longer office and home visits end up providing better care.\u003c/p>\n\u003cp>\"I'm not sure we know if this makes you healthier at the end of the day,\" Baker says. \"It will make you happier, definitely, but the jury is still out about whether it improves outcomes.\"\u003c/p>\n\u003cp>\u003cstrong>'It's Lovely'\u003c/strong>\u003c/p>\n\u003cp>Back in Half Moon Bay, physician Lorraine Page says she doesn't need data. She tries to find the words for the improvement she has seen in her life and the lives of her patients.\u003c/p>\n\u003cp>\"It's … lovely,\" she says with a laugh. \"It's just lovely. The patients do better, I get to see the whole person, the whole family. It's true family practice. And it's very straightforward. I see the person, I get paid. It's simple.\"\u003c/p>\n\u003cp>This type of practice, she says, is what many young doctors-to-be have in mind when they first think about entering medicine.\u003c/p>\n\u003cp>It's an odd twist that Page's current work is considered the cutting- edge of primary care medicine, when it so closely resembles a kind of 1950s Norman Rockwell painting of what a general practitioner is.\u003c/p>\n\u003cp>Most doctors don't even think about what they want anymore, Page says. They get caught up in the system and don't realize there's another choice.\u003c/p>\n\u003cp>But leaving was surprisingly easy.\u003c/p>\n\u003cp>\"Look, your skills are in your mind,\" Page says. \"You can do that anywhere.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Jon Brooks contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Lorraine Page, believe it or not, makes house calls.\u003c/p>\n\u003cp>One place she visits is the home of Ann Caponio, a one-bedroom apartment in Half Moon Bay, California. You can tell a knitter lives there: baskets of wool and hanks of yarn adorn the room, and in the corner sits a wooden spinning wheel.\u003c/p>\n\u003caside class=\"pullquote alignright\">A new model gains in popularity: no insurance but unlimited doctor visits are provided for a monthly fee.\u003c/aside>\n\u003cp>But arthritis has put an end to that hobby. And for a while, Caponio, 69, wasn't even getting out.\u003c/p>\n\u003cp>\"I kind of stopped going downtown,\" she says, in her Midland, Texas twang, a holdover from childhood. \"Omigod those stairs.\"\u003c/p>\n\u003cp>She's talking about a steep, 17-step staircase leading to her front door. Three hip replacements left negotiating them a dangerous proposition.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I tend to fall. And I fell on those damned stairs once.\"\u003c/p>\n\u003cp>And that's where Lorraine Page enters the picture.\u003c/p>\n\u003cp>Besides the house calls, Page provides a little more than Caponio might expect from a primary care doc available through Medicare. Page, for instance, has aided her patient with a number of safety issues, including helping her find someone to rig up a chairlift on those stairs. Now, she can sit on a seat at the top and glide to the bottom.\u003c/p>\n\u003cp>\"It opens up a whole new world for me,\" Caponio says.\u003c/p>\n\u003cp>\u003cstrong>A Different Model\u003c/strong>\u003c/p>\n\u003cp>A whole new world is what Dr. Page herself has been experiencing, ever since she left the traditional clinic setting to try something different. She does have a small office, but prefers to visit most of her patients in their homes.\u003c/p>\n\u003caside class=\"pullquote alignright\">When they learn they can get off the production line, 'Doctors will be in mass exodus.'\u003ccite>Dr. Pamela Wible\u003c/cite>\u003c/aside>\n\u003cp>She's one of a growing number of doctors who have cut loose from what she calls the \"assembly-line, volume approach\" that most of her colleagues have experienced. These breakaway docs are now using a health care delivery model called direct primary care. Page has cut back on the number of patients she sees, and spends more time with the ones she does. She doesn't take insurance and deals mostly in cash. Page charges each time she sees a patient, but most direct primary care doctors bill a monthly fee for unlimited visits.\u003c/p>\n\u003cp>In her previous practice, Page says, the pressure to see more patients in less time wore her down, as did the need for an army of support staff to process the copious paperwork required by insurance companies.\u003c/p>\n\u003cp>\"At our office, we had six full-time doctors. And we had seven full-time insurance people. So [that's] more than one full-time person trying to get reimbursement for patients I was seeing.\"\u003c/p>\n\u003cp>The benefits of leaving that bureaucratic load behind includes more time with patients but shorter days as her total load has been reduced. And she's doing the kind of family-care medicine for which she was trained.\u003c/p>\n\u003cp>\"And I enjoy it a lot more,\" Page says. \"Let's not minimize that.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>What Doctors Want\u003c/strong>\u003c/p>\n\u003cp>A 2012 \u003ca href=\"http://www.medscape.com/features/slideshow/compensation/2012/public\" target=\"_blank\">Medscape study\u003c/a> found that 46 percent of primary care physicians showed such dissatisfaction with their careers, they wouldn't pursue medicine if they could choose again. Another\u003ca href=\"http://www.physiciansfoundation.org/healthcare-research/a-survey-of-americas-physicians-practice-patterns-and-perspectives\" target=\"_blank\"> study\u003c/a>, from the Physicians Foundation, found 60 percent of primary care doctors would not recommend a career in medicine. Just six percent described the morale of their colleagues as positive.\u003c/p>\n\u003cp>Overall, says Wanda Filer, president of the American Academy of Family Physicians, primary care doctors feel overworked and ineffective. \"Most patients are just rushed out the door,\" she says. \"That's not what doctors want to do. This new model of care gets the physician and the patient out of that hamster-wheel model.\"\u003c/p>\n\u003cp>Filer says about three percent of the organization's 69,000 primary care doctors have made the move to direct primary care in the past couple of years, and that number is increasing rapidly as other physicians see it succeed.\u003c/p>\n\u003cp>In fact, Filer says, her organization has taken the unusual step of convening informational seminars for the large number of family doctors who have expressed interest in getting off the grid and starting a kinder, gentler practice.\u003c/p>\n\u003cp>\u003cb>Cash and Care\u003c/b>\u003c/p>\n\u003cfigure id=\"attachment_220077\" class=\"wp-caption alignright\" style=\"max-width: 357px\">\u003cimg class=\"wp-image-220077\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/08/emiliescott1-885x1180.jpg\" alt=\"Dr. Emilie Scott of Irvine, Calif.\" width=\"357\" height=\"476\">\u003cfigcaption class=\"wp-caption-text\">Dr. Emilie Scott of Irvine, Calif., says the direct primary care model has put 'the heart back in medicine' for her. (David Gorn/KQED) \u003ccite>(David Gorn/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While direct primary care has some similarities to \u003ca href=\"http://www.healthline.com/health-news/the-future-of-healthcare-could-be-in-concierge-medicine-063015\" target=\"_blank\">concierge medicine\u003c/a>, it differs in that direct primary care rejects insurance. And, because concierge medicine sprang from wealthy patients’ desire for greater access to their doctors, patients can \u003ca href=\"http://www.wsj.com/articles/SB10001424052702303471004579165470633112630\" target=\"_blank\">pay up to thousands of dollars a month\u003c/a> for same-day appointments, round-the-clock phone access, house calls and other services.\u003c/p>\n\u003cp>In contrast, direct primary care doctors charge a relatively small monthly fee. While that can be an extra cost for those who also need insurance to cover more serious medical problems, many patients have high-deductible plans, making the monthly expense of direct primary care a good deal, especially for those who go to the doctor a lot.\u003c/p>\n\u003cp>For doctors, the main idea behind direct primary care is to simplify -- scale down, deal mostly in cash and focus on taking better care of fewer patients. This includes a good deal of listening and analysis of how a patient's current environment or life situation may be affecting their health.\u003c/p>\n\u003cp>This type of service \u003ca href=\"http://www.kevinmd.com/blog/2011/07/direct-primary-care-reduces-primary-care-costs.html\" target=\"_blank\">took off as a movement\u003c/a> in 2011, and the model was first evaluated in a 2013 \u003ca href=\"http://www.chcf.org/publications/2013/04/retainer-direct-primary-care\" target=\"_blank\">study\u003c/a> by the California Health Care Foundation. It's gaining significant traction, says Laurence Baker, the chair of Stanford University's Department of Health Research and Policy.\u003c/p>\n\u003cp>\"Absolutely it's a growing segment of primary care,\" he says. \"The model we have is challenged in a lot of ways, the longer a patient waits to see a doctor, the shorter time spent with the doctor. So we have to think about what else we can do to change that.\u003c/p>\n\u003cp>\"I would be surprised if it took over the world,\" Baker added, \"But I certainly wouldn't be surprised if it grew substantially more in the next few years.\"\u003c/p>\n\u003cp>\u003cstrong>'Doctors Will Be in Mass Exodus'\u003c/strong>\u003c/p>\n\u003cp>The reason doctors need to see so many patients in rapid succession is because of huge overhead, says Pamela Wible, a physician in Eugene, Ore., who helps doctors set up their ideal practice using the direct primary care model. In fact, she says, most doctors see just a small fraction of gross earnings.\u003c/p>\n\u003cp>But the kind of streamlined operation found in direct primary care allows doctors to keep a greater share of the money coming in, she says, even if they make less overall than in a traditional practice.\u003c/p>\n\u003cp>\"My expenses are so low, they're now about 10 percent of my practice,\" Wible says. \"And it used to be 74 percent.\"\u003c/p>\n\u003cp>Wible says the direct primary care model has at its heart the relationship between doctor and patient. She says doctors \"will be in mass exodus\" once they learn they can run their practice differently and \"get off the production line.\"\u003c/p>\n\u003cp>Dr. Emilie Scott did just that, in March. She had worked in an academic medical setting for many years, then in a large group practice for another five before venturing out on her own.\u003c/p>\n\u003cp>There are no waiting room magazines in her tiny Irvine medical office, because there is no waiting room. And that's because there is no waiting.\u003c/p>\n\u003cp>She charges her patients $59 per month. Just five months in, she says, her practice is already breaking even.\u003c/p>\n\u003cp>\"For me, it puts the heart back in medicine,\" Scott says, grinning. In the past, \"I had to see patients in a rapid style, trying to get patients out the door. It wears on you.\"\u003c/p>\n\u003cp>She understands the fear some doctors have of taking the leap, in part because of the massive debt they've incurred from medical school. But, she says, \"The point here isn't to become a millionaire. You make a good living, and you can practice in line with your values.\"\u003c/p>\n\u003cp>Scott said some of her patients are surprised at how little her service costs.\u003c/p>\n\u003cp>\"I had one woman who said she couldn't afford it but said she'd listen, and then I explained it, and she was like, 'Are we on Candid Camera or something? What's the catch?'\"\u003c/p>\n\u003cp>\u003cstrong>Shrinking the Physician Pool?\u003c/strong>\u003c/p>\n\u003cp>Janet Coffman, a health policy professor at the University of California, San Francisco, says she doesn't expect direct primary care to explode on the medical scene. Rather, she believes it will make slow and steady inroads. She doesn't think insurance companies will fight the model, even though it cuts them out of the medical care delivery system.\u003c/p>\n\u003cp>But one major effect direct primary care could have, she said, is to further shrink the already inadequate pool of primary care physicians.\u003c/p>\n\u003cp>\"If I were an insurance company, I think I'd be more concerned about recruiting and keeping PCPs because of this,\" Coffman says.\u003c/p>\n\u003cp>Betsy Imholz, director of special projects for Consumers Union, agrees that could be a concern if direct primary care catches on.\u003c/p>\n\u003cp>“Primary care is one of the least lucrative areas for doctors to go into,” Imholz says, “and therefore sometimes difficult for insurers to get sufficient numbers of.”\u003c/p>\n\u003cp>Imholz sees some other potential problems with the model. While she understands why both doctors and patients are attracted to direct primary care — “the old \u003ca href=\"https://www.youtube.com/watch?v=Y10VEkyKd3w\" target=\"_blank\">Marcus Welby\u003c/a> model,” as she puts it — she thinks it’s a move in the opposite direction of the current push for an integrated health care system. Ideally, doctors would have access to patients’ electronic health records, and \u003ca href=\"http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2014/rwjf409988\" target=\"_blank\">all-payer claims databases\u003c/a>, at least \u003ca href=\"http://www.commondreams.org/newswire/2016/08/03/all-six-states-keep-consumers-dark-cost-medical-procedures\" target=\"_blank\">theoretically\u003c/a>, would allow purchasers of insurance to compare costs.\u003c/p>\n\u003cp>“It goes against this coordinated care model that the Affordable Care Act and the U.S. is coming to,” she says, “having things not fragmented but coordinated [in a way that] enables us to check, make quality assessments.”\u003c/p>\n\u003cp>Imholz is also concerned this type of practice could attract healthier people, who might see direct primary care as a substitute for insurance rather than an extra. And that could deprive the ACA \u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2016/03/30/theyre-sicker-plus-aca-enrollees-cost-more-in-care-major-insurer-finds/\" target=\"_blank\">risk pool \u003c/a>of the very type of patients \u003ca href=\"http://www.newsweek.com/obamacare-premiums-rise-10-percent-2017-490268\" target=\"_blank\">needed to keep cost increases manageable\u003c/a>.\u003c/p>\n\u003cp>Consumers in California, Imholz said, should also keep in mind a little-known benefit of the plans offered on the state’s health care exchange, Covered California: those plans are required to offer three visits outside of the deductible, costing only a co-pay.\u003c/p>\n\u003cp>Ultimately, she says, if patients do want to go the route of direct primary care, they should create their own \u003ca href=\"https://www.healthit.gov/providers-professionals/faqs/what-personal-health-record\" target=\"_blank\">personal health record\u003c/a> for each visit, in case at some point they need to visit a specialist for a serious health problem.\u003c/p>\n\u003cp>As to whether direct primary care will positively impact patients' health, Laurence Baker says it's not clear whether or not the longer office and home visits end up providing better care.\u003c/p>\n\u003cp>\"I'm not sure we know if this makes you healthier at the end of the day,\" Baker says. \"It will make you happier, definitely, but the jury is still out about whether it improves outcomes.\"\u003c/p>\n\u003cp>\u003cstrong>'It's Lovely'\u003c/strong>\u003c/p>\n\u003cp>Back in Half Moon Bay, physician Lorraine Page says she doesn't need data. She tries to find the words for the improvement she has seen in her life and the lives of her patients.\u003c/p>\n\u003cp>\"It's … lovely,\" she says with a laugh. \"It's just lovely. The patients do better, I get to see the whole person, the whole family. It's true family practice. And it's very straightforward. I see the person, I get paid. It's simple.\"\u003c/p>\n\u003cp>This type of practice, she says, is what many young doctors-to-be have in mind when they first think about entering medicine.\u003c/p>\n\u003cp>It's an odd twist that Page's current work is considered the cutting- edge of primary care medicine, when it so closely resembles a kind of 1950s Norman Rockwell painting of what a general practitioner is.\u003c/p>\n\u003cp>Most doctors don't even think about what they want anymore, Page says. They get caught up in the system and don't realize there's another choice.\u003c/p>\n\u003cp>But leaving was surprisingly easy.\u003c/p>\n\u003cp>\"Look, your skills are in your mind,\" Page says. \"You can do that anywhere.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>STAT today is reporting on a \"withering assault\" by scientists debunking a headline-making study that claimed a genetic mutation greatly increases the risk of contracting a severe form of multiple sclerosis.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/27253448\" target=\"_blank\">study\u003c/a>, published in the June issue of Neuron, claimed to identify a single malfunctioning gene called NR1H3 as the cause of primary progressive multiple sclerosis in some patients.\u003c/p>\n\u003cp>\"This is by far the strongest connection ever found between any single genetic mutation and MS,\" wrote our genetics specialist, Dr. Barry Starr, in a \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/06/08/genetic-cause-found-for-progressive-multiple-sclerosis/\" target=\"_blank\">post\u003c/a> about the discovery.\u003c/p>\n\u003cp>About 60,000 people in the U.S. have PPMS, according to statistics from multiple sclerosis organizations. None of the therapies currently in use for multiple sclerosis have been shown to work for PPMS.\u003c/p>\n\u003cp>STAT's report says scientists looking at larger genetic databases had not found an association between NR1H3 and multiple sclerosis. One researcher published a failed attempt to replicate the original study in a non-peer-reviewed \u003ca href=\"http://biorxiv.org/content/early/2016/06/29/061366\" target=\"_blank\">paper\u003c/a> posted on the bioRxiv website.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">Carles Vilariño-Güell of the University of British Columbia, the lead researcher of the \u003c/span>\u003cem style=\"line-height: 1.5\">Neuron\u003c/em>\u003cspan style=\"line-height: 1.5\"> paper, defended the study to STAT. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">“I do believe [the association between the mutation and MS] is correct, although it would be nice to have some independent replication,” he said. “In addition to the data in the \u003cem>Neuron\u003c/em> article, we have unpublished results that provide additional support” for the original claim.\"\u003c/span>\u003c/p>\n\u003cp>Read STAT's coverage here:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>https://www.statnews.com/2016/09/09/multiple-sclerosis-gene-attack/\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>STAT today is reporting on a \"withering assault\" by scientists debunking a headline-making study that claimed a genetic mutation greatly increases the risk of contracting a severe form of multiple sclerosis.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/27253448\" target=\"_blank\">study\u003c/a>, published in the June issue of Neuron, claimed to identify a single malfunctioning gene called NR1H3 as the cause of primary progressive multiple sclerosis in some patients.\u003c/p>\n\u003cp>\"This is by far the strongest connection ever found between any single genetic mutation and MS,\" wrote our genetics specialist, Dr. Barry Starr, in a \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/06/08/genetic-cause-found-for-progressive-multiple-sclerosis/\" target=\"_blank\">post\u003c/a> about the discovery.\u003c/p>\n\u003cp>About 60,000 people in the U.S. have PPMS, according to statistics from multiple sclerosis organizations. None of the therapies currently in use for multiple sclerosis have been shown to work for PPMS.\u003c/p>\n\u003cp>STAT's report says scientists looking at larger genetic databases had not found an association between NR1H3 and multiple sclerosis. One researcher published a failed attempt to replicate the original study in a non-peer-reviewed \u003ca href=\"http://biorxiv.org/content/early/2016/06/29/061366\" target=\"_blank\">paper\u003c/a> posted on the bioRxiv website.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">Carles Vilariño-Güell of the University of British Columbia, the lead researcher of the \u003c/span>\u003cem style=\"line-height: 1.5\">Neuron\u003c/em>\u003cspan style=\"line-height: 1.5\"> paper, defended the study to STAT. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">“I do believe [the association between the mutation and MS] is correct, although it would be nice to have some independent replication,” he said. “In addition to the data in the \u003cem>Neuron\u003c/em> article, we have unpublished results that provide additional support” for the original claim.\"\u003c/span>\u003c/p>\n\u003cp>Read STAT's coverage here:\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>https://www.statnews.com/2016/09/09/multiple-sclerosis-gene-attack/\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>What if doctors could call up a computerized map that would show them how a case of cancer is likely to progress?\u003c/p>\n\u003cp>Tumor cells can mutate in unexpected ways. And cancers can suddenly grow. For doctors, anticipating cancer's next moves can help guide timely, effective patient treatment.\u003c/p>\n\u003caside class=\"pullquote alignright\">The program maps cancer progression in much the same way historical explorers drew maps of the Earth without satellite imaging.\u003c/aside>\n\u003cp>A mapping program, called \u003ca href=\"https://sites.google.com/site/troncopackage/picnic\">PiCnIc\u003c/a> for short, aims to help physicians in staying a step ahead of cancer and preparing long-term treatment plans with fewer elements of surprise.\u003c/p>\n\u003cp>How does it work?\u003c/p>\n\u003cp>PiCnIc \"takes in patient data, guesses potential scenarios and tells you the most likely scenario,\" says \u003ca href=\"https://cs.nyu.edu/mishra/\">Bud Mishra\u003c/a>, a professor at New York University's Courant Institute of Mathematical Sciences who led a multinational team in developing the program.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>PiCnIc produces maps of cancer progression in much the same way historical explorers drew maps of the Earth without satellite imaging. The program, like the explorers, draws tiny regional maps and then pieces them together like a puzzle.\u003c/p>\n\u003cp>The program extracts the simplest pieces of information from medical data, which Mishra calls \"little blocks of causality.\" They describe one stage of cancer, along with a potential outcome.\u003c/p>\n\u003cp>Once the blocks of causality are constructed, PiCnIc examines them to retain only the likeliest paths. This process is akin to discarding poorly drawn regional maps before attempting to put together a global map.\u003c/p>\n\u003cp>The end result is a graphical representation of the possible scenarios a cancer patient might encounter. From it, physicians can hypothesize how cancer will progress and plan accordingly.\u003c/p>\n\u003cp>Just like a good cartographer, PiCnIc is capable of drawing all kinds of maps, as long as appropriate medical data are available. \"[PiCnIc] is quite flexible. It can incorporate pretty much any cancer type,\" says \u003ca href=\"http://faculty.mdanderson.org/Nicholas_Navin/Default.asp?SNID=0\">Nicholas Navin\u003c/a>, a professor at the University of Texas MD Anderson Cancer Center who wasn't involved in the creation of PiCnIc. Navin says that PiCnIc, at its current stage of development, \"already gives [us] enough information to be clinically useful.\"\u003c/p>\n\u003cp>The program can also update the maps to factor in advances in cancer research as well, says \u003ca href=\"https://sites.google.com/site/giuliocaravagna/\" target=\"_blank\">Giulio Caravagna\u003c/a>, a computational biologist at the University of Edinburgh who participated in the research project. As new medical data become available, researchers can rerun PiCnIc with ease to generate updated maps of cancer. \"And there is already a pretty good amount of data, like the \u003ca href=\"http://cancergenome.nih.gov/\" target=\"_blank\">Cancer Genome Atlas\u003c/a>,\" says Caravagna.\u003c/p>\n\u003cp>The research work was published on the \u003cem>Proceedings of the National Academy of Sciences\u003c/em> \u003ca href=\"http://www.pnas.org/content/113/28/E4025.abstract\">in late June\u003c/a>. Mishra says that he plans to look into \"commercial opportunities\" for PiCnIc and collaborations with \"large research labs\" to improve it.\u003c/p>\n\u003cp>For now, though, the PiCnIc maps \"shouldn't be interpreted too much in making decisions for individual patient,\" says Navin.\u003c/p>\n\u003cp>\"We are a little bit underpowered to comprehensively build these [maps of cancer]... there are still little ways to go,\" says \u003ca href=\"http://compbio.cs.brown.edu/\">Ben Raphael\u003c/a>, a computational biologist at Brown University.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A cartographer is only as good as the measurements the explorers bring in, after all.\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=A+Map+To+Help+Cancer+Doctors+Find+Their+Way&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>PiCnIc produces maps of cancer progression in much the same way historical explorers drew maps of the Earth without satellite imaging. The program, like the explorers, draws tiny regional maps and then pieces them together like a puzzle.\u003c/p>\n\u003cp>The program extracts the simplest pieces of information from medical data, which Mishra calls \"little blocks of causality.\" They describe one stage of cancer, along with a potential outcome.\u003c/p>\n\u003cp>Once the blocks of causality are constructed, PiCnIc examines them to retain only the likeliest paths. This process is akin to discarding poorly drawn regional maps before attempting to put together a global map.\u003c/p>\n\u003cp>The end result is a graphical representation of the possible scenarios a cancer patient might encounter. From it, physicians can hypothesize how cancer will progress and plan accordingly.\u003c/p>\n\u003cp>Just like a good cartographer, PiCnIc is capable of drawing all kinds of maps, as long as appropriate medical data are available. \"[PiCnIc] is quite flexible. It can incorporate pretty much any cancer type,\" says \u003ca href=\"http://faculty.mdanderson.org/Nicholas_Navin/Default.asp?SNID=0\">Nicholas Navin\u003c/a>, a professor at the University of Texas MD Anderson Cancer Center who wasn't involved in the creation of PiCnIc. Navin says that PiCnIc, at its current stage of development, \"already gives [us] enough information to be clinically useful.\"\u003c/p>\n\u003cp>The program can also update the maps to factor in advances in cancer research as well, says \u003ca href=\"https://sites.google.com/site/giuliocaravagna/\" target=\"_blank\">Giulio Caravagna\u003c/a>, a computational biologist at the University of Edinburgh who participated in the research project. As new medical data become available, researchers can rerun PiCnIc with ease to generate updated maps of cancer. \"And there is already a pretty good amount of data, like the \u003ca href=\"http://cancergenome.nih.gov/\" target=\"_blank\">Cancer Genome Atlas\u003c/a>,\" says Caravagna.\u003c/p>\n\u003cp>The research work was published on the \u003cem>Proceedings of the National Academy of Sciences\u003c/em> \u003ca href=\"http://www.pnas.org/content/113/28/E4025.abstract\">in late June\u003c/a>. Mishra says that he plans to look into \"commercial opportunities\" for PiCnIc and collaborations with \"large research labs\" to improve it.\u003c/p>\n\u003cp>For now, though, the PiCnIc maps \"shouldn't be interpreted too much in making decisions for individual patient,\" says Navin.\u003c/p>\n\u003cp>\"We are a little bit underpowered to comprehensively build these [maps of cancer]... there are still little ways to go,\" says \u003ca href=\"http://compbio.cs.brown.edu/\">Ben Raphael\u003c/a>, a computational biologist at Brown University.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A cartographer is only as good as the measurements the explorers bring in, after all.\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=A+Map+To+Help+Cancer+Doctors+Find+Their+Way&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"onourwatch": {
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
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