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"content": "\u003cp>There's about 10 feet between Judge Craig Hannah's courtroom bench and the place where a defendant stands to be arraigned here in Buffalo City Court.\u003c/p>\n\u003cp>But for 26-year-old Caitlyn Stein, it has been a long, arduous 10 feet.\u003c/p>\n\u003cp>\"This is your first day back! Good to see you!\" Judge Hannah says as he greets her.\u003c/p>\n\u003cp>\"Good to see you,\" Stein says, smiling.\u003c/p>\n\u003cp>\"We've got to do that \u003cem>after \u003c/em>picture. We did the \u003cem>before\u003c/em>,\" Judge Hannah reminds her.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It's 10 feet of space where Stein began to walk back 10 years of crippling intravenous heroin addiction and its sordid aftermath: burned bridges with family and friends, and a stream of lies and criminality to support her drug habit.\u003c/p>\n\u003cp>Today is Stein's first day back before Hannah after a month of inpatient treatment in Buffalo's new opioid intervention court.\u003c/p>\n\u003cp>Stein shows the judge a folder full of awards and certificates earned during her recovery.\u003c/p>\n\u003cp>\"Oh, you've also been a positive peer mentor. Wow. You really did your thing down there. Congratulations,\" Hannah says, looking Stein in the eyes. \"How many days clean?\"\u003c/p>\n\u003cp>\"Twenty-nine today, judge.\"\u003c/p>\n\u003cp>\"Keep up the good work, that's awesome.\"\u003c/p>\n\u003cp>\"I will.\"\u003c/p>\n\u003cp>\u003cstrong>'See Another Christmas'\u003c/strong>\u003c/p>\n\u003cp>Federal, county and city court officials are looking hard at Buffalo, N.Y.'s new opioid crisis intervention court as one potential model solution to the epidemic of heroin and opioid overdoses that continue to devastate families and communities across America, taxing local governments, first responders and the nation's criminal justice system.\u003c/p>\n\u003cp>\"Right now we're trying to save them. I'm trying to save their life,\" says Judge Hannah, who presides over this first-in-the-nation experiment that aims to fast-track addicts into wraparound treatment before adjudicating their criminal cases. \"I want them to have another sunset, another time with their family, to see another Christmas.\"\u003c/p>\n\u003cp>Buffalo's opiate court is, essentially, an iteration of the traditional drug court where an addicted nonviolent offender is channeled into recovery as an alternative to jail and a chance at a reduced sentence.\u003c/p>\n\u003cp>When Stein first appeared before Judge Hannah, she was dressed in an orange city jail jumpsuit and shackled in handcuffs and chains. She was pounds thinner with dark circles under her eyes and heroin track marks on her arms.\u003c/p>\n\u003cp>Today she looks alert and upbeat, dressed in jeans and a casual top.\u003c/p>\n\u003cp>And now she gets to walk right up to Judge Hannah's bench, to cross those 10 feet and talk face-to-face.\u003c/p>\n\u003cp>\"How do you feel?\"\u003c/p>\n\u003cp>\"I feel like me again and it's awesome,\" Stein replies.\u003c/p>\n\u003cp>\"You know you have to see me every day after treatment right, unless you're in group?\"\u003c/p>\n\u003cp>\"OK, yeah I know,\" she says.\u003c/p>\n\u003cp>In that moment, Hannah seems more like a friend than the black-robed judge who could order Stein to jail if she runs — again — from treatment.\u003c/p>\n\u003cp>The first go-around Stein bolted from her detox bed and the serious heroin possession charges hanging over her.\u003c/p>\n\u003cp>She wanted to get high.\u003c/p>\n\u003cp>After Stein was rearrested in August, Judge Hannah gave her another chance to get clean and a second chance to maybe get those criminal charges reduced.\u003c/p>\n\u003cp>\u003cstrong>'Put the Clock on Hold'\u003c/strong>\u003c/p>\n\u003cp>The necessity for a special opiate court underscores the crippling severity of the nation's drug overdose and addiction crisis, which \u003ca href=\"https://www.cdc.gov/nchs/data/health_policy/monthly-drug-overdose-death-estimates.pdf\">killed some 64,000 Americans\u003c/a> from February 2016 to February 2017, according to preliminary data from the CDC.\u003c/p>\n\u003cp>The big difference here is speed: If the defendant wants help to kick heroin or opioids, Judge Hannah and his team quickly hit \"pause\" on the criminal charges to get the person into treatment fast, often within hours or the next morning.\u003c/p>\n\u003cp>\"Right from arraignment, we put the clock on hold. We turn off the court reporter, everything's off the record, and we're talking about getting you help,\" Hannah says. \"And once we get you help and get you stabilized, we put the criminal case back on the calendar.\"\u003c/p>\n\u003cp>Usually that's on the calendar of the city's long-established drug court with a chance to get the criminal charges reduced or even dismissed. But often in traditional drug courts it can take weeks or longer to get a defendant into a detox or an inpatient treatment center.\u003c/p>\n\u003cp>And with opioid addicts, that delay can prove fatal, particularly with heroin and fentanyl.\u003c/p>\n\u003cp>\"We couldn't wait three or four weeks until we got the individuals into a treatment program or plan,\" says John Flynn, the district attorney for Erie County, N.Y., which includes Buffalo. \"Because they didn't get it right away, they were going back out in the streets, shooting up fentanyl, and dying.\"\u003c/p>\n\u003cp>Erie County is on track this year to record the highest opiate overdose death total in its history.\u003c/p>\n\u003cp>\"We average just over one overdose death per day,\" says Mary St. Mary with the county's Department of Health.\u003c/p>\n\u003cp>\u003cstrong>Rigorous Treatment \u003c/strong>\u003c/p>\n\u003cp>The court's program includes random, regular drug testing and a nightly curfew. Defendants have to check in at 8 p.m. and \"ping\" their location to a court staffer.\u003c/p>\n\u003cp>Participants are also channeled into one-on-one and group counseling among other support services.\u003c/p>\n\u003cp>So Judge Hannah knows fast if someone's using again or didn't show up for counseling or curfew.\u003c/p>\n\u003cp>\"Addicts are very good at lying, at manipulating and having them finally take accountability\" is vital, says Brooke Crouse, the opioid court liaison for Horizon Health Services, a main provider of the court's addiction treatment services.\u003c/p>\n\u003cp>\"We have someone who finished the program in June and he still calls in every night at 8 just for that accountability, to stay focused,\" Crouse says.\u003c/p>\n\u003cp>And after a 30-day inpatient detox, participants enter 30 days of outpatient treatment.\u003c/p>\n\u003cp>And every weekday at 11 a.m. during that treatment, every recovering addict has to check in with Hannah. To sit in court, wait for his or her name to be called, and walk up close to his bench for a one-on-one talk.\u003c/p>\n\u003cp>Any slip-up is usually addressed within hours at the next morning's one-on-one.\u003c/p>\n\u003cp>\"If they don't go to group, it's addressed at 11. If they skip out on curfew, it's addressed at 11,\" Crouse says.\u003c/p>\n\u003cp>If, however, an opiate court participant — Hannah prefers that term to defendant — fails to show up, he issues a warrant for their arrest.\u003c/p>\n\u003cp>\u003cstrong>'Put Eyes on Them'\u003c/strong>\u003c/p>\n\u003cp>A stern talking-to by Judge Hannah or his compassion or the possibility of an arrest warrant is not always enough.\u003c/p>\n\u003cp>\"It's easier once those cuffs come off to run out the door and go get high instead of going to get treatment to get better,\" Crouse says.\u003c/p>\n\u003cp>No one gets indefinitely kicked out of the program for minor infractions, and Hannah will let you restart your treatment multiple times. And given the reality of relapse during recovery, many participants are on their second time through the court.\u003c/p>\n\u003cp>It's 28-year-old Amanda Davis' second time attempting the program. She landed here after getting arrested for drug possession and petty larceny. She was stealing store items including energy drinks and selling them on the street to feed her heroin habit.\u003c/p>\n\u003cp>\"I started on pills — Percocet, oxy, morphine — anything I could get my hands on. And moved to heroin,\" Davis says. A Colorado native, Davis says she moved to Buffalo to try to get away from addiction. She could not. \"I was using every single day, as much as I could.\" She says her life completely fell apart during her eight years of drug abuse, which also saw several family members die because of opioid and alcohol abuse.\u003c/p>\n\u003cp>After washing out of the program the first time, she asked to come back. She now believes she's finally on track to stay clean.\u003c/p>\n\u003cp>\"Judge Hannah has been the most helpful, useful person I've had in my life in the last eight years,\" Davis says. \"If I wasn't here I think I'd be dead. I've lost three siblings to this.\"\u003c/p>\n\u003cp>At a recent morning session, Hannah wasn't tolerating any more excuses and spin from a middle-aged man who earlier in the week failed his drug test.\u003c/p>\n\u003cp>\"I just need you to be honest with me so I can help you,\" he tells the man, who didn't want his name used. \"Right now you are \u003cem>outside\u003c/em> the circle of trust,\" Hannah tells him. \"You're gonna have to work hard to get back inside the circle. OK?\"\u003c/p>\n\u003cp>The man says he's heading off to group therapy and then a job fair at a local church.\u003c/p>\n\u003cp>\"OK, your test is negative today, so keep up the good work,\" Hannah tells him. \"Looks like you're starting to get back on track.\"\u003c/p>\n\u003cp>\"I thank God for this at the end of the day,\" the man says. \"For you, the court. Something good's going to come out of this, I know it.\"\u003c/p>\n\u003cp>Judge Hannah says the close-in talking, closing that gap between the podium and his bench, is not for show.\u003c/p>\n\u003cp>\"If you don't put eyes on them and have that face-to-face continual contact, and also to reassure them that we're actually working and caring for them, I think a lot of people get lost and they fall off in their recovery,\" he says.\u003c/p>\n\u003cp>The public defender's office here is an enthusiastic backer of the opioid court. Flynn, the Erie County DA, says local law enforcement are supportive as well. It's dumb, Flynn says, to keep arresting, jailing and prosecuting repeat offenders who are, first and foremost, opioid addicts in need of help.\u003c/p>\n\u003cp>\"If an individual doesn't get the help they need, they are going to be a perpetual criminal. They're going to be committing petty larcenies every day,\" Flynn says. \"They're going to be engaging in prostitution, perhaps, in drug possession, perhaps drug sales to further their habit. They are a revolving door within our criminal justice system. And the police don't want that.\"\u003c/p>\n\u003cp>\u003cstrong>A National Model?\u003c/strong>\u003c/p>\n\u003cp>Buffalo's program, in which criminal addicts are immediately assessed and referred for treatment within hours, is generating attention. \"This fast-tracking (in Buffalo) is really unique and generating a lot of interest out there,\" says Christopher Deutsch with the \u003ca href=\"http://www.nadcp.org/\">National Association of Drug Court Professionals\u003c/a>.\u003c/p>\n\u003cp>\"That's a big piece of it,\" Bureau of Justice Assistance policy adviser Gregory Torain says of the city's rapid-response model. \"That's very new.\"\u003c/p>\n\u003cp>The opiate court was created in May of this year with the help of a $300,000 grant from the Justice Department. It's too soon to draw big conclusions.\u003c/p>\n\u003cp>But Torain says the Bureau of Justice Assistance is \"encouraged by what we've seen so far, what they've been able to do.\" He says the bureau will continue to assess and support the court's efforts.\u003c/p>\n\u003cp>So far the numbers show that Buffalo may be on to something: Of the roughly 140 participants, only four have washed out of the program.\u003c/p>\n\u003cp>\"I'm very happy with that number,\" says Jeffrey Smith, project director of New York's 8th Judicial District and a prime mover behind creation of the court. \"And zero deaths (in the program). I'm ecstatic about that number.\"\u003c/p>\n\u003cp>Richard Baum, acting director of the office of National Drug Control Policy, colloquially called the drug czar, recently visited the opioid court to examine how the federal goverment might help replicate the idea in other heroin-damaged cities across the country.\u003c/p>\n\u003cp>County and city court officials from all over the country are also calling and emailing about the program, court officials say.\u003c/p>\n\u003cp>Health professionals agree heroin and opioid addicts are particularly vulnerable to overdose during the detox phase and the period right after. And the courts \"really need to be aware of that and all the stakeholders — judges, prosecutors, law enforcement — all need to be communicating with each other about that,\" Deutsch says, adding that \"Buffalo really is out in front in adapting that model.\"\u003c/p>\n\u003cp>The interest in Buffalo's experiment comes as a committee created by the National Governors Association is studying how states could expand drug treatment within the criminal justice system.\u003c/p>\n\u003cp>\u003cstrong>'People Are Going to Slip Up'\u003c/strong>\u003c/p>\n\u003cp>Part of the opioid court's success, so far, might be the fact that Judge Hannah knows firsthand about addiction.\u003c/p>\n\u003cp>For a time in his youth, Hannah says, he struggled with cocaine dependency.\u003c/p>\n\u003cp>\"I know that you can have every intention of trying to stay clean, but at 2 o'clock in the morning when that demon calls, and no one's around and no one's looking, a lot of people are going to slip up,\" he says. \"You can't lock up an addiction, because the addiction is still there.\"\u003c/p>\n\u003cp>In the court's hallway, recovering addict Caitlyn Stein says if Judge Hannah hadn't given her a second chance she'd likely be in prison or dead.\u003c/p>\n\u003cp>\"Having someone who understands and doesn't judge me for it, knows that, like, no one is exempt from this disease. If it'd been another judge, I'm not sure I'd be here today clean.\"\u003c/p>\n\u003cp>She always wanted to get clean, she says, since starting to shoot up heroin at 16.\u003c/p>\n\u003cp>\"Been in jail a couple times but only stayed clean for a short period of time. This has completely changed everything for me,\" Stein says. \"I can finally live again. It feels good to laugh, like belly laugh, and I cry, but I'm OK with crying now. Where before I was just a zombie, is the best way to put it. Use to live and live to use. I don't ever want to go back to that.\"\u003c/p>\n\u003cp>Then, just a few days later, a few days into her outpatient treatment, Stein failed to show up for her daily check-in with Judge Hannah.\u003c/p>\n\u003cp>A warrant has been issued for her arrest.\u003c/p>\n\u003cp>And the next time Stein sees Hannah, she is likely to be in handcuffs and behind that wooden podium about 10 feet from his bench.\u003c/p>\n\u003cp>And in the court's eyes, anyway, it will be back to Day 1 of her recovery.\u003c/p>\n\u003cp>Court officials say she's been in touch via phone and always promises to turn herself in the next day.\u003c/p>\n\u003cp>So far, she has not.\u003c/p>\n\u003cp>Judge Hannah tells me he's pulling for Stein and all of those cycling through his opioid court experiment.\u003c/p>\n\u003cp>\"I always tell everyone, we play by Vegas rules: What happens here stays here. You tell me what's happening, we're not going to charge you with new charges. We're going to give you the help that you need, because we know that this is an addiction.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"But we can't help you,\" Hannah adds, \"until you're honest with yourself.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=To+Save+Opioid+Addicts%2C+This+Experimental+Court+Is+Ditching+The+Delays&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There's about 10 feet between Judge Craig Hannah's courtroom bench and the place where a defendant stands to be arraigned here in Buffalo City Court.\u003c/p>\n\u003cp>But for 26-year-old Caitlyn Stein, it has been a long, arduous 10 feet.\u003c/p>\n\u003cp>\"This is your first day back! Good to see you!\" Judge Hannah says as he greets her.\u003c/p>\n\u003cp>\"Good to see you,\" Stein says, smiling.\u003c/p>\n\u003cp>\"We've got to do that \u003cem>after \u003c/em>picture. We did the \u003cem>before\u003c/em>,\" Judge Hannah reminds her.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It's 10 feet of space where Stein began to walk back 10 years of crippling intravenous heroin addiction and its sordid aftermath: burned bridges with family and friends, and a stream of lies and criminality to support her drug habit.\u003c/p>\n\u003cp>Today is Stein's first day back before Hannah after a month of inpatient treatment in Buffalo's new opioid intervention court.\u003c/p>\n\u003cp>Stein shows the judge a folder full of awards and certificates earned during her recovery.\u003c/p>\n\u003cp>\"Oh, you've also been a positive peer mentor. Wow. You really did your thing down there. Congratulations,\" Hannah says, looking Stein in the eyes. \"How many days clean?\"\u003c/p>\n\u003cp>\"Twenty-nine today, judge.\"\u003c/p>\n\u003cp>\"Keep up the good work, that's awesome.\"\u003c/p>\n\u003cp>\"I will.\"\u003c/p>\n\u003cp>\u003cstrong>'See Another Christmas'\u003c/strong>\u003c/p>\n\u003cp>Federal, county and city court officials are looking hard at Buffalo, N.Y.'s new opioid crisis intervention court as one potential model solution to the epidemic of heroin and opioid overdoses that continue to devastate families and communities across America, taxing local governments, first responders and the nation's criminal justice system.\u003c/p>\n\u003cp>\"Right now we're trying to save them. I'm trying to save their life,\" says Judge Hannah, who presides over this first-in-the-nation experiment that aims to fast-track addicts into wraparound treatment before adjudicating their criminal cases. \"I want them to have another sunset, another time with their family, to see another Christmas.\"\u003c/p>\n\u003cp>Buffalo's opiate court is, essentially, an iteration of the traditional drug court where an addicted nonviolent offender is channeled into recovery as an alternative to jail and a chance at a reduced sentence.\u003c/p>\n\u003cp>When Stein first appeared before Judge Hannah, she was dressed in an orange city jail jumpsuit and shackled in handcuffs and chains. She was pounds thinner with dark circles under her eyes and heroin track marks on her arms.\u003c/p>\n\u003cp>Today she looks alert and upbeat, dressed in jeans and a casual top.\u003c/p>\n\u003cp>And now she gets to walk right up to Judge Hannah's bench, to cross those 10 feet and talk face-to-face.\u003c/p>\n\u003cp>\"How do you feel?\"\u003c/p>\n\u003cp>\"I feel like me again and it's awesome,\" Stein replies.\u003c/p>\n\u003cp>\"You know you have to see me every day after treatment right, unless you're in group?\"\u003c/p>\n\u003cp>\"OK, yeah I know,\" she says.\u003c/p>\n\u003cp>In that moment, Hannah seems more like a friend than the black-robed judge who could order Stein to jail if she runs — again — from treatment.\u003c/p>\n\u003cp>The first go-around Stein bolted from her detox bed and the serious heroin possession charges hanging over her.\u003c/p>\n\u003cp>She wanted to get high.\u003c/p>\n\u003cp>After Stein was rearrested in August, Judge Hannah gave her another chance to get clean and a second chance to maybe get those criminal charges reduced.\u003c/p>\n\u003cp>\u003cstrong>'Put the Clock on Hold'\u003c/strong>\u003c/p>\n\u003cp>The necessity for a special opiate court underscores the crippling severity of the nation's drug overdose and addiction crisis, which \u003ca href=\"https://www.cdc.gov/nchs/data/health_policy/monthly-drug-overdose-death-estimates.pdf\">killed some 64,000 Americans\u003c/a> from February 2016 to February 2017, according to preliminary data from the CDC.\u003c/p>\n\u003cp>The big difference here is speed: If the defendant wants help to kick heroin or opioids, Judge Hannah and his team quickly hit \"pause\" on the criminal charges to get the person into treatment fast, often within hours or the next morning.\u003c/p>\n\u003cp>\"Right from arraignment, we put the clock on hold. We turn off the court reporter, everything's off the record, and we're talking about getting you help,\" Hannah says. \"And once we get you help and get you stabilized, we put the criminal case back on the calendar.\"\u003c/p>\n\u003cp>Usually that's on the calendar of the city's long-established drug court with a chance to get the criminal charges reduced or even dismissed. But often in traditional drug courts it can take weeks or longer to get a defendant into a detox or an inpatient treatment center.\u003c/p>\n\u003cp>And with opioid addicts, that delay can prove fatal, particularly with heroin and fentanyl.\u003c/p>\n\u003cp>\"We couldn't wait three or four weeks until we got the individuals into a treatment program or plan,\" says John Flynn, the district attorney for Erie County, N.Y., which includes Buffalo. \"Because they didn't get it right away, they were going back out in the streets, shooting up fentanyl, and dying.\"\u003c/p>\n\u003cp>Erie County is on track this year to record the highest opiate overdose death total in its history.\u003c/p>\n\u003cp>\"We average just over one overdose death per day,\" says Mary St. Mary with the county's Department of Health.\u003c/p>\n\u003cp>\u003cstrong>Rigorous Treatment \u003c/strong>\u003c/p>\n\u003cp>The court's program includes random, regular drug testing and a nightly curfew. Defendants have to check in at 8 p.m. and \"ping\" their location to a court staffer.\u003c/p>\n\u003cp>Participants are also channeled into one-on-one and group counseling among other support services.\u003c/p>\n\u003cp>So Judge Hannah knows fast if someone's using again or didn't show up for counseling or curfew.\u003c/p>\n\u003cp>\"Addicts are very good at lying, at manipulating and having them finally take accountability\" is vital, says Brooke Crouse, the opioid court liaison for Horizon Health Services, a main provider of the court's addiction treatment services.\u003c/p>\n\u003cp>\"We have someone who finished the program in June and he still calls in every night at 8 just for that accountability, to stay focused,\" Crouse says.\u003c/p>\n\u003cp>And after a 30-day inpatient detox, participants enter 30 days of outpatient treatment.\u003c/p>\n\u003cp>And every weekday at 11 a.m. during that treatment, every recovering addict has to check in with Hannah. To sit in court, wait for his or her name to be called, and walk up close to his bench for a one-on-one talk.\u003c/p>\n\u003cp>Any slip-up is usually addressed within hours at the next morning's one-on-one.\u003c/p>\n\u003cp>\"If they don't go to group, it's addressed at 11. If they skip out on curfew, it's addressed at 11,\" Crouse says.\u003c/p>\n\u003cp>If, however, an opiate court participant — Hannah prefers that term to defendant — fails to show up, he issues a warrant for their arrest.\u003c/p>\n\u003cp>\u003cstrong>'Put Eyes on Them'\u003c/strong>\u003c/p>\n\u003cp>A stern talking-to by Judge Hannah or his compassion or the possibility of an arrest warrant is not always enough.\u003c/p>\n\u003cp>\"It's easier once those cuffs come off to run out the door and go get high instead of going to get treatment to get better,\" Crouse says.\u003c/p>\n\u003cp>No one gets indefinitely kicked out of the program for minor infractions, and Hannah will let you restart your treatment multiple times. And given the reality of relapse during recovery, many participants are on their second time through the court.\u003c/p>\n\u003cp>It's 28-year-old Amanda Davis' second time attempting the program. She landed here after getting arrested for drug possession and petty larceny. She was stealing store items including energy drinks and selling them on the street to feed her heroin habit.\u003c/p>\n\u003cp>\"I started on pills — Percocet, oxy, morphine — anything I could get my hands on. And moved to heroin,\" Davis says. A Colorado native, Davis says she moved to Buffalo to try to get away from addiction. She could not. \"I was using every single day, as much as I could.\" She says her life completely fell apart during her eight years of drug abuse, which also saw several family members die because of opioid and alcohol abuse.\u003c/p>\n\u003cp>After washing out of the program the first time, she asked to come back. She now believes she's finally on track to stay clean.\u003c/p>\n\u003cp>\"Judge Hannah has been the most helpful, useful person I've had in my life in the last eight years,\" Davis says. \"If I wasn't here I think I'd be dead. I've lost three siblings to this.\"\u003c/p>\n\u003cp>At a recent morning session, Hannah wasn't tolerating any more excuses and spin from a middle-aged man who earlier in the week failed his drug test.\u003c/p>\n\u003cp>\"I just need you to be honest with me so I can help you,\" he tells the man, who didn't want his name used. \"Right now you are \u003cem>outside\u003c/em> the circle of trust,\" Hannah tells him. \"You're gonna have to work hard to get back inside the circle. OK?\"\u003c/p>\n\u003cp>The man says he's heading off to group therapy and then a job fair at a local church.\u003c/p>\n\u003cp>\"OK, your test is negative today, so keep up the good work,\" Hannah tells him. \"Looks like you're starting to get back on track.\"\u003c/p>\n\u003cp>\"I thank God for this at the end of the day,\" the man says. \"For you, the court. Something good's going to come out of this, I know it.\"\u003c/p>\n\u003cp>Judge Hannah says the close-in talking, closing that gap between the podium and his bench, is not for show.\u003c/p>\n\u003cp>\"If you don't put eyes on them and have that face-to-face continual contact, and also to reassure them that we're actually working and caring for them, I think a lot of people get lost and they fall off in their recovery,\" he says.\u003c/p>\n\u003cp>The public defender's office here is an enthusiastic backer of the opioid court. Flynn, the Erie County DA, says local law enforcement are supportive as well. It's dumb, Flynn says, to keep arresting, jailing and prosecuting repeat offenders who are, first and foremost, opioid addicts in need of help.\u003c/p>\n\u003cp>\"If an individual doesn't get the help they need, they are going to be a perpetual criminal. They're going to be committing petty larcenies every day,\" Flynn says. \"They're going to be engaging in prostitution, perhaps, in drug possession, perhaps drug sales to further their habit. They are a revolving door within our criminal justice system. And the police don't want that.\"\u003c/p>\n\u003cp>\u003cstrong>A National Model?\u003c/strong>\u003c/p>\n\u003cp>Buffalo's program, in which criminal addicts are immediately assessed and referred for treatment within hours, is generating attention. \"This fast-tracking (in Buffalo) is really unique and generating a lot of interest out there,\" says Christopher Deutsch with the \u003ca href=\"http://www.nadcp.org/\">National Association of Drug Court Professionals\u003c/a>.\u003c/p>\n\u003cp>\"That's a big piece of it,\" Bureau of Justice Assistance policy adviser Gregory Torain says of the city's rapid-response model. \"That's very new.\"\u003c/p>\n\u003cp>The opiate court was created in May of this year with the help of a $300,000 grant from the Justice Department. It's too soon to draw big conclusions.\u003c/p>\n\u003cp>But Torain says the Bureau of Justice Assistance is \"encouraged by what we've seen so far, what they've been able to do.\" He says the bureau will continue to assess and support the court's efforts.\u003c/p>\n\u003cp>So far the numbers show that Buffalo may be on to something: Of the roughly 140 participants, only four have washed out of the program.\u003c/p>\n\u003cp>\"I'm very happy with that number,\" says Jeffrey Smith, project director of New York's 8th Judicial District and a prime mover behind creation of the court. \"And zero deaths (in the program). I'm ecstatic about that number.\"\u003c/p>\n\u003cp>Richard Baum, acting director of the office of National Drug Control Policy, colloquially called the drug czar, recently visited the opioid court to examine how the federal goverment might help replicate the idea in other heroin-damaged cities across the country.\u003c/p>\n\u003cp>County and city court officials from all over the country are also calling and emailing about the program, court officials say.\u003c/p>\n\u003cp>Health professionals agree heroin and opioid addicts are particularly vulnerable to overdose during the detox phase and the period right after. And the courts \"really need to be aware of that and all the stakeholders — judges, prosecutors, law enforcement — all need to be communicating with each other about that,\" Deutsch says, adding that \"Buffalo really is out in front in adapting that model.\"\u003c/p>\n\u003cp>The interest in Buffalo's experiment comes as a committee created by the National Governors Association is studying how states could expand drug treatment within the criminal justice system.\u003c/p>\n\u003cp>\u003cstrong>'People Are Going to Slip Up'\u003c/strong>\u003c/p>\n\u003cp>Part of the opioid court's success, so far, might be the fact that Judge Hannah knows firsthand about addiction.\u003c/p>\n\u003cp>For a time in his youth, Hannah says, he struggled with cocaine dependency.\u003c/p>\n\u003cp>\"I know that you can have every intention of trying to stay clean, but at 2 o'clock in the morning when that demon calls, and no one's around and no one's looking, a lot of people are going to slip up,\" he says. \"You can't lock up an addiction, because the addiction is still there.\"\u003c/p>\n\u003cp>In the court's hallway, recovering addict Caitlyn Stein says if Judge Hannah hadn't given her a second chance she'd likely be in prison or dead.\u003c/p>\n\u003cp>\"Having someone who understands and doesn't judge me for it, knows that, like, no one is exempt from this disease. If it'd been another judge, I'm not sure I'd be here today clean.\"\u003c/p>\n\u003cp>She always wanted to get clean, she says, since starting to shoot up heroin at 16.\u003c/p>\n\u003cp>\"Been in jail a couple times but only stayed clean for a short period of time. This has completely changed everything for me,\" Stein says. \"I can finally live again. It feels good to laugh, like belly laugh, and I cry, but I'm OK with crying now. Where before I was just a zombie, is the best way to put it. Use to live and live to use. I don't ever want to go back to that.\"\u003c/p>\n\u003cp>Then, just a few days later, a few days into her outpatient treatment, Stein failed to show up for her daily check-in with Judge Hannah.\u003c/p>\n\u003cp>A warrant has been issued for her arrest.\u003c/p>\n\u003cp>And the next time Stein sees Hannah, she is likely to be in handcuffs and behind that wooden podium about 10 feet from his bench.\u003c/p>\n\u003cp>And in the court's eyes, anyway, it will be back to Day 1 of her recovery.\u003c/p>\n\u003cp>Court officials say she's been in touch via phone and always promises to turn herself in the next day.\u003c/p>\n\u003cp>So far, she has not.\u003c/p>\n\u003cp>Judge Hannah tells me he's pulling for Stein and all of those cycling through his opioid court experiment.\u003c/p>\n\u003cp>\"I always tell everyone, we play by Vegas rules: What happens here stays here. You tell me what's happening, we're not going to charge you with new charges. We're going to give you the help that you need, because we know that this is an addiction.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"But we can't help you,\" Hannah adds, \"until you're honest with yourself.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=To+Save+Opioid+Addicts%2C+This+Experimental+Court+Is+Ditching+The+Delays&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Now Recognizes a Third Gender",
"title": "California Now Recognizes a Third Gender",
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"content": "\u003cp>Gender is no longer either male or female, according to the state of California.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It means that when somebody looks at my license, it's not going to be as confusing to them.'\u003c/aside>\n\u003cp>Gov. Jerry Brown on Sunday signed into law \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">legislation\u003c/a> that recognizes a third gender option. Starting Jan. 1, Californians will be able to apply to change their birth certificates from male or female to \"nonbinary.\" In 2019, Californians will be able to identify themselves as nonbinary on driver's licenses.\u003c/p>\n\u003cp>The bill was one of \u003ca href=\"https://www.gov.ca.gov/news.php?id=20027\" target=\"_blank\" rel=\"noopener\">many\u003c/a> Brown left to the last day of the Oct. 15 deadline to either sign or veto.\u003c/p>\n\u003cp>California joins Oregon and Washington D.C. in creating the third gender option on driver's licenses. New York state may \u003ca href=\"https://www.nbcnews.com/feature/nbc-out/lawmakers-new-york-d-c-propose-third-sex-driver-s-n774741\" target=\"_blank\" rel=\"noopener\">follow suit\u003c/a>. Unlike California, Oregon and Washington have not passed an actual law enacting the change, and neither accommodates a revision on birth certificates. \u003ca href=\"https://en.wikipedia.org/wiki/Legal_recognition_of_non-binary_gender\" target=\"_blank\" rel=\"noopener\">Countries\u003c/a> that recognize a third gender include Australia, Germany and India.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KjrmGaNfPZB7ShxMWOYSoqqYzOWGS4B2\"]The legislation, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">SB 179\u003c/a>, from state Sen. Toni Atkins (D-San Diego) and Scott Wiener (D-San Francisco), also rescinds the requirement that individuals who want to change their gender must submit a sworn statement from a physician declaring they have undergone clinical treatment. That change takes effect Sept. 1, 2018.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"With Governor Brown’s signature on this bill, transgender and non-binary people will now be able to identify themselves as they are, not as who society tells them they should be,\" said Wiener, in a statement.\u003c/p>\n\u003cp>The new law not only addresses the experience of inter-sex people — those individuals born with ambiguous sexual characteristics — but also codifies a \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/24/boy-girl-both-neither-a-new-generation-overthrows-gender/\" target=\"_blank\" rel=\"noopener\">growing trend\u003c/a> among transgender youth who eschew a traditional gender identity, decoupling it from not only their innate physiology, but from the notion that only males and females exist.\u003c/p>\n\u003cp>A 2015 \u003ca href=\"http://www.ustranssurvey.org/report\" target=\"_blank\" rel=\"noopener\">survey\u003c/a> by the National Center for Transgender Equality found a third of the almost 28,000 respondents chose \"nonbinary/genderqueer” when given a choice of terms to best describe themselves.\u003c/p>\n\u003cp>\"The binary gender designations of female and male fail to adequately represent the diversity of human experience,\" SB 179 states. \"Nonbinary is an umbrella term for people with gender identities that fall somewhere outside of the traditional conceptions of strictly either female or male. \"\u003c/p>\n\u003cp>Courts in Oregon and California have already granted requests by residents to change their gender to a third type. In California, dozens of people have petitioned courts to make the change.\u003c/p>\n\u003cp>One person who will benefit from the law is Jak Kazmarek, a KQED employee who has identified as nonbinary for 17 years. Kazmarek uses the pronoun \"they\" instead of \"he\" or \"she,\" something many nonbinary people do to reflect a gender identification outside the traditional male or female.\u003c/p>\n\u003cp>Kazmarek says they were the 25th person in California to petition a court for a gender change to nonbinary, a request the court granted in May. But the change had no practical effect -- there is currently no option to list your gender as anything other than male or female on a driver's license.\u003c/p>\n\u003cp>\"Right now, when somebody looks at an ID and they look at me, they don't see female,\" Kazmarek said. \"They also don't see male, though. That exposes me to a lot of questions. It's a really vulnerable place to be.\"\u003c/p>\n\u003cp>Kazmarek said that the state's sanction of nonbinary identity is \"huge.\"\u003c/p>\n\u003cp>\"It means that when somebody looks at my license, it's not going to be as confusing to them.\"\u003c/p>\n\u003cp>Ending the requirement that a physician sign off on someone's change of gender will also have a big effect, Kazmarek said.\u003c/p>\n\u003cp>\"I've been very privileged because I live in an area where people support me. There's a lot of people that live in other areas where it's difficult to find a doctor that's willing to write that note.\"\u003c/p>\n\u003cp>Opposition to the bill has come mostly from \u003ca href=\"http://www.californiafamily.org/2017/gender-change-anti-religious-liberty-bills-nearing-final-approval-2/\" target=\"_blank\" rel=\"noopener\">Christian groups\u003c/a>. It did not appear to have much effect: The bill passed the Senate 26-12 and the Assembly 57-21.\u003c/p>\n\u003cp>The issue of whether or not to recognize a third gender is headed for a day of reckoning on the federal level, too. Last November, Colorado U.S. District Court Judge R. Brooke Jackson remanded the case of Dana Zzyym back to the U.S. State Department after Lambda Legal, on behalf of Zzyym, \u003ca href=\"https://www.lambdalegal.org/news/us_20151026_zzyym-intersex-denied-passport\" target=\"_blank\" rel=\"noopener\">sued\u003c/a> the department for denying Zzyym's application for a passport. The agency rejected the request because Zzyym did not choose male or female on the application.\u003c/p>\n\u003cp>“I find that the administrative record contains no evidence that the Department followed a rational decision-making process in deciding to implement its binary-only gender passport policy,\" Jackson wrote in his decision. \"Therefore, the proper next step is to remand the case to the Department to give it an opportunity either to shore up the record, if it can, or reconsider its policy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the State Department declined Zzyym's application again, in May. The court then granted a motion to \u003ca href=\"https://www.washingtonpost.com/news/post-nation/wp/2017/06/28/a-navy-veteran-who-identifies-as-neither-male-nor-female-cant-get-a-passport-that-could-change/?utm_term=.26879130b6c5\" target=\"_blank\" rel=\"noopener\">reopen\u003c/a> the case.\u003c/p>\n\n",
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"excerpt": "Gov. Jerry Brown has signed into law legislation that requires a third gender option for driver's licenses and birth certificates. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gender is no longer either male or female, according to the state of California.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It means that when somebody looks at my license, it's not going to be as confusing to them.'\u003c/aside>\n\u003cp>Gov. Jerry Brown on Sunday signed into law \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">legislation\u003c/a> that recognizes a third gender option. Starting Jan. 1, Californians will be able to apply to change their birth certificates from male or female to \"nonbinary.\" In 2019, Californians will be able to identify themselves as nonbinary on driver's licenses.\u003c/p>\n\u003cp>The bill was one of \u003ca href=\"https://www.gov.ca.gov/news.php?id=20027\" target=\"_blank\" rel=\"noopener\">many\u003c/a> Brown left to the last day of the Oct. 15 deadline to either sign or veto.\u003c/p>\n\u003cp>California joins Oregon and Washington D.C. in creating the third gender option on driver's licenses. New York state may \u003ca href=\"https://www.nbcnews.com/feature/nbc-out/lawmakers-new-york-d-c-propose-third-sex-driver-s-n774741\" target=\"_blank\" rel=\"noopener\">follow suit\u003c/a>. Unlike California, Oregon and Washington have not passed an actual law enacting the change, and neither accommodates a revision on birth certificates. \u003ca href=\"https://en.wikipedia.org/wiki/Legal_recognition_of_non-binary_gender\" target=\"_blank\" rel=\"noopener\">Countries\u003c/a> that recognize a third gender include Australia, Germany and India.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The legislation, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">SB 179\u003c/a>, from state Sen. Toni Atkins (D-San Diego) and Scott Wiener (D-San Francisco), also rescinds the requirement that individuals who want to change their gender must submit a sworn statement from a physician declaring they have undergone clinical treatment. That change takes effect Sept. 1, 2018.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"With Governor Brown’s signature on this bill, transgender and non-binary people will now be able to identify themselves as they are, not as who society tells them they should be,\" said Wiener, in a statement.\u003c/p>\n\u003cp>The new law not only addresses the experience of inter-sex people — those individuals born with ambiguous sexual characteristics — but also codifies a \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/24/boy-girl-both-neither-a-new-generation-overthrows-gender/\" target=\"_blank\" rel=\"noopener\">growing trend\u003c/a> among transgender youth who eschew a traditional gender identity, decoupling it from not only their innate physiology, but from the notion that only males and females exist.\u003c/p>\n\u003cp>A 2015 \u003ca href=\"http://www.ustranssurvey.org/report\" target=\"_blank\" rel=\"noopener\">survey\u003c/a> by the National Center for Transgender Equality found a third of the almost 28,000 respondents chose \"nonbinary/genderqueer” when given a choice of terms to best describe themselves.\u003c/p>\n\u003cp>\"The binary gender designations of female and male fail to adequately represent the diversity of human experience,\" SB 179 states. \"Nonbinary is an umbrella term for people with gender identities that fall somewhere outside of the traditional conceptions of strictly either female or male. \"\u003c/p>\n\u003cp>Courts in Oregon and California have already granted requests by residents to change their gender to a third type. In California, dozens of people have petitioned courts to make the change.\u003c/p>\n\u003cp>One person who will benefit from the law is Jak Kazmarek, a KQED employee who has identified as nonbinary for 17 years. Kazmarek uses the pronoun \"they\" instead of \"he\" or \"she,\" something many nonbinary people do to reflect a gender identification outside the traditional male or female.\u003c/p>\n\u003cp>Kazmarek says they were the 25th person in California to petition a court for a gender change to nonbinary, a request the court granted in May. But the change had no practical effect -- there is currently no option to list your gender as anything other than male or female on a driver's license.\u003c/p>\n\u003cp>\"Right now, when somebody looks at an ID and they look at me, they don't see female,\" Kazmarek said. \"They also don't see male, though. That exposes me to a lot of questions. It's a really vulnerable place to be.\"\u003c/p>\n\u003cp>Kazmarek said that the state's sanction of nonbinary identity is \"huge.\"\u003c/p>\n\u003cp>\"It means that when somebody looks at my license, it's not going to be as confusing to them.\"\u003c/p>\n\u003cp>Ending the requirement that a physician sign off on someone's change of gender will also have a big effect, Kazmarek said.\u003c/p>\n\u003cp>\"I've been very privileged because I live in an area where people support me. There's a lot of people that live in other areas where it's difficult to find a doctor that's willing to write that note.\"\u003c/p>\n\u003cp>Opposition to the bill has come mostly from \u003ca href=\"http://www.californiafamily.org/2017/gender-change-anti-religious-liberty-bills-nearing-final-approval-2/\" target=\"_blank\" rel=\"noopener\">Christian groups\u003c/a>. It did not appear to have much effect: The bill passed the Senate 26-12 and the Assembly 57-21.\u003c/p>\n\u003cp>The issue of whether or not to recognize a third gender is headed for a day of reckoning on the federal level, too. Last November, Colorado U.S. District Court Judge R. Brooke Jackson remanded the case of Dana Zzyym back to the U.S. State Department after Lambda Legal, on behalf of Zzyym, \u003ca href=\"https://www.lambdalegal.org/news/us_20151026_zzyym-intersex-denied-passport\" target=\"_blank\" rel=\"noopener\">sued\u003c/a> the department for denying Zzyym's application for a passport. The agency rejected the request because Zzyym did not choose male or female on the application.\u003c/p>\n\u003cp>“I find that the administrative record contains no evidence that the Department followed a rational decision-making process in deciding to implement its binary-only gender passport policy,\" Jackson wrote in his decision. \"Therefore, the proper next step is to remand the case to the Department to give it an opportunity either to shore up the record, if it can, or reconsider its policy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the State Department declined Zzyym's application again, in May. The court then granted a motion to \u003ca href=\"https://www.washingtonpost.com/news/post-nation/wp/2017/06/28/a-navy-veteran-who-identifies-as-neither-male-nor-female-cant-get-a-passport-that-could-change/?utm_term=.26879130b6c5\" target=\"_blank\" rel=\"noopener\">reopen\u003c/a> the case.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In any given year, nearly 1 in 5 adults in the U.S. suffer from a mental illness, yet fewer than half of those suffering receive treatment.\u003c/p>\n\u003caside class=\"alignright\">Signs of depression in the human voice might help to diagnose mental health problems\n\u003cul>\n\u003cli>Speaking lower, flatter and softer\u003c/li>\n\u003cli>Sounding labored, with more pauses, starts and stops\u003c/li>\n\u003cli>Sounding strained or breathy\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>In an attempt to fill that gap, companies are developing digital technology to help doctors diagnose, monitor and treat psychiatric disorders.\u003c/p>\n\u003cp>The behavioral health startup Ellipsis Health, based in San Francisco, uses machine learning to analyze audio recordings of conversations between doctors and patients during exams. The software works as a screening tool to flag patients whose speech matches the voice patterns of depressed individuals, alerting clinicians to follow up with a full diagnostic interview.\u003c/p>\n\u003cp>Meanwhile, Boston's \u003ca href=\"http://www.cogitocorp.com/\" target=\"_blank\" rel=\"noopener\">Cogito\u003c/a> has developed an app to use metadata from patients' phones to alert health care providers about sudden changes in behavior that might be linked to mental health.\u003c/p>\n\u003cp>\u003cstrong>Difficulty of Diagnosis\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One reason for the lack of treatment for mental illness is that conditions like depression, anxiety and post‐traumatic stress disorder are difficult to diagnose.\u003c/p>\n\u003cp>There are no biological markers of mental illness that can be picked up in a blood test or a brain scan, so physicians must rely on patients’ self‐reports of their symptoms and on mental health questionnaires.\u003c/p>\n\u003cp>But self‐reporting and doctor observations can be highly subjective. Low energy, for example, can be a sign of depression, a normal response to a busy schedule, or an indicator of hypothyroidism. Subsequently, many physicians miss or misdiagnose psychiatric disorders; one \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60879-5/abstract\" target=\"_blank\" rel=\"noopener\">study \u003c/a>found that primary care doctors correctly identify depression in patients only 50 percent of the time.\u003c/p>\n\u003cp>However, there are a few consistent physiological changes that take place in the body when something is off in your brain. Some researchers think these types of changes could be used as objective flags for mental illness.\u003c/p>\n\u003cp>\u003cstrong>It’s Not What You Say, But How You Say It\u003c/strong>\u003c/p>\n\u003cp>When someone is depressed, their range of pitch and volume drop, so they tend to speak \u003ca href=\"http://ieeexplore.ieee.org/document/7117386/?reload=true\" target=\"_blank\" rel=\"noopener\">lower, flatter and softer\u003c/a>. Speech also sounds labored, with more pauses, starts and stops. Another key indicator is the tension or relaxation of the vocal cords, which can make speech sound strained or breathy. Too much tension or relaxation has been linked to depression and \u003ca href=\"http://ieeexplore.ieee.org/document/7384418/\" target=\"_blank\" rel=\"noopener\">suicide risk\u003c/a>. Depressed patients’ tongues and breath may also become uncoordinated, resulting in a slight slurring of speech.\u003c/p>\n\u003cp>These types of vocal traits — called paraverbal features — are detectable in other mental illnesses too, including bipolar and post‐traumatic stress disorder.\u003c/p>\n\u003cp>Researchers have been studying these different paraverbal patterns for over a decade, but they’ve only recently been able to make use of them with the rise of advanced computer analytics. Some of the qualities are noticeable to a trained ear, but others are more subtle.\u003c/p>\n\u003cp>Computer algorithms can pick up on differences in tone that a human might miss, and they can also quantify them. This technology helps clinicians track patients over time by comparing individuals to their own baselines, particularly important if a person has a naturally deep or breathy voice that is not indicative of depression.\u003c/p>\n\u003cp>“There’s no doubt that paraverbal features can be helpful in making clinical diagnoses,” says Danielle Ramo, an assistant professor of psychiatry at UCSF who is not affiliated with either company. “To the extent that machines are able to take advantage of paraverbal features in communication, that is a step forward in using machines to inform clinical diagnoses or treatment planning.”\u003c/p>\n\u003cp>Ellipsis used these vocal traits to create its tool. The program was initially trained by taking millions of conversations between nondepressed individuals and mining them for key features in speech patterns, such as pitch, cadence and enunciation. Data scientists then added conversations, data from mental health questionnaires and clinical information, all from depressed patients. That trained the software to identify vocal features indicative of depression.\u003c/p>\n\u003cp>One potential benefit of the Ellipsis program is that it could alert physicians if their patients may be depressed, even if that’s not the reason they went to the doctor in the first place.\u003c/p>\n\u003cp>“There are a lot of problems in the process of screening for mental health disorders,\" says Mark Richman, medical director of the Disease Management Program at Northwell Health, a health network in Long Island and New York City that is in talks with Ellipsis to use its program. \"Some of that has to do with limited sensitivity of the tools that are used to do that, some of it has to do with limited time to address and identify mental health disorders.”\u003c/p>\n\u003cp>Richman says he hopes a tool like the one from Ellipsis will help doctors catch patients who might otherwise fall through the cracks, but without taking up valuable face time in the exam room.\u003c/p>\n\u003cp>Ellipsis founder and CEO Mainul Mondal says that making doctor appointments more efficient was a key focus for the company.\u003c/p>\n\u003cp>“People like talking to their health teams. They feel loyalty\u003cbr>\nand the trust is there, and they’re already having the conversations,” he says.\u003c/p>\n\u003cp>By capturing and utilizing the conversation — with the patient’s consent — clinicians could screen every patient for depression without taking up extra time, following up with only those who are flagged as high risk.\u003c/p>\n\u003cp>Integrating the software into the normal flow of a doctor’s visit is the next step, says Elizabeth Shriberg, the Ellipsis chief scientific officer. Including Northwell, Ellipsis is now in talks with other large health care providers around the country to introduce the program into exam rooms, the company says.\u003c/p>\n\u003cp>\u003cstrong>Monitoring From Afar\u003c/strong>\u003c/p>\n\u003cp>Other physicians want to use voice and behavior analysis technology to learn more about what happens to patients when they’re \u003cem>outside\u003c/em> the exam room.\u003c/p>\n\u003cfigure id=\"attachment_436000\" class=\"wp-caption alignright\" style=\"max-width: 248px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/companion-2-0-android-Home-1.png\">\u003cimg class=\"wp-image-436000 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/companion-2-0-android-Home-1-800x1422.png\" alt=\"\" width=\"248\" height=\"441\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-800x1422.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-160x284.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-768x1365.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-1020x1813.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-1180x2098.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-960x1707.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-240x427.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-375x667.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-520x924.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1.png 1440w\" sizes=\"(max-width: 248px) 100vw, 248px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Image from the dashboard of Cogito's Companion app, meant to diagnose depression and other mental health conditions. \u003ccite>(Cogito)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We often get data only when people come into a clinic … and we know that there's a lot that goes on, obviously, outside of the clinic walls,” says David Ahern, director of the program in Behavioral Informatics and eHealth at Brigham and Women’s Hospital in Boston. “It's this huge unmet need of both understanding the nature of a … mental health disorder as it evolves over time and the experience of patients over time.”\u003c/p>\n\u003cp>Ahern leads a \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02167373?term=cogito&rank=1\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> testing the efficacy of Cogito's Companion app. Cogito was founded eight years ago as a spin-off from the MIT Media Lab in Boston. In addition to Companion, it makes software that gives real‐time feedback to customer call centers.\u003c/p>\n\u003cp>With patients' consent, the Companion app mines background metadata from their phone, including text frequency, call logs and geolocation. Using this data, the program creates a daily score for each patient, which is sent to their care team, alerting them if sudden changes in behavior might be linked to a decline in mental health. For example, if a patient starts to text less and has fewer or shorter calls, it may signal that they’re isolating themselves. Their caregiver can then reach out immediately to see if they are all right rather than having to wait until the next visit.\u003c/p>\n\u003cp>Patients also record a short audio diary a few times a week, which the app analyzes for nonverbal markers of depression, such as tenseness or breathiness, low pitch, volume or range. These results are also included in the patient’s daily score, giving the care team several objective measures of their mental state. In addition to depression, the app is also being \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02742064?term=cogito&rank=2\" target=\"_blank\" rel=\"noopener\">tested\u003c/a> on patients with bipolar disorder and post‐traumatic disorder, with the goal of predicting the onset of acute psychiatric episodes and suicide risk.\u003c/p>\n\u003cp>Skyler Place, vice president of behavioral science at Cogito, says he hopes doctors will use the system to be more proactive, not just in patients’ mental health care, but in their overall quality of life. In another trial for veterans at risk for post‐traumatic stress disorder and suicide, clinicians were able to detect major lifestyle changes through the app, as when one person lost his job and another became homeless.\u003c/p>\n\u003cp>“While the original goal was suicide prevention, in addition to being able to capture that risk, it’s really able to provide an overall risk score for the veteran population, and the clinicians are able to then provide the right service to these veterans in the moment when they need them.”\u003c/p>\n\u003cp>\u003cstrong>Replacing Clinicians? Not so Fast\u003c/strong>\u003c/p>\n\u003cp>As with the adoption of many new technologies, users may be reasonably concerned about privacy. Both Cogito and Ellipsis say that all the proper precautions are taken to store and protect the data, and in many cases the content of the conversations or voice recordings is irrelevant and even discarded.\u003c/p>\n\u003cp>The voice screening software is also not perfect; Cogito’s is currently about 75 percent accurate at flagging mental illness\u003cstrong> \u003c/strong>as compared to clinical interviews with mental health professionals. Ellipsis declined to state how accurate its software is.\u003c/p>\n\u003cp>Adam Miner, a clinical psychologist and instructor at\u003cbr>\nStanford University, says that, “Clinicians regularly take into account patient's tone and vocal patterns when making diagnostic decisions. If a new technology can help measure, or compare patterns over time, there is the potential to add value.” However, he cautions, there are “risks in oversimplifying the complexity of medical diagnoses.”\u003c/p>\n\u003cp>The two companies were quick to emphasize that the technology is not a replacement for human clinicians, but simply an aid or tool, akin to a blood test or an electrocardiogram.\u003c/p>\n\u003cp>“It's a buddy for health teams,” says Mondal. “It is an adviser for behavioral health; you flag patients so health systems can intervene.” After a patient is flagged as needing additional attention, either before or after diagnosis, it is still up to the clinician to administer care, an interaction that hasn’t been disrupted by artificial intelligence.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Yet.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In any given year, nearly 1 in 5 adults in the U.S. suffer from a mental illness, yet fewer than half of those suffering receive treatment.\u003c/p>\n\u003caside class=\"alignright\">Signs of depression in the human voice might help to diagnose mental health problems\n\u003cul>\n\u003cli>Speaking lower, flatter and softer\u003c/li>\n\u003cli>Sounding labored, with more pauses, starts and stops\u003c/li>\n\u003cli>Sounding strained or breathy\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>In an attempt to fill that gap, companies are developing digital technology to help doctors diagnose, monitor and treat psychiatric disorders.\u003c/p>\n\u003cp>The behavioral health startup Ellipsis Health, based in San Francisco, uses machine learning to analyze audio recordings of conversations between doctors and patients during exams. The software works as a screening tool to flag patients whose speech matches the voice patterns of depressed individuals, alerting clinicians to follow up with a full diagnostic interview.\u003c/p>\n\u003cp>Meanwhile, Boston's \u003ca href=\"http://www.cogitocorp.com/\" target=\"_blank\" rel=\"noopener\">Cogito\u003c/a> has developed an app to use metadata from patients' phones to alert health care providers about sudden changes in behavior that might be linked to mental health.\u003c/p>\n\u003cp>\u003cstrong>Difficulty of Diagnosis\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One reason for the lack of treatment for mental illness is that conditions like depression, anxiety and post‐traumatic stress disorder are difficult to diagnose.\u003c/p>\n\u003cp>There are no biological markers of mental illness that can be picked up in a blood test or a brain scan, so physicians must rely on patients’ self‐reports of their symptoms and on mental health questionnaires.\u003c/p>\n\u003cp>But self‐reporting and doctor observations can be highly subjective. Low energy, for example, can be a sign of depression, a normal response to a busy schedule, or an indicator of hypothyroidism. Subsequently, many physicians miss or misdiagnose psychiatric disorders; one \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60879-5/abstract\" target=\"_blank\" rel=\"noopener\">study \u003c/a>found that primary care doctors correctly identify depression in patients only 50 percent of the time.\u003c/p>\n\u003cp>However, there are a few consistent physiological changes that take place in the body when something is off in your brain. Some researchers think these types of changes could be used as objective flags for mental illness.\u003c/p>\n\u003cp>\u003cstrong>It’s Not What You Say, But How You Say It\u003c/strong>\u003c/p>\n\u003cp>When someone is depressed, their range of pitch and volume drop, so they tend to speak \u003ca href=\"http://ieeexplore.ieee.org/document/7117386/?reload=true\" target=\"_blank\" rel=\"noopener\">lower, flatter and softer\u003c/a>. Speech also sounds labored, with more pauses, starts and stops. Another key indicator is the tension or relaxation of the vocal cords, which can make speech sound strained or breathy. Too much tension or relaxation has been linked to depression and \u003ca href=\"http://ieeexplore.ieee.org/document/7384418/\" target=\"_blank\" rel=\"noopener\">suicide risk\u003c/a>. Depressed patients’ tongues and breath may also become uncoordinated, resulting in a slight slurring of speech.\u003c/p>\n\u003cp>These types of vocal traits — called paraverbal features — are detectable in other mental illnesses too, including bipolar and post‐traumatic stress disorder.\u003c/p>\n\u003cp>Researchers have been studying these different paraverbal patterns for over a decade, but they’ve only recently been able to make use of them with the rise of advanced computer analytics. Some of the qualities are noticeable to a trained ear, but others are more subtle.\u003c/p>\n\u003cp>Computer algorithms can pick up on differences in tone that a human might miss, and they can also quantify them. This technology helps clinicians track patients over time by comparing individuals to their own baselines, particularly important if a person has a naturally deep or breathy voice that is not indicative of depression.\u003c/p>\n\u003cp>“There’s no doubt that paraverbal features can be helpful in making clinical diagnoses,” says Danielle Ramo, an assistant professor of psychiatry at UCSF who is not affiliated with either company. “To the extent that machines are able to take advantage of paraverbal features in communication, that is a step forward in using machines to inform clinical diagnoses or treatment planning.”\u003c/p>\n\u003cp>Ellipsis used these vocal traits to create its tool. The program was initially trained by taking millions of conversations between nondepressed individuals and mining them for key features in speech patterns, such as pitch, cadence and enunciation. Data scientists then added conversations, data from mental health questionnaires and clinical information, all from depressed patients. That trained the software to identify vocal features indicative of depression.\u003c/p>\n\u003cp>One potential benefit of the Ellipsis program is that it could alert physicians if their patients may be depressed, even if that’s not the reason they went to the doctor in the first place.\u003c/p>\n\u003cp>“There are a lot of problems in the process of screening for mental health disorders,\" says Mark Richman, medical director of the Disease Management Program at Northwell Health, a health network in Long Island and New York City that is in talks with Ellipsis to use its program. \"Some of that has to do with limited sensitivity of the tools that are used to do that, some of it has to do with limited time to address and identify mental health disorders.”\u003c/p>\n\u003cp>Richman says he hopes a tool like the one from Ellipsis will help doctors catch patients who might otherwise fall through the cracks, but without taking up valuable face time in the exam room.\u003c/p>\n\u003cp>Ellipsis founder and CEO Mainul Mondal says that making doctor appointments more efficient was a key focus for the company.\u003c/p>\n\u003cp>“People like talking to their health teams. They feel loyalty\u003cbr>\nand the trust is there, and they’re already having the conversations,” he says.\u003c/p>\n\u003cp>By capturing and utilizing the conversation — with the patient’s consent — clinicians could screen every patient for depression without taking up extra time, following up with only those who are flagged as high risk.\u003c/p>\n\u003cp>Integrating the software into the normal flow of a doctor’s visit is the next step, says Elizabeth Shriberg, the Ellipsis chief scientific officer. Including Northwell, Ellipsis is now in talks with other large health care providers around the country to introduce the program into exam rooms, the company says.\u003c/p>\n\u003cp>\u003cstrong>Monitoring From Afar\u003c/strong>\u003c/p>\n\u003cp>Other physicians want to use voice and behavior analysis technology to learn more about what happens to patients when they’re \u003cem>outside\u003c/em> the exam room.\u003c/p>\n\u003cfigure id=\"attachment_436000\" class=\"wp-caption alignright\" style=\"max-width: 248px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/companion-2-0-android-Home-1.png\">\u003cimg class=\"wp-image-436000 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/companion-2-0-android-Home-1-800x1422.png\" alt=\"\" width=\"248\" height=\"441\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-800x1422.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-160x284.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-768x1365.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-1020x1813.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-1180x2098.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-960x1707.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-240x427.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-375x667.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-520x924.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1.png 1440w\" sizes=\"(max-width: 248px) 100vw, 248px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Image from the dashboard of Cogito's Companion app, meant to diagnose depression and other mental health conditions. \u003ccite>(Cogito)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We often get data only when people come into a clinic … and we know that there's a lot that goes on, obviously, outside of the clinic walls,” says David Ahern, director of the program in Behavioral Informatics and eHealth at Brigham and Women’s Hospital in Boston. “It's this huge unmet need of both understanding the nature of a … mental health disorder as it evolves over time and the experience of patients over time.”\u003c/p>\n\u003cp>Ahern leads a \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02167373?term=cogito&rank=1\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> testing the efficacy of Cogito's Companion app. Cogito was founded eight years ago as a spin-off from the MIT Media Lab in Boston. In addition to Companion, it makes software that gives real‐time feedback to customer call centers.\u003c/p>\n\u003cp>With patients' consent, the Companion app mines background metadata from their phone, including text frequency, call logs and geolocation. Using this data, the program creates a daily score for each patient, which is sent to their care team, alerting them if sudden changes in behavior might be linked to a decline in mental health. For example, if a patient starts to text less and has fewer or shorter calls, it may signal that they’re isolating themselves. Their caregiver can then reach out immediately to see if they are all right rather than having to wait until the next visit.\u003c/p>\n\u003cp>Patients also record a short audio diary a few times a week, which the app analyzes for nonverbal markers of depression, such as tenseness or breathiness, low pitch, volume or range. These results are also included in the patient’s daily score, giving the care team several objective measures of their mental state. In addition to depression, the app is also being \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02742064?term=cogito&rank=2\" target=\"_blank\" rel=\"noopener\">tested\u003c/a> on patients with bipolar disorder and post‐traumatic disorder, with the goal of predicting the onset of acute psychiatric episodes and suicide risk.\u003c/p>\n\u003cp>Skyler Place, vice president of behavioral science at Cogito, says he hopes doctors will use the system to be more proactive, not just in patients’ mental health care, but in their overall quality of life. In another trial for veterans at risk for post‐traumatic stress disorder and suicide, clinicians were able to detect major lifestyle changes through the app, as when one person lost his job and another became homeless.\u003c/p>\n\u003cp>“While the original goal was suicide prevention, in addition to being able to capture that risk, it’s really able to provide an overall risk score for the veteran population, and the clinicians are able to then provide the right service to these veterans in the moment when they need them.”\u003c/p>\n\u003cp>\u003cstrong>Replacing Clinicians? Not so Fast\u003c/strong>\u003c/p>\n\u003cp>As with the adoption of many new technologies, users may be reasonably concerned about privacy. Both Cogito and Ellipsis say that all the proper precautions are taken to store and protect the data, and in many cases the content of the conversations or voice recordings is irrelevant and even discarded.\u003c/p>\n\u003cp>The voice screening software is also not perfect; Cogito’s is currently about 75 percent accurate at flagging mental illness\u003cstrong> \u003c/strong>as compared to clinical interviews with mental health professionals. Ellipsis declined to state how accurate its software is.\u003c/p>\n\u003cp>Adam Miner, a clinical psychologist and instructor at\u003cbr>\nStanford University, says that, “Clinicians regularly take into account patient's tone and vocal patterns when making diagnostic decisions. If a new technology can help measure, or compare patterns over time, there is the potential to add value.” However, he cautions, there are “risks in oversimplifying the complexity of medical diagnoses.”\u003c/p>\n\u003cp>The two companies were quick to emphasize that the technology is not a replacement for human clinicians, but simply an aid or tool, akin to a blood test or an electrocardiogram.\u003c/p>\n\u003cp>“It's a buddy for health teams,” says Mondal. “It is an adviser for behavioral health; you flag patients so health systems can intervene.” After a patient is flagged as needing additional attention, either before or after diagnosis, it is still up to the clinician to administer care, an interaction that hasn’t been disrupted by artificial intelligence.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>SAN DIEGO — Kerri De Nies received the news this spring from her son’s pediatrician: Her chubby-cheeked toddler had a rare brain disorder.\u003c/p>\n\u003cp>She’d never heard of the disease — adrenoleukodystrophy, or ALD — and she soon felt devastated and overwhelmed.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If you pick it up in the early stages … you are at a much better place in terms of treating it effectively.'\u003ccite>Dr. Florian Eichler, Massachusetts General Hospital\u003c/cite>\u003c/aside>\n\u003cp>“I probably read everything you could possibly read online — every single website,” De Nies said as she cradled her son, Gregory Mac Phee. “It’s definitely hard to think about what could potentially happen. You think about the worst-case scenario.”\u003c/p>\n\u003cp>ALD is a \u003ca href=\"http://myelin.org/ald-adrenoleukodystrophy/\">brain disorder\u003c/a> depicted in the 1992 movie “Lorenzo’s Oil,” about a couple whose son became debilitated by the disease. The most serious form of the illness typically strikes boys between ages 4 and 10. Most are diagnosed too late for treatment to be successful, and they often die before their 10th birthday.\u003c/p>\n\u003cp>The more De Nies learned about ALD, the more she realized how fortunate she and Gregory were to have discovered it so early. Her son’s blood was tested when he was about 10 months old.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California is one of only a handful of states nationwide that screens babies for the gene mutation that causes the disease — a test that dramatically increases Gregory’s chances of survival.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s mind-boggling that not every state is testing.'\u003ccite>Kerri De Nies, mother of child with ALD\u003c/cite>\u003c/aside>\n\u003cp>The state began testing newborns for ALD in September 2016, seven months after the federal government added it to the list of recommended screenings. The testing included all babies born after February of that year.\u003c/p>\n\u003cp>“If you pick it up in the early stages … you are at a much better place in terms of treating it effectively,” said Florian Eichler, a neurologist at Massachusetts General Hospital. “That’s where the newborn screening is so important. It really helps you detect these boys at risk.”\u003c/p>\n\u003cp>Eichler said he has seen many families whose boys were diagnosed late. “Listening to families and their ordeal gives you a real sense of what this has done over generations and how much suffering could be prevented through the screening program,” he said.\u003c/p>\n\u003cp>New York was the first to begin screening, in 2013, followed last year by Connecticut and California. A few other states, including Pennsylvania and Minnesota, have since followed.\u003c/p>\n\u003cp>“It’s mind-boggling that not every state is testing,” said De Nies, who teaches children’s ballet in San Diego. “Families will not know until it could be too late for them.”\u003c/p>\n\u003cp>Advocates, including several moms who lost their sons to the disease, were instrumental in getting the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1559\">screening law\u003c/a> passed in California. Now they are continuing to lobby legislators and pushing health officials to add ALD to screening panels across the nation.\u003c/p>\n\u003cp>Janis Sherwood said that since her son Sawyer’s death from ALD, she has felt an urgency to educate doctors, families and others about the disease. In the past few years, she turned her attention to newborn screening. She believes that as California collects data on how the boys do in treatment, other states will follow. “I think that we are going to see a domino effect as we get more states on board,” she said.\u003c/p>\n\u003cp>About 1 in every 18,000 people have ALD. Of boys with the genetic defect, about 30 to 40 percent will develop the life-threatening form of the disease, which leads to vision, gait and memory problems — and eventually death. It destroys myelin, the protective surface that surrounds some nerve cells.\u003c/p>\n\u003cp>Technicians draw the blood of newborns in the hospital soon after they are born. In California, state law requires that the blood be tested for about 80 diseases, including cystic fibrosis, severe combined immunodeficiency and primary congenital hypothyroidism.\u003c/p>\n\u003cp>Around the nation, testing kits cost a hospital or birthing facility about $120, said Jeff Botkin, who heads the medical ethics division at the University of Utah. “This is an extraordinarily low cost for this number of tests,” he said in an email. The tests are typically covered by insurers or Medicaid.\u003c/p>\n\u003cp>Some conditions on the screening list are relatively common, but ALD is among the rare disorders the tests ferret out that can lead to serious health issues or even death if not detected and treated, Botkin said.\u003c/p>\n\u003cp>There is no answer to the question of how common a condition should be to merit spending health care dollars to test for it, Botkin said. But many of the conditions for which the federal government recommends screening are rare, which means they could affect 1 in 50,000 babies or fewer. “The major question is whether the condition is treatable,” Botkin said.\u003c/p>\n\u003cp>Both boys and girls get tested for ALD because they can both be carriers of the genetic defect and develop the less serious adult form of the disease. Only boys, however, develop the more serious, ultimately fatal, childhood disease.\u003c/p>\n\u003cp>When doctors know that boys have the mutation, they perform brain MRIs beginning when the boys are toddlers. If an MRI starts to show telltale changes in the brain, doctors can intervene to halt the progression of the disease.\u003c/p>\n\u003cp>The common treatment, a bone marrow transplant, is risky and complicated, but it is often successful if the donor is a good match and the procedure is performed before the children have visible symptoms, UCLA neurologist Raman Sankar said. Doctors are also having some success with gene therapy, in which the children undergo a transplant with their own stem cells rather than a donor’s, Sankar said.\u003c/p>\n\u003cp>The earlier the transplant, the better a child’s chance of survival, he said. “The delay may make the difference between whether he can have a lifesaving treatment or not.”\u003c/p>\n\u003cp>Before newborn screening, boys in the early stages of ALD frequently were incorrectly diagnosed with hyperactivity and other conditions, said Richard Olney, who heads the genetic disease screening program for the California public health department. “Many families had to go through a sort of diagnostic odyssey,” he said. “It only became clear as they developed progressively worse problems that they had a serious genetic condition.”\u003c/p>\n\u003cp>By the time a brain MRI was performed, there was often too much damage to save the child. That’s part of the challenge for clinicians who may not be familiar with ALD: “How do you know when this is a critical brain disease versus just a normal part of development?” Eichler said.\u003c/p>\n\u003cp>Those with the genetic mutation who do not develop the disease in childhood may still have a milder form as adults. People with the mutation also need to be monitored by an endocrinologist, because many will suffer from a condition in which their adrenal glands fail to produce enough of a stress hormone that is needed to fight infections.\u003c/p>\n\u003cp>Gina Cousineau’s 8-year-old son, Evan, was diagnosed with ALD in May 2007 after he came home from swim practice and had a seizure. Though he underwent a bone marrow transplant, Evan died from a secondary infection before he turned 9.\u003c/p>\n\u003cp>Cousineau lives in the southern Orange County city of San Clemente and helped lobby for the California law that requires ALD screening. She said newborn testing benefits infants with ALD and can help families discover that siblings or other relatives have the gene mutation.\u003c/p>\n\u003cp>“Thank God this newborn screening came into effect,” Cousineau said. “Knowledge is power. Had I had the knowledge with my son, Evan, he would be alive today.”\u003c/p>\n\u003cp>De Nies said she worries about Gregory’s future, but she’s confident her son will live a long life. And she credits Cousineau and other mothers whose sons didn’t have the same chance.\u003c/p>\n\u003cp>“Without them, we would never know about the gene mutation,” she said. “I just feel like they are our fairy godmothers.”\u003c/p>\n\u003cp>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\">Kaiser Family Foundation\u003c/a>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>SAN DIEGO — Kerri De Nies received the news this spring from her son’s pediatrician: Her chubby-cheeked toddler had a rare brain disorder.\u003c/p>\n\u003cp>She’d never heard of the disease — adrenoleukodystrophy, or ALD — and she soon felt devastated and overwhelmed.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If you pick it up in the early stages … you are at a much better place in terms of treating it effectively.'\u003ccite>Dr. Florian Eichler, Massachusetts General Hospital\u003c/cite>\u003c/aside>\n\u003cp>“I probably read everything you could possibly read online — every single website,” De Nies said as she cradled her son, Gregory Mac Phee. “It’s definitely hard to think about what could potentially happen. You think about the worst-case scenario.”\u003c/p>\n\u003cp>ALD is a \u003ca href=\"http://myelin.org/ald-adrenoleukodystrophy/\">brain disorder\u003c/a> depicted in the 1992 movie “Lorenzo’s Oil,” about a couple whose son became debilitated by the disease. The most serious form of the illness typically strikes boys between ages 4 and 10. Most are diagnosed too late for treatment to be successful, and they often die before their 10th birthday.\u003c/p>\n\u003cp>The more De Nies learned about ALD, the more she realized how fortunate she and Gregory were to have discovered it so early. Her son’s blood was tested when he was about 10 months old.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California is one of only a handful of states nationwide that screens babies for the gene mutation that causes the disease — a test that dramatically increases Gregory’s chances of survival.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s mind-boggling that not every state is testing.'\u003ccite>Kerri De Nies, mother of child with ALD\u003c/cite>\u003c/aside>\n\u003cp>The state began testing newborns for ALD in September 2016, seven months after the federal government added it to the list of recommended screenings. The testing included all babies born after February of that year.\u003c/p>\n\u003cp>“If you pick it up in the early stages … you are at a much better place in terms of treating it effectively,” said Florian Eichler, a neurologist at Massachusetts General Hospital. “That’s where the newborn screening is so important. It really helps you detect these boys at risk.”\u003c/p>\n\u003cp>Eichler said he has seen many families whose boys were diagnosed late. “Listening to families and their ordeal gives you a real sense of what this has done over generations and how much suffering could be prevented through the screening program,” he said.\u003c/p>\n\u003cp>New York was the first to begin screening, in 2013, followed last year by Connecticut and California. A few other states, including Pennsylvania and Minnesota, have since followed.\u003c/p>\n\u003cp>“It’s mind-boggling that not every state is testing,” said De Nies, who teaches children’s ballet in San Diego. “Families will not know until it could be too late for them.”\u003c/p>\n\u003cp>Advocates, including several moms who lost their sons to the disease, were instrumental in getting the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1559\">screening law\u003c/a> passed in California. Now they are continuing to lobby legislators and pushing health officials to add ALD to screening panels across the nation.\u003c/p>\n\u003cp>Janis Sherwood said that since her son Sawyer’s death from ALD, she has felt an urgency to educate doctors, families and others about the disease. In the past few years, she turned her attention to newborn screening. She believes that as California collects data on how the boys do in treatment, other states will follow. “I think that we are going to see a domino effect as we get more states on board,” she said.\u003c/p>\n\u003cp>About 1 in every 18,000 people have ALD. Of boys with the genetic defect, about 30 to 40 percent will develop the life-threatening form of the disease, which leads to vision, gait and memory problems — and eventually death. It destroys myelin, the protective surface that surrounds some nerve cells.\u003c/p>\n\u003cp>Technicians draw the blood of newborns in the hospital soon after they are born. In California, state law requires that the blood be tested for about 80 diseases, including cystic fibrosis, severe combined immunodeficiency and primary congenital hypothyroidism.\u003c/p>\n\u003cp>Around the nation, testing kits cost a hospital or birthing facility about $120, said Jeff Botkin, who heads the medical ethics division at the University of Utah. “This is an extraordinarily low cost for this number of tests,” he said in an email. The tests are typically covered by insurers or Medicaid.\u003c/p>\n\u003cp>Some conditions on the screening list are relatively common, but ALD is among the rare disorders the tests ferret out that can lead to serious health issues or even death if not detected and treated, Botkin said.\u003c/p>\n\u003cp>There is no answer to the question of how common a condition should be to merit spending health care dollars to test for it, Botkin said. But many of the conditions for which the federal government recommends screening are rare, which means they could affect 1 in 50,000 babies or fewer. “The major question is whether the condition is treatable,” Botkin said.\u003c/p>\n\u003cp>Both boys and girls get tested for ALD because they can both be carriers of the genetic defect and develop the less serious adult form of the disease. Only boys, however, develop the more serious, ultimately fatal, childhood disease.\u003c/p>\n\u003cp>When doctors know that boys have the mutation, they perform brain MRIs beginning when the boys are toddlers. If an MRI starts to show telltale changes in the brain, doctors can intervene to halt the progression of the disease.\u003c/p>\n\u003cp>The common treatment, a bone marrow transplant, is risky and complicated, but it is often successful if the donor is a good match and the procedure is performed before the children have visible symptoms, UCLA neurologist Raman Sankar said. Doctors are also having some success with gene therapy, in which the children undergo a transplant with their own stem cells rather than a donor’s, Sankar said.\u003c/p>\n\u003cp>The earlier the transplant, the better a child’s chance of survival, he said. “The delay may make the difference between whether he can have a lifesaving treatment or not.”\u003c/p>\n\u003cp>Before newborn screening, boys in the early stages of ALD frequently were incorrectly diagnosed with hyperactivity and other conditions, said Richard Olney, who heads the genetic disease screening program for the California public health department. “Many families had to go through a sort of diagnostic odyssey,” he said. “It only became clear as they developed progressively worse problems that they had a serious genetic condition.”\u003c/p>\n\u003cp>By the time a brain MRI was performed, there was often too much damage to save the child. That’s part of the challenge for clinicians who may not be familiar with ALD: “How do you know when this is a critical brain disease versus just a normal part of development?” Eichler said.\u003c/p>\n\u003cp>Those with the genetic mutation who do not develop the disease in childhood may still have a milder form as adults. People with the mutation also need to be monitored by an endocrinologist, because many will suffer from a condition in which their adrenal glands fail to produce enough of a stress hormone that is needed to fight infections.\u003c/p>\n\u003cp>Gina Cousineau’s 8-year-old son, Evan, was diagnosed with ALD in May 2007 after he came home from swim practice and had a seizure. Though he underwent a bone marrow transplant, Evan died from a secondary infection before he turned 9.\u003c/p>\n\u003cp>Cousineau lives in the southern Orange County city of San Clemente and helped lobby for the California law that requires ALD screening. She said newborn testing benefits infants with ALD and can help families discover that siblings or other relatives have the gene mutation.\u003c/p>\n\u003cp>“Thank God this newborn screening came into effect,” Cousineau said. “Knowledge is power. Had I had the knowledge with my son, Evan, he would be alive today.”\u003c/p>\n\u003cp>De Nies said she worries about Gregory’s future, but she’s confident her son will live a long life. And she credits Cousineau and other mothers whose sons didn’t have the same chance.\u003c/p>\n\u003cp>“Without them, we would never know about the gene mutation,” she said. “I just feel like they are our fairy godmothers.”\u003c/p>\n\u003cp>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\">Kaiser Family Foundation\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Farmworkers Want Pesticide Banned in California After EPA Refuses",
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"content": "\u003cp>Environmentalists and farmworkers are pushing California regulators to ban the \u003ca href=\"https://www.epa.gov/sites/production/files/2016-05/documents/session-2-chlorpyrifos-human-health-risk-assessment-approach.pdf\" target=\"_blank\" rel=\"noopener\">most commonly\u003c/a> used conventional insecticide in the country. The Environmental Protection Agency under President Obama proposed \u003ca href=\"https://www.gpo.gov/fdsys/pkg/FR-2015-11-06/pdf/2015-28083.pdf\" target=\"_blank\" rel=\"noopener\">banning\u003c/a> chlorpyrifos in 2015 because studies suggest it threatens human health, but the Trump administration \u003ca href=\"https://www.epa.gov/newsreleases/epa-administrator-pruitt-denies-petition-ban-widely-used-pesticide-0\" target=\"_blank\" rel=\"noopener\">reversed\u003c/a> that decision this spring. Now activists are pushing for a statewide ban.\u003c/p>\n\u003cp>\u003cstrong>Clorpyrifos: What Is it? \u003c/strong>\u003c/p>\n\u003cp>Dow Chemical registered chlorpyrifos in 1965. Around 6 million pounds are used nationally every year, and about a million pounds are used annually in California. Farmers use it to kill pests like ants, moths, larvae and worms on about 60 crops, including oranges, alfalfa and almonds.\u003c/p>\n\u003cp>Chlorpyrifos is part of a class of chemicals called organophosphates, which can poison the nervous systems of insects and mammals. \u003ca href=\"https://www.osha.gov/SLTC/emergencypreparedness/guides/nerve.html\" target=\"_blank\" rel=\"noopener\">Sarin gas, \u003c/a>the nerve agent used in chemical warfare, is also an organophosphate, though chlorpyrifos is much less toxic.\u003c/p>\n\u003caside class=\"pullquote alignright\">'They know it impacts children's brains — the question is about what levels.'\u003ccite>Paul Towers, Pesticide Action Network\u003c/cite>\u003c/aside>\n\u003cp>At high doses, nerve agents like chlorpyrifos cause symptoms like headaches, nausea, dizziness and disorientation. If larger doses are ingested, it can lead to vomiting, stomachaches, diarrhea and even death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The EPA banned chlorpyrifos for the majority of home and garden uses in 2000 due to toxic effects on the nervous system. The agency has also restricted its use on a few commercial crops like apples and tomatoes. A few years ago the U.K. banned the chemical on nearly all crops.\u003c/p>\n\u003cp>\u003cstrong>Trump EPA Revokes Ban\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In March, the new chief of the EPA, Scott Pruitt, rejected the proposed ban, which had been recommended by EPA scientists. In a \u003ca href=\"https://www.epa.gov/newsreleases/epa-administrator-pruitt-denies-petition-ban-widely-used-pesticide-0\">press release\u003c/a> Pruitt said, \"By reversing the previous administration’s steps to ban one of the most widely used pesticides in the world, we are returning to using sound science in decision-making — rather than predetermined results.\" He said the EPA would not make any final decisions on chlorpyrifos until 2022, pending the agency's further scientific review.\u003c/p>\n\u003cp>Pruitt's actions outraged environmentalists and many scientists who have studied the chemical for decades. Activists were further angered this spring when the widely used pesticide Vulcan (whose active ingredient is chlorpyrifos) drifted from a field in Kern County over to a group of farmworkers picking cabbage. Five of them sought medical treatment.\u003c/p>\n\u003cfigure id=\"attachment_435787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-435787 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/chlorpyrifos-pics-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics.jpg 1280w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Protesters near the state Capitol in Sacramento calling for a ban on chlorpyrifos in September 2017. \u003ccite>(Joan Cusick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>California Tightens Restrictions, But No Ban\u003c/strong>\u003c/p>\n\u003cp>The California Department of Pesticide Regulation is in the midst of reviewing the science on chlorpyrifos to analyze whether a statewide ban is justified. California already had stricter rules related to its application than most states. For example, farmers must have a permit to apply the chemical; they must post a warning after they spray a field; and the state requires buffer zones between sprayed fields and human dwellings.\u003c/p>\n\u003cp>Last week CDPR implemented even stricter rules while it completes its lengthy scientific review. The interim guidelines require greater distances between fields sprayed with chlorpyrifos and \"sensitive areas\" like homes. The distances are now up to 500 feet, about three times longer than previous requirements.\u003c/p>\n\u003cp>“Our scientists have figured out a way that we can use this pesticide with protections and restrictions in place safely in California,\" said CDPR spokeswoman Charlotte Fadipe. \"And we are saying we want more scientific eyes on this to see if those restrictions are robust enough or whether we need to do more.”\u003c/p>\n\u003cp>But the enhanced mitigation does not satisfy activists.\u003c/p>\n\u003cp>\"We are calling on DPR to hit the pause button on continued use of this chemical based on what they know, \" said Paul Towers of Pesticide Action Network. \"They know it impacts children's brains -- the question is about what levels. So while we determine that through two different lengthy scientific bodies we should suspend the use of chlorpyrifos in California.\"\u003c/p>\n\u003cp>When EPA scientists proposed banning chlorpyrifos in November 2015, their recommendation was based on the \u003ca href=\"http://unesdoc.unesco.org/images/0013/001395/139578e.pdf\">precautionary \u003c/a>principle: better to err on the side of caution rather than putting anyone at risk. Towers is calling on state regulators to take the same stance to protect agricultural communities.\u003c/p>\n\u003cfigure id=\"attachment_435850\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-435850 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/JCP_2026-X2-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2.jpg 1280w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">California farmworker protests use of chlorpyrifos at the state capitol in July 2017. \u003ccite>(Joan Cusick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Does the Science Justify a Ban?\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The majority of research available has looked at how exposure to chlorpyrifos influences the developing fetus rather than workers in the field. Research shows that prenatal exposure can lead to preterm births, abnormal reflexes in newborns, pervasive attention problems, motor control deficiencies and lower IQ. Scientists have also noted that some young children who have been exposed to the chemical have conditions related to compromised lung function, like asthma.\u003c/p>\n\u003cp>Brenda Eskenazi is an epidemiologist and neuropsychologist at UC Berkeley who has studied organophosphates for many years. She says the EPA under the Obama administration made a sound scientific decision when the agency recommended a ban. “A weight of evidence strongly suggests that chlorpyrifos has sufficient evidence in animals — limited evidence in humans — to restrict or even ban it’s use.”\u003c/p>\n\u003cp>Eskenazi also says chlorpyrifos is not the worst organophosphate used in agriculture; there are other chemicals that may be more toxic to human health. But environmentalists are targeting chlorpyrifos because it is one of the most widely studied chemicals in the world, even though there is still little research on whether residue in produce could impact consumer health.\u003c/p>\n\u003cp>Dow Agrosciences says it remains confident that authorized uses of its product offer wide margins of protection for human health and safety. In a statement the company said, \"Overall, more than 4,000 studies and reports have examined chlorpyrifos in terms of health, safety and the environment. No pest-control product has been or continues to be more thoroughly evaluated.\"\u003c/p>\n\u003cp>Towers draws a different conclusion from the abundance of research.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"If we can't act on this pesticide,\" he say, \"what pesticide can we act on?\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Environmentalists and farmworkers are pushing California regulators to ban the \u003ca href=\"https://www.epa.gov/sites/production/files/2016-05/documents/session-2-chlorpyrifos-human-health-risk-assessment-approach.pdf\" target=\"_blank\" rel=\"noopener\">most commonly\u003c/a> used conventional insecticide in the country. The Environmental Protection Agency under President Obama proposed \u003ca href=\"https://www.gpo.gov/fdsys/pkg/FR-2015-11-06/pdf/2015-28083.pdf\" target=\"_blank\" rel=\"noopener\">banning\u003c/a> chlorpyrifos in 2015 because studies suggest it threatens human health, but the Trump administration \u003ca href=\"https://www.epa.gov/newsreleases/epa-administrator-pruitt-denies-petition-ban-widely-used-pesticide-0\" target=\"_blank\" rel=\"noopener\">reversed\u003c/a> that decision this spring. Now activists are pushing for a statewide ban.\u003c/p>\n\u003cp>\u003cstrong>Clorpyrifos: What Is it? \u003c/strong>\u003c/p>\n\u003cp>Dow Chemical registered chlorpyrifos in 1965. Around 6 million pounds are used nationally every year, and about a million pounds are used annually in California. Farmers use it to kill pests like ants, moths, larvae and worms on about 60 crops, including oranges, alfalfa and almonds.\u003c/p>\n\u003cp>Chlorpyrifos is part of a class of chemicals called organophosphates, which can poison the nervous systems of insects and mammals. \u003ca href=\"https://www.osha.gov/SLTC/emergencypreparedness/guides/nerve.html\" target=\"_blank\" rel=\"noopener\">Sarin gas, \u003c/a>the nerve agent used in chemical warfare, is also an organophosphate, though chlorpyrifos is much less toxic.\u003c/p>\n\u003caside class=\"pullquote alignright\">'They know it impacts children's brains — the question is about what levels.'\u003ccite>Paul Towers, Pesticide Action Network\u003c/cite>\u003c/aside>\n\u003cp>At high doses, nerve agents like chlorpyrifos cause symptoms like headaches, nausea, dizziness and disorientation. If larger doses are ingested, it can lead to vomiting, stomachaches, diarrhea and even death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The EPA banned chlorpyrifos for the majority of home and garden uses in 2000 due to toxic effects on the nervous system. The agency has also restricted its use on a few commercial crops like apples and tomatoes. A few years ago the U.K. banned the chemical on nearly all crops.\u003c/p>\n\u003cp>\u003cstrong>Trump EPA Revokes Ban\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In March, the new chief of the EPA, Scott Pruitt, rejected the proposed ban, which had been recommended by EPA scientists. In a \u003ca href=\"https://www.epa.gov/newsreleases/epa-administrator-pruitt-denies-petition-ban-widely-used-pesticide-0\">press release\u003c/a> Pruitt said, \"By reversing the previous administration’s steps to ban one of the most widely used pesticides in the world, we are returning to using sound science in decision-making — rather than predetermined results.\" He said the EPA would not make any final decisions on chlorpyrifos until 2022, pending the agency's further scientific review.\u003c/p>\n\u003cp>Pruitt's actions outraged environmentalists and many scientists who have studied the chemical for decades. Activists were further angered this spring when the widely used pesticide Vulcan (whose active ingredient is chlorpyrifos) drifted from a field in Kern County over to a group of farmworkers picking cabbage. Five of them sought medical treatment.\u003c/p>\n\u003cfigure id=\"attachment_435787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-435787 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/chlorpyrifos-pics-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics.jpg 1280w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Protesters near the state Capitol in Sacramento calling for a ban on chlorpyrifos in September 2017. \u003ccite>(Joan Cusick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>California Tightens Restrictions, But No Ban\u003c/strong>\u003c/p>\n\u003cp>The California Department of Pesticide Regulation is in the midst of reviewing the science on chlorpyrifos to analyze whether a statewide ban is justified. California already had stricter rules related to its application than most states. For example, farmers must have a permit to apply the chemical; they must post a warning after they spray a field; and the state requires buffer zones between sprayed fields and human dwellings.\u003c/p>\n\u003cp>Last week CDPR implemented even stricter rules while it completes its lengthy scientific review. The interim guidelines require greater distances between fields sprayed with chlorpyrifos and \"sensitive areas\" like homes. The distances are now up to 500 feet, about three times longer than previous requirements.\u003c/p>\n\u003cp>“Our scientists have figured out a way that we can use this pesticide with protections and restrictions in place safely in California,\" said CDPR spokeswoman Charlotte Fadipe. \"And we are saying we want more scientific eyes on this to see if those restrictions are robust enough or whether we need to do more.”\u003c/p>\n\u003cp>But the enhanced mitigation does not satisfy activists.\u003c/p>\n\u003cp>\"We are calling on DPR to hit the pause button on continued use of this chemical based on what they know, \" said Paul Towers of Pesticide Action Network. \"They know it impacts children's brains -- the question is about what levels. So while we determine that through two different lengthy scientific bodies we should suspend the use of chlorpyrifos in California.\"\u003c/p>\n\u003cp>When EPA scientists proposed banning chlorpyrifos in November 2015, their recommendation was based on the \u003ca href=\"http://unesdoc.unesco.org/images/0013/001395/139578e.pdf\">precautionary \u003c/a>principle: better to err on the side of caution rather than putting anyone at risk. Towers is calling on state regulators to take the same stance to protect agricultural communities.\u003c/p>\n\u003cfigure id=\"attachment_435850\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-435850 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/JCP_2026-X2-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2.jpg 1280w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">California farmworker protests use of chlorpyrifos at the state capitol in July 2017. \u003ccite>(Joan Cusick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Does the Science Justify a Ban?\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The majority of research available has looked at how exposure to chlorpyrifos influences the developing fetus rather than workers in the field. Research shows that prenatal exposure can lead to preterm births, abnormal reflexes in newborns, pervasive attention problems, motor control deficiencies and lower IQ. Scientists have also noted that some young children who have been exposed to the chemical have conditions related to compromised lung function, like asthma.\u003c/p>\n\u003cp>Brenda Eskenazi is an epidemiologist and neuropsychologist at UC Berkeley who has studied organophosphates for many years. She says the EPA under the Obama administration made a sound scientific decision when the agency recommended a ban. “A weight of evidence strongly suggests that chlorpyrifos has sufficient evidence in animals — limited evidence in humans — to restrict or even ban it’s use.”\u003c/p>\n\u003cp>Eskenazi also says chlorpyrifos is not the worst organophosphate used in agriculture; there are other chemicals that may be more toxic to human health. But environmentalists are targeting chlorpyrifos because it is one of the most widely studied chemicals in the world, even though there is still little research on whether residue in produce could impact consumer health.\u003c/p>\n\u003cp>Dow Agrosciences says it remains confident that authorized uses of its product offer wide margins of protection for human health and safety. In a statement the company said, \"Overall, more than 4,000 studies and reports have examined chlorpyrifos in terms of health, safety and the environment. No pest-control product has been or continues to be more thoroughly evaluated.\"\u003c/p>\n\u003cp>Towers draws a different conclusion from the abundance of research.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"If we can't act on this pesticide,\" he say, \"what pesticide can we act on?\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Isolation is Big Health Risk for Seniors. But There's Community Online",
"title": "Isolation is Big Health Risk for Seniors. But There's Community Online",
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"content": "\u003cp class=\"p1\">\u003cem>Originally published June 26, 2017\u003c/em>\u003c/p>\n\u003cp class=\"p1\">Orazgul Tachmuradova, age 71, emigrated to the United States alone, about a decade ago. Learning to get around San Francisco wasn't easy.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“My eyes are not good, my hearing’s not good, my English is not good,” is how she puts it. Having grown up in a rural area, surrounded by family, she was “slowly dying of disconnection.” \u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'The iPad is like a genie -- Hello, Siri? Tell me this one!' \u003ccite>Orazgul Tachmuradova, 71\u003c/cite>\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“This world does not belong to me; I do not belong to this world,” she recalls feeling.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But recently, things have been looking up, thanks to a new high-tech relationship.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The iPad is like a \u003cem>genie\u003c/em>,” she says. She mimes pressing a button: “Hello, Siri? Tell me this one!”\u003c/p>\n\u003cp class=\"p1\">Tachmuradova and Siri started conversing during a year-long pilot project, now coming to an end, at San Francisco’s \u003cspan class=\"s2\">\u003ca href=\"http://curryseniorcenter.org\">Curry Senior Center\u003c/a>. Seventeen s\u003c/span>eniors were given iPads, FitBits and digital scales to monitor their health, and to reduce isolation by teaching them how to socialize, learn and enjoy themselves online.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\"> “When I started this program, I was reborn,” says Tachmuradova. “I am becoming alive! More and more now, we are busy. I don’t feel I am alone. I live alone without \u003ci>being\u003c/i> alone.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">All of the program’s seniors live alone, and most are very low-income.\u003cb> \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“Some people felt isolated, technologically-wise, because they didn't know what other people were doing on the internet,” says Angela Di Martino, who teaches the weekly class on how to use the devices. “Now I think they feel a lot more comfortable because they have that knowledge.”\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'I live alone without \u003ci>being\u003c/i> alone.'\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino devoted early lessons to finding trustworthy medical information on the web, emailing your doctor and checking lab results online. Her students have also been introduced to an array of social tech tools; some of the group’s favorite are FaceTime and Skype for video chatting and Messenger for sharing photos. Many in the group use their iPads to tune in the radio or podcasts, and one has \u003ca href=\"https://www.youtube.com/user/MJofSanFran\">\u003cspan class=\"s2\">her own YouTube channel\u003c/span>\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The last few classes have been devoted to iPad photography, so today everyone is editing their best shots. In one corner, Marilyn Chan and Shirley Smith keep leaning over to see what’s happening on each other’s screens. Chan is polishing up a selfie of the two of them making the most of Ben & Jerry’s Free Cone Day. Across the room, Linda Rospendowski, 68, is contemplating a photo of herself in a hot pink dress. But she has a problem: The photographer has chopped off the top of her head, and she's wondering if you can digitally repair hair. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The bouffant—it has to be there,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>America: Getting Old\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">As baby boomers head into their 60s and 70s, advocacy groups are now exploring the benefits of this kind of tech education for seniors. Prime candidates are elderly people who live in rural areas, are estranged or live far from family, or have health or mobility problems that make it difficult to get around.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_414753\" class=\"wp-caption alignleft\" style=\"max-width: 386px\">\u003cimg class=\"wp-image-414753 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1020x680.jpg\" alt=\"\" width=\"386\" height=\"257\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1.jpg 1600w\" sizes=\"(max-width: 386px) 100vw, 386px\">\u003cfigcaption class=\"wp-caption-text\">Linda Rospendowski, 68, and Orazgul Tachmuradova, 71, work on editing their photos. \u003ccite>(Kara Platoni/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Lisa Marsh Ryerson, president of the AARP Foundation, a charitable affiliate of the advocacy group for seniors, points out that 10,000 Americans turn 65 every day. But despite their numbers, baby boomers don’t always feel like they’re aging together. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“As many as 40 percent of adults who are 65 or older say that they experience significant loneliness,” says Ryerson.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">Loneliness isn’t quite the same thing as being alone, but both can influence health. “Loneliness is something that is subjective. It’s our own perception of our experiences,” says Ryerson. It is also one measure of distress. Isolation, on the other hand, is an objective metric, “based on the size of someone’s social network, the frequency of contact with their social network and their access to services.”\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">[contextly_sidebar id=\"pJzqgRcGnSSnAs2omLf83MRF0ZoTRCKk\"]Isolation can cause health problems even for a person who feels perfectly satisfied with a small or distant network. (Imagine not knowing anyone nearby who can check on you when you’re ill.) Ryerson says isolation is often triggered by loss of hearing or mobility, a move to a new community or a partner’s death, and it’s especially common among those who are low-income or identify as a member of a marginalized group.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">To address the problem, the AARP Foundation recently launched \u003ca href=\"https://connect2affect.org/\">\u003cspan class=\"s2\">Connect2Affect\u003c/span>\u003c/a>, a resource portal for older adults and caregivers that encourages online engagement, and includes a \u003ca href=\"https://connect2affect.org/wp-content/uploads/2017/03/A-Profile-of-Social-Connectedness.pdf\">\u003cspan class=\"s2\">study of social connectedness among people over age 62\u003c/span>\u003c/a>. The \u003ca href=\"https://aarptek.aarp.org/\">\u003cspan class=\"s2\">AARP Academy\u003c/span>\u003c/a> also offers free online tutorials for using smartphones, tablets or social media, and for conducting job searches on the internet. \u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">Meanwhile, the National Council on Aging completed its own \u003ca href=\"https://www.ncoa.org/healthy-aging/aging-mastery-program/\">\u003cspan class=\"s3\">two-year tablet program\u003c/span>\u003c/a>, similar to Curry’s. The result? “The more time [participants] were spending on the tablets, the stronger their social interactions, their emotional support, self-esteem,” says \u003c/span>\u003cspan class=\"s4\">Susan Stiles, senior director of product development and strategy for the group. \u003c/span>\u003c/p>\n\u003cp class=\"p5\">\u003cstrong>\u003cspan class=\"s1\">Getting Seniors Connected\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Yet enticing people online isn’t always easy. According to a \u003ca href=\"http://www.pewinternet.org/2017/05/17/technology-use-among-seniors/\">\u003cspan class=\"s2\">study \u003c/span>\u003c/a>\u003cspan class=\"s2\">released in May by the Pew Research Center\u003c/span>, while mobile device use is climbing among seniors, still only about a third own a tablet, 42 percent own smartphones, and just over half have broadband at home. Only about a third use social media.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“There were some fears going into the project,” says Stiles of the NCOA program. “People did not necessarily think that a tablet computer had any relevancy for their lives. They had privacy concerns and were afraid of potentially being exposed to scams.” (Ditto the Curry class, where people asked pointed questions about putting credit card information on their iPad and worried about being unfairly charged when ordering photo prints online.)\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">For the NCOA program, the trick was helping users find their personal killer app. For a former taxi driver now in his 90s, it was Google Maps. Stiles recalls a colleague asking the man to name some streets on his old route. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“She zoomed in on these streets and his eyes just lit up, \" Stiles says. \"And then he wanted to go everywhere in New York City.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">For a former B-movie actress, the most alluring app was YouTube, where she found her old film clips.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Tablets seem to be a nice middle ground for those who are skeptical of full-sized computers. You can use voice commands instead of struggling with a mouse or keyboard; they fit neatly into a small living space like a senior apartment; and you can use them while sitting in your favorite comfy chair. “It doesn't feel like this weighty technology object,” says Stiles. “It really feels like a book.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Designing for Seniors\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Pittsburgh-based Breezie, which sells tech solutions for seniors and \u003ca href=\"https://www.breezie.com/breezie-in-action/breezie-brings-online-benefits-to-seniors-in-florida/\">\u003cspan class=\"s2\">partnered with the NCOA on its program\u003c/span>\u003c/a>, is trying to make Android-based devices even easier for new users by offering a service that simplifies a tablet’s interface. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“If you went right now to a Best Buy and if you bought a tablet to give to a senior, there are 43 different settings you would want to change before you make it senior-friendly,”\u003cb> \u003c/b>says CEO and founder Jeh Kazimi. He means things that Breezie can pre-adjust, like brightness and volume, consolidating logins, and making the screen more forgiving if you accidentally put your thumb on it. The company is also trying to develop a way to cancel out hand tremor for people with Parkinson's disease, because uneven pressure can make the tablet think a user is swiping when they mean to click.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_415056\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS15_Platoni.jpg\">\u003cimg class=\"size-large wp-image-415056\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS15_Platoni-1020x804.jpg\" alt=\"\" width=\"640\" height=\"504\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-1020x804.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-160x126.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-800x631.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-768x605.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-1180x930.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-960x757.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-240x189.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-375x296.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-520x410.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaycee Springer, 65, polishes up her photo of the sun setting over San Francisco. \u003ccite>(Kara Platoni/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Caregivers or Breezie staff can also curate each person’s desktop, like providing ready-made YouTube playlists for fans of jazz music or Muhammad Ali’s boxing matches. For an avid gardener, Kazimi says, they might install a few outdoorsy apps “that don’t show you ads every two minutes or ask you to upgrade every three minutes.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But tablets aren’t a foolproof platform. Kazimi has seen seniors who need stickers to label the camera, volume and charging socket, because the devices can suddenly flip screen orientation, leaving confused people holding them upside down and wondering where the buttons are. Di Martino encountered some unexpected hurdles, too, “like a couple of the men in the class didn't know how to type.” She helped get people comfortable with the touchscreen by offering styluses, which are more accurate pointing tools than fingers. And she encouraged her students to feel OK about making mistakes. “Sometimes I tell them, ‘I don’t know what that button does. Let’s hit it,’” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cstrong>\u003cspan class=\"s1\">Dip in Loneliness\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The seniors in the Curry program report different feelings about living alone—for example, Kaycee Springer enjoys it and is content using video chat to keep in touch with her daughters long-distance. But she does feel a bit socially crimped in the Tenderloin, where it doesn't always seem safe to walk around, especially at night. And she knows some of her elderly neighbors are extremely withdrawn. “There are people in my building, they just lay around and do absolutely nothing,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino has put together some preliminary stats from surveying participants at the program’s 6-month point. Almost all of the seniors said they used their iPad daily. As with the NCOA program, she noted a slight dip in reported loneliness. But the leaders of both projects say it’s hard to know if that stems from people making friends in class or becoming more social online. The AARP’s Ryerson says you might as well encourage both, so that technological and real-world connections reinforce each other. For example, she says, “FitBits are about taking steps. So let’s walk together.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the Curry Center, one other result is very clear: Now that the class is ending, nobody wants to give up their iPads. \"We just started!” exclaims Tachmuradova.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Springer still finds her tablet hard to put down: “I will put it on my bed—and then I will go, ‘\u003ci>It’s calling me\u003c/i>.’”\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino says not to worry—they’re looking into a second phase that will allow everyone to keep their tablets, perhaps in exchange for peer mentoring the next round of students. Now that she’s taught them every iPad trick she knows, their new challenge will be teaching each other. \u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">\u003cem>Originally published June 26, 2017\u003c/em>\u003c/p>\n\u003cp class=\"p1\">Orazgul Tachmuradova, age 71, emigrated to the United States alone, about a decade ago. Learning to get around San Francisco wasn't easy.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“My eyes are not good, my hearing’s not good, my English is not good,” is how she puts it. Having grown up in a rural area, surrounded by family, she was “slowly dying of disconnection.” \u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'The iPad is like a genie -- Hello, Siri? Tell me this one!' \u003ccite>Orazgul Tachmuradova, 71\u003c/cite>\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“This world does not belong to me; I do not belong to this world,” she recalls feeling.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But recently, things have been looking up, thanks to a new high-tech relationship.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The iPad is like a \u003cem>genie\u003c/em>,” she says. She mimes pressing a button: “Hello, Siri? Tell me this one!”\u003c/p>\n\u003cp class=\"p1\">Tachmuradova and Siri started conversing during a year-long pilot project, now coming to an end, at San Francisco’s \u003cspan class=\"s2\">\u003ca href=\"http://curryseniorcenter.org\">Curry Senior Center\u003c/a>. Seventeen s\u003c/span>eniors were given iPads, FitBits and digital scales to monitor their health, and to reduce isolation by teaching them how to socialize, learn and enjoy themselves online.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\"> “When I started this program, I was reborn,” says Tachmuradova. “I am becoming alive! More and more now, we are busy. I don’t feel I am alone. I live alone without \u003ci>being\u003c/i> alone.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">All of the program’s seniors live alone, and most are very low-income.\u003cb> \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“Some people felt isolated, technologically-wise, because they didn't know what other people were doing on the internet,” says Angela Di Martino, who teaches the weekly class on how to use the devices. “Now I think they feel a lot more comfortable because they have that knowledge.”\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'I live alone without \u003ci>being\u003c/i> alone.'\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino devoted early lessons to finding trustworthy medical information on the web, emailing your doctor and checking lab results online. Her students have also been introduced to an array of social tech tools; some of the group’s favorite are FaceTime and Skype for video chatting and Messenger for sharing photos. Many in the group use their iPads to tune in the radio or podcasts, and one has \u003ca href=\"https://www.youtube.com/user/MJofSanFran\">\u003cspan class=\"s2\">her own YouTube channel\u003c/span>\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The last few classes have been devoted to iPad photography, so today everyone is editing their best shots. In one corner, Marilyn Chan and Shirley Smith keep leaning over to see what’s happening on each other’s screens. Chan is polishing up a selfie of the two of them making the most of Ben & Jerry’s Free Cone Day. Across the room, Linda Rospendowski, 68, is contemplating a photo of herself in a hot pink dress. But she has a problem: The photographer has chopped off the top of her head, and she's wondering if you can digitally repair hair. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The bouffant—it has to be there,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>America: Getting Old\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">As baby boomers head into their 60s and 70s, advocacy groups are now exploring the benefits of this kind of tech education for seniors. Prime candidates are elderly people who live in rural areas, are estranged or live far from family, or have health or mobility problems that make it difficult to get around.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_414753\" class=\"wp-caption alignleft\" style=\"max-width: 386px\">\u003cimg class=\"wp-image-414753 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1020x680.jpg\" alt=\"\" width=\"386\" height=\"257\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1.jpg 1600w\" sizes=\"(max-width: 386px) 100vw, 386px\">\u003cfigcaption class=\"wp-caption-text\">Linda Rospendowski, 68, and Orazgul Tachmuradova, 71, work on editing their photos. \u003ccite>(Kara Platoni/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Lisa Marsh Ryerson, president of the AARP Foundation, a charitable affiliate of the advocacy group for seniors, points out that 10,000 Americans turn 65 every day. But despite their numbers, baby boomers don’t always feel like they’re aging together. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“As many as 40 percent of adults who are 65 or older say that they experience significant loneliness,” says Ryerson.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">Loneliness isn’t quite the same thing as being alone, but both can influence health. “Loneliness is something that is subjective. It’s our own perception of our experiences,” says Ryerson. It is also one measure of distress. Isolation, on the other hand, is an objective metric, “based on the size of someone’s social network, the frequency of contact with their social network and their access to services.”\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003c/p>\u003cp>\u003c/p>\u003cp>Isolation can cause health problems even for a person who feels perfectly satisfied with a small or distant network. (Imagine not knowing anyone nearby who can check on you when you’re ill.) Ryerson says isolation is often triggered by loss of hearing or mobility, a move to a new community or a partner’s death, and it’s especially common among those who are low-income or identify as a member of a marginalized group.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">To address the problem, the AARP Foundation recently launched \u003ca href=\"https://connect2affect.org/\">\u003cspan class=\"s2\">Connect2Affect\u003c/span>\u003c/a>, a resource portal for older adults and caregivers that encourages online engagement, and includes a \u003ca href=\"https://connect2affect.org/wp-content/uploads/2017/03/A-Profile-of-Social-Connectedness.pdf\">\u003cspan class=\"s2\">study of social connectedness among people over age 62\u003c/span>\u003c/a>. The \u003ca href=\"https://aarptek.aarp.org/\">\u003cspan class=\"s2\">AARP Academy\u003c/span>\u003c/a> also offers free online tutorials for using smartphones, tablets or social media, and for conducting job searches on the internet. \u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">Meanwhile, the National Council on Aging completed its own \u003ca href=\"https://www.ncoa.org/healthy-aging/aging-mastery-program/\">\u003cspan class=\"s3\">two-year tablet program\u003c/span>\u003c/a>, similar to Curry’s. The result? “The more time [participants] were spending on the tablets, the stronger their social interactions, their emotional support, self-esteem,” says \u003c/span>\u003cspan class=\"s4\">Susan Stiles, senior director of product development and strategy for the group. \u003c/span>\u003c/p>\n\u003cp class=\"p5\">\u003cstrong>\u003cspan class=\"s1\">Getting Seniors Connected\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Yet enticing people online isn’t always easy. According to a \u003ca href=\"http://www.pewinternet.org/2017/05/17/technology-use-among-seniors/\">\u003cspan class=\"s2\">study \u003c/span>\u003c/a>\u003cspan class=\"s2\">released in May by the Pew Research Center\u003c/span>, while mobile device use is climbing among seniors, still only about a third own a tablet, 42 percent own smartphones, and just over half have broadband at home. Only about a third use social media.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“There were some fears going into the project,” says Stiles of the NCOA program. “People did not necessarily think that a tablet computer had any relevancy for their lives. They had privacy concerns and were afraid of potentially being exposed to scams.” (Ditto the Curry class, where people asked pointed questions about putting credit card information on their iPad and worried about being unfairly charged when ordering photo prints online.)\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">For the NCOA program, the trick was helping users find their personal killer app. For a former taxi driver now in his 90s, it was Google Maps. Stiles recalls a colleague asking the man to name some streets on his old route. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“She zoomed in on these streets and his eyes just lit up, \" Stiles says. \"And then he wanted to go everywhere in New York City.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">For a former B-movie actress, the most alluring app was YouTube, where she found her old film clips.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Tablets seem to be a nice middle ground for those who are skeptical of full-sized computers. You can use voice commands instead of struggling with a mouse or keyboard; they fit neatly into a small living space like a senior apartment; and you can use them while sitting in your favorite comfy chair. “It doesn't feel like this weighty technology object,” says Stiles. “It really feels like a book.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Designing for Seniors\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Pittsburgh-based Breezie, which sells tech solutions for seniors and \u003ca href=\"https://www.breezie.com/breezie-in-action/breezie-brings-online-benefits-to-seniors-in-florida/\">\u003cspan class=\"s2\">partnered with the NCOA on its program\u003c/span>\u003c/a>, is trying to make Android-based devices even easier for new users by offering a service that simplifies a tablet’s interface. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“If you went right now to a Best Buy and if you bought a tablet to give to a senior, there are 43 different settings you would want to change before you make it senior-friendly,”\u003cb> \u003c/b>says CEO and founder Jeh Kazimi. He means things that Breezie can pre-adjust, like brightness and volume, consolidating logins, and making the screen more forgiving if you accidentally put your thumb on it. The company is also trying to develop a way to cancel out hand tremor for people with Parkinson's disease, because uneven pressure can make the tablet think a user is swiping when they mean to click.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_415056\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS15_Platoni.jpg\">\u003cimg class=\"size-large wp-image-415056\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS15_Platoni-1020x804.jpg\" alt=\"\" width=\"640\" height=\"504\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-1020x804.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-160x126.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-800x631.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-768x605.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-1180x930.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-960x757.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-240x189.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-375x296.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-520x410.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaycee Springer, 65, polishes up her photo of the sun setting over San Francisco. \u003ccite>(Kara Platoni/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Caregivers or Breezie staff can also curate each person’s desktop, like providing ready-made YouTube playlists for fans of jazz music or Muhammad Ali’s boxing matches. For an avid gardener, Kazimi says, they might install a few outdoorsy apps “that don’t show you ads every two minutes or ask you to upgrade every three minutes.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But tablets aren’t a foolproof platform. Kazimi has seen seniors who need stickers to label the camera, volume and charging socket, because the devices can suddenly flip screen orientation, leaving confused people holding them upside down and wondering where the buttons are. Di Martino encountered some unexpected hurdles, too, “like a couple of the men in the class didn't know how to type.” She helped get people comfortable with the touchscreen by offering styluses, which are more accurate pointing tools than fingers. And she encouraged her students to feel OK about making mistakes. “Sometimes I tell them, ‘I don’t know what that button does. Let’s hit it,’” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cstrong>\u003cspan class=\"s1\">Dip in Loneliness\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The seniors in the Curry program report different feelings about living alone—for example, Kaycee Springer enjoys it and is content using video chat to keep in touch with her daughters long-distance. But she does feel a bit socially crimped in the Tenderloin, where it doesn't always seem safe to walk around, especially at night. And she knows some of her elderly neighbors are extremely withdrawn. “There are people in my building, they just lay around and do absolutely nothing,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino has put together some preliminary stats from surveying participants at the program’s 6-month point. Almost all of the seniors said they used their iPad daily. As with the NCOA program, she noted a slight dip in reported loneliness. But the leaders of both projects say it’s hard to know if that stems from people making friends in class or becoming more social online. The AARP’s Ryerson says you might as well encourage both, so that technological and real-world connections reinforce each other. For example, she says, “FitBits are about taking steps. So let’s walk together.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the Curry Center, one other result is very clear: Now that the class is ending, nobody wants to give up their iPads. \"We just started!” exclaims Tachmuradova.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Springer still finds her tablet hard to put down: “I will put it on my bed—and then I will go, ‘\u003ci>It’s calling me\u003c/i>.’”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino says not to worry—they’re looking into a second phase that will allow everyone to keep their tablets, perhaps in exchange for peer mentoring the next round of students. Now that she’s taught them every iPad trick she knows, their new challenge will be teaching each other. \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Spinal Patients Continue Remarkable Recovery After Stem Cell Injections, Company Says",
"title": "Spinal Patients Continue Remarkable Recovery After Stem Cell Injections, Company Says",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Patients with spinal injuries have continued to heal long after they’ve received an initial injection of stem cells, \u003ca href=\"http://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3Chttp://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3E\">according to data\u003c/a> released Oct. 2 by the biotech company conducting a clinical trial on the treatment.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The rate of recovery at 12 months is more than double the rates of recovery seen at 12 months in both matched historical controls (29%) and published data in a similar patient population (26%).'\u003ccite>Asterias Biotherapeutics\u003c/cite>\u003c/aside>\n\u003cp>One year after six patients with severe spinal injuries were dosed with 10 million stem cells, four in the group have recovered at least two full motor levels of movement on at least one side of their bodies. That degree of improvement, based on the International Standards for Neurological Classification of Spinal Cord Injury \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232636/\" target=\"_blank\" rel=\"noopener\">scale\u003c/a>, is about twice the rate of recovery patients historically see, according to the company, Asterias Biotherapeutics of Fremont, California.\u003c/p>\n\u003cp>\"The rate of recovery at 12 months is more than double the rates of recovery seen at 12 months in both matched historical controls (29%) and published data in a similar patient population (26%),\" the company wrote in a press release.\u003c/p>\n\u003cp>According to Edward Wirth III, chief medical officer at Asterias, all six patients in the second cohort of the study progressed at least one motor level on one side; three patients improved two levels on one side; and one patient advanced three motor levels on one side. In addition, Wirth said, almost all the patients showed improvement on both sides of their bodies, and two of them jumped two motor levels on both sides.\u003c/p>\n\u003cp>Regaining two motor levels in spinocervical patients is significant. That could make the difference between full paralysis from the neck down, a condition that would require a ventilator to breathe, versus regaining some arm, hand and finger movement, allowing patients to take care of many of life’s daily tasks unassisted.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>We reported \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/23/stem-cells-may-have-restored-use-of-hands-and-arms-in-paralyzed-man/\">last year\u003c/a> on the striking initial results of this experimental phase 2 clinical trial, called \u003ca href=\"http://www.scistar-study.com/\">SCiStar.\u003c/a> The updated information suggests patients in this second cohort of the study not only received strong early benefit from the large single dose of stem cells, but that they have continued to improve over time.\u003c/p>\n\u003cp>Dr. Charles Liu, an investigator on the study and director of the USC Neurorestoration Center, has a patient in the second cohort of the trial, 21-year-old Kris Boesen of Fresno, whose substantial progress we first \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/03/23/strong-stem-cell-therapy-results-for-paralyzed-patients-company-says/\">reported\u003c/a> in September 2016.\u003c/p>\n\u003cp>Liu says most spinal-injury patients, once they’ve gone through initial recovery, tend to remain at the same level of movement.\u003c/p>\n\u003cp>“They can get a little bit better, but there’s definitely a point of plateau,\" Liu says.\u003c/p>\n\u003cp>But the new data from the trial shows continued progress. At the \u003ca href=\"http://www.globenewswire.com/NewsRoom/AttachmentNg/5f3b3123-31c5-48ec-be59-dd0b842a21ca\">six-month mark\u003c/a>, for instance, only two of the patients attained two-motor-level-improvement. After 12 months, two more had attained the milestone.\u003c/p>\n\u003cp>“Usually what you see is a plateau and that’s not what we’re seeing here. They continued to improve,” Liu says. “It was a durable effect. And that’s incredibly exciting.”\u003c/p>\n\u003cp>The six people in the second cohort obviously represent a small sample size, and some patients do spontaneously recover from spinal injuries. But Liu believes now that the replication of Boesen's progress has occurred in multiple patients, it’s more difficult to write them off as outliers.\u003c/p>\n\u003cp>There are five cohorts of patients in the study. The first received 2 million stem cells, the second 10 million, and the third is still in the process of receiving 20 million. The patients who received 2 million stem cells showed some benefit from the treatment, but not nearly as much as the 10-million-cell cohort.\u003cb> \u003c/b>The fourth and fifth cohorts target a different level of spinal injury, using dosages of 10 million and 20 million cells.\u003c/p>\n\u003cp>Enrollment is completed for the first four rounds of the trial; the fifth cohort's enrollment has begun and is expected to be completed by the end of this year, Asterias officials said.\u003c/p>\n\u003cp>The San Francisco Chronicle also \u003ca href=\"http://www.sfgate.com/health/article/Super-exciting-results-in-stem-cell-therapy-12245199.php\" target=\"_blank\" rel=\"noopener\">wrote about the trial\u003c/a> this week, in a front-page article. Reporter Erin Allday spoke with Christopher Block, a 31-year-old patient in the SCiStar trial who had virtually no movement in his arms after he injured his spinal cord in a biking accident.\u003c/p>\n\u003cp>“About a month after my stem cells, I was able to begin feeding myself,” Block told the Chronicle. He can now raise himself out of his wheelchair and change his shirt, he said.\u003c/p>\n\u003cp>On Monday, Asterias announced that the FDA had granted its request for designation of its stem cell treatment as a regenerative medicine advanced therapy, or \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm537670.htm\" target=\"_blank\" rel=\"noopener\">RMAT\u003c/a>. One of the conditions of that designation is that preliminary clinical evidence indicates the treatment has \"potential to address unmet medical needs\" related to a \"serious or life-threatening disease or condition.\" The designation, which was created under the 21st Century Cures Act last year, was designed to accelerate review and approval by the FDA.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>SCiStar is partially funded by the California Institute for Regenerative Medicine, or CIRM, the publicly funded stem cell agency created by a state initiative in 2004.\u003c/p>\n\n",
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"excerpt": "Patients with spinal injuries have continued to heal long after they’ve received an initial injection of stem cells, according to data released by the biotech company conducting a clinical trial on the treatment.",
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"description": "Patients with spinal injuries have continued to heal long after they’ve received an initial injection of stem cells, according to data released by the biotech company conducting a clinical trial on the treatment.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Patients with spinal injuries have continued to heal long after they’ve received an initial injection of stem cells, \u003ca href=\"http://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3Chttp://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3E\">according to data\u003c/a> released Oct. 2 by the biotech company conducting a clinical trial on the treatment.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The rate of recovery at 12 months is more than double the rates of recovery seen at 12 months in both matched historical controls (29%) and published data in a similar patient population (26%).'\u003ccite>Asterias Biotherapeutics\u003c/cite>\u003c/aside>\n\u003cp>One year after six patients with severe spinal injuries were dosed with 10 million stem cells, four in the group have recovered at least two full motor levels of movement on at least one side of their bodies. That degree of improvement, based on the International Standards for Neurological Classification of Spinal Cord Injury \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232636/\" target=\"_blank\" rel=\"noopener\">scale\u003c/a>, is about twice the rate of recovery patients historically see, according to the company, Asterias Biotherapeutics of Fremont, California.\u003c/p>\n\u003cp>\"The rate of recovery at 12 months is more than double the rates of recovery seen at 12 months in both matched historical controls (29%) and published data in a similar patient population (26%),\" the company wrote in a press release.\u003c/p>\n\u003cp>According to Edward Wirth III, chief medical officer at Asterias, all six patients in the second cohort of the study progressed at least one motor level on one side; three patients improved two levels on one side; and one patient advanced three motor levels on one side. In addition, Wirth said, almost all the patients showed improvement on both sides of their bodies, and two of them jumped two motor levels on both sides.\u003c/p>\n\u003cp>Regaining two motor levels in spinocervical patients is significant. That could make the difference between full paralysis from the neck down, a condition that would require a ventilator to breathe, versus regaining some arm, hand and finger movement, allowing patients to take care of many of life’s daily tasks unassisted.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We reported \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/23/stem-cells-may-have-restored-use-of-hands-and-arms-in-paralyzed-man/\">last year\u003c/a> on the striking initial results of this experimental phase 2 clinical trial, called \u003ca href=\"http://www.scistar-study.com/\">SCiStar.\u003c/a> The updated information suggests patients in this second cohort of the study not only received strong early benefit from the large single dose of stem cells, but that they have continued to improve over time.\u003c/p>\n\u003cp>Dr. Charles Liu, an investigator on the study and director of the USC Neurorestoration Center, has a patient in the second cohort of the trial, 21-year-old Kris Boesen of Fresno, whose substantial progress we first \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/03/23/strong-stem-cell-therapy-results-for-paralyzed-patients-company-says/\">reported\u003c/a> in September 2016.\u003c/p>\n\u003cp>Liu says most spinal-injury patients, once they’ve gone through initial recovery, tend to remain at the same level of movement.\u003c/p>\n\u003cp>“They can get a little bit better, but there’s definitely a point of plateau,\" Liu says.\u003c/p>\n\u003cp>But the new data from the trial shows continued progress. At the \u003ca href=\"http://www.globenewswire.com/NewsRoom/AttachmentNg/5f3b3123-31c5-48ec-be59-dd0b842a21ca\">six-month mark\u003c/a>, for instance, only two of the patients attained two-motor-level-improvement. After 12 months, two more had attained the milestone.\u003c/p>\n\u003cp>“Usually what you see is a plateau and that’s not what we’re seeing here. They continued to improve,” Liu says. “It was a durable effect. And that’s incredibly exciting.”\u003c/p>\n\u003cp>The six people in the second cohort obviously represent a small sample size, and some patients do spontaneously recover from spinal injuries. But Liu believes now that the replication of Boesen's progress has occurred in multiple patients, it’s more difficult to write them off as outliers.\u003c/p>\n\u003cp>There are five cohorts of patients in the study. The first received 2 million stem cells, the second 10 million, and the third is still in the process of receiving 20 million. The patients who received 2 million stem cells showed some benefit from the treatment, but not nearly as much as the 10-million-cell cohort.\u003cb> \u003c/b>The fourth and fifth cohorts target a different level of spinal injury, using dosages of 10 million and 20 million cells.\u003c/p>\n\u003cp>Enrollment is completed for the first four rounds of the trial; the fifth cohort's enrollment has begun and is expected to be completed by the end of this year, Asterias officials said.\u003c/p>\n\u003cp>The San Francisco Chronicle also \u003ca href=\"http://www.sfgate.com/health/article/Super-exciting-results-in-stem-cell-therapy-12245199.php\" target=\"_blank\" rel=\"noopener\">wrote about the trial\u003c/a> this week, in a front-page article. Reporter Erin Allday spoke with Christopher Block, a 31-year-old patient in the SCiStar trial who had virtually no movement in his arms after he injured his spinal cord in a biking accident.\u003c/p>\n\u003cp>“About a month after my stem cells, I was able to begin feeding myself,” Block told the Chronicle. He can now raise himself out of his wheelchair and change his shirt, he said.\u003c/p>\n\u003cp>On Monday, Asterias announced that the FDA had granted its request for designation of its stem cell treatment as a regenerative medicine advanced therapy, or \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm537670.htm\" target=\"_blank\" rel=\"noopener\">RMAT\u003c/a>. One of the conditions of that designation is that preliminary clinical evidence indicates the treatment has \"potential to address unmet medical needs\" related to a \"serious or life-threatening disease or condition.\" The designation, which was created under the 21st Century Cures Act last year, was designed to accelerate review and approval by the FDA.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>SCiStar is partially funded by the California Institute for Regenerative Medicine, or CIRM, the publicly funded stem cell agency created by a state initiative in 2004.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Governor Signs Law Allowing Californians to Choose to Liquefy Their Remains",
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"content": "\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Update, October 16, 2017:\u003c/b>\u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">Gov. Jerry Brown last night signed into law the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB967\" target=\"_blank\" rel=\"noopener noreferrer\">bill\u003c/a> that legalizes a method of disposing of human remains commonly called 'water cremation.' \u003c/span>\u003c/p>\n\u003cp>The method doesn't actually use water, but uses a chemical that speeds up decomposition of bodies and leaves behind only sterile water, bones, and medical implants or devices.\u003c/p>\n\u003cp>\u003cspan class=\"s1\">The new law establishes procedures for licensing and regulating mortuaries or other companies that aim to adopt the method, to be overseen by the Cemetery and Funeral Bureau within the state Department of Consumer Affairs. \u003c/span>\u003cem>\u003cspan class=\"s1\">\u003cbr>\n\u003c/span>\u003c/em>\u003c/p>\n\u003cp>Supporters say water cremation offers a green alternative to traditional cremation or burial.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Original Story, July 24, 2017:\u003c/strong>\u003c/p>\n\u003cp>You may not equate death with climate change, but disposing of human remains leaves a fairly hefty \u003ca href=\"https://www3.epa.gov/carbon-footprint-calculator/\" target=\"_blank\" rel=\"noopener noreferrer\">carbon footprint\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">Supporters of a California bill allowing dead bodies to be dissolved in a hot chemical bath are hoping to overcome the 'ick factor.'\u003c/aside>\n\u003cp>“Cremation is really what people hold up as the environmentally friendly option,” says \u003ca href=\"http://www.caitlindoughty.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Caitlin Doughty\u003c/a>, a mortician in Los Angeles. “It’s better than the whole rigmarole of formaldehyde and chemicals and big caskets that go into the more traditional funeral industry, but it still releases mercury into the air, and it uses a whole ton of natural gas.”\u003c/p>\n\u003cp>Plus, Doughty says, cemeteries monopolize land, an increasingly precious resource as the population grows.\u003c/p>\n\u003cp>Hence the growing popularity of a green alternative, known as water cremation, bio-cremation or flameless cremation. Basically, the body is dissolved in a hot chemical bath, leaving a sterile solution that can be flushed down the drain. The carbon footprint of this process is just a quarter of traditional fire cremation because it uses so much less energy; and only a sixth of a burial because it doesn't require the materials for concrete headstones, mahogany caskets or the chemicals used in embalming.\u003c/p>\n\u003cp>State lawmakers are considering a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB967\" target=\"_blank\" rel=\"noopener noreferrer\">bill\u003c/a> that would legalize water cremation. In the last decade, two previous efforts have failed, although the process has been approved in 14 other states, including neighboring Nevada. This year, a third attempt is gaining momentum in California, progressing further in the Legislature than the previous bills.\u003c/p>\n\u003cp>\u003cstrong>Not an Acid Bath\u003c/strong>\u003c/p>\n\u003cp>There’s only one place in California where bodies are currently dissolved — legally, at least. That would be a chilly lab at UCLA, where cadavers that have outlived their usefulness at the medical school end up. The room smells a little like shellfish, which I think might be the smell of melted flesh. But the guy in charge, Dean Fisher, laughs at that notion.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This just leaves us questioning. Why did part of grandma go to the waste treatment plant?'\u003ccite>Ned Dolejsi, Catholic Church spokesman\u003c/cite>\u003c/aside>\n\u003cp>Fisher, the head of the university's \u003ca href=\"https://www.uclahealth.org/donatedbody/default.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">Donated Body Program,\u003c/a> explains that I'm sniffing potassium hydroxide\u003cb>,\u003c/b> a base, and the chemical of choice for liquefying bodies, because it catalyzes the hydrogen in water to more rapidly attack the chemical bonds between molecules in the body. (The process is technically called\u003cem> alkaline hydrolysis.)\u003c/em>\u003c/p>\n\u003cp>“So, it's not an acid at all,\" said Fisher. \"Some people say this is an acid bath, and they're wrong.”\u003c/p>\n\u003cp>Potassium hydroxide is found in the Earth's crust — and in many household cleaning products. It's the same chemical that breaks down or composts organic matter in dirt.\u003c/p>\n\u003cp>“So, like, if you were to bury a body in soil, all we're doing is we're speeding that up,\" says Fisher. \"We're adding heat to that.”\u003c/p>\n\u003cfigure id=\"attachment_428986\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-428986 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/Fisher-machine-800x599.jpg\" alt=\"\" width=\"800\" height=\"599\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-800x599.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-768x575.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-1020x764.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-1180x883.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-960x719.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-520x389.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine.jpg 1893w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">UCLA's Dean Fisher opens an alkaline hydrolysis machine that can dissolve bodies. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Whirlpool for the Dead\u003c/strong>\u003c/p>\n\u003cp>That heat is applied inside a shiny stainless-steel chamber, about the size of a large van. The front of the machine has a circular hatch, modeled after a submarine door. The hatch leads to a dark tunnel where cadavers are heated to 302 degrees and then bathed in 270 gallons of liquid for three to four hours. That's about twice as long as the time required for a fire cremation.\u003c/p>\n\u003cp>The cost varies widely in the U.S., depending on location, but typically, funeral homes charge $150-$500 more for a water cremation than for one done with flames.\u003c/p>\n\u003cp>What's usually left at the end of the process is a tray scattered with clean white bones, and maybe some items of medical hardware. Fisher shows me an example when he opens the door, revealing the remains of a dissolved male body.\u003c/p>\n\u003cp>“There’s a pacemaker in there,\" says Fisher. \"There’s a couple of prosthetics. It looks like he’s had a hip replacement, and it looks like he’s had a knee replacement, also.”\u003c/p>\n\u003cp>Some of the metal in these parts can be recycled, and everything left over is sterile. Nothing organic survives during a water cremation. No bacteria — not even a strand of DNA.\u003c/p>\n\u003cp>The bones will be pulverized into a white powder that can be placed in an urn, just like the ashes in a traditional cremation.\u003c/p>\n\u003cfigure id=\"attachment_429008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-429008\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/IMG_33511-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The pulverized bones from a water cremation ready to be placed inside an urn. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>From a cupboard nearby, Fisher holds up a tooth with a mercury filling. The silver molar demonstrates part of why water is more eco-friendly than flame. When you burn a body, the toxic mercury in dental fillings vaporizes and escapes into the air.\u003c/p>\n\u003cp>\u003cstrong>Ick Factor\u003c/strong>\u003c/p>\n\u003cp>But water cremation proved a tough sell the last two times legalization was tried in California. There's an inherent ick factor: You’re reducing loved ones to a chemical broth that swirls down the drain.\u003c/p>\n\u003cp>“This just leaves us questioning,\" said Ned Dolejsi, the executive director of the \u003ca href=\"http://www.cacatholic.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Catholic Conference\u003c/a>. \"Why did part of grandma go to the waste treatment plant?”\u003cb> \u003c/b>He says water cremation isn't inherently wrong, but it also doesn’t treat life — or death — with dignity and respect.\u003c/p>\n\u003cp>The proposed bill sailed through the Assembly in June. Now it's before the Senate.\u003c/p>\n\u003cp>If the bill is made law, water cremation will be available in California starting in 2020.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been edited.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Gov. Jerry Brown signed into law an eco-friendly option for disposing of cadavers.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Update, October 16, 2017:\u003c/b>\u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">Gov. Jerry Brown last night signed into law the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB967\" target=\"_blank\" rel=\"noopener noreferrer\">bill\u003c/a> that legalizes a method of disposing of human remains commonly called 'water cremation.' \u003c/span>\u003c/p>\n\u003cp>The method doesn't actually use water, but uses a chemical that speeds up decomposition of bodies and leaves behind only sterile water, bones, and medical implants or devices.\u003c/p>\n\u003cp>\u003cspan class=\"s1\">The new law establishes procedures for licensing and regulating mortuaries or other companies that aim to adopt the method, to be overseen by the Cemetery and Funeral Bureau within the state Department of Consumer Affairs. \u003c/span>\u003cem>\u003cspan class=\"s1\">\u003cbr>\n\u003c/span>\u003c/em>\u003c/p>\n\u003cp>Supporters say water cremation offers a green alternative to traditional cremation or burial.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Original Story, July 24, 2017:\u003c/strong>\u003c/p>\n\u003cp>You may not equate death with climate change, but disposing of human remains leaves a fairly hefty \u003ca href=\"https://www3.epa.gov/carbon-footprint-calculator/\" target=\"_blank\" rel=\"noopener noreferrer\">carbon footprint\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">Supporters of a California bill allowing dead bodies to be dissolved in a hot chemical bath are hoping to overcome the 'ick factor.'\u003c/aside>\n\u003cp>“Cremation is really what people hold up as the environmentally friendly option,” says \u003ca href=\"http://www.caitlindoughty.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Caitlin Doughty\u003c/a>, a mortician in Los Angeles. “It’s better than the whole rigmarole of formaldehyde and chemicals and big caskets that go into the more traditional funeral industry, but it still releases mercury into the air, and it uses a whole ton of natural gas.”\u003c/p>\n\u003cp>Plus, Doughty says, cemeteries monopolize land, an increasingly precious resource as the population grows.\u003c/p>\n\u003cp>Hence the growing popularity of a green alternative, known as water cremation, bio-cremation or flameless cremation. Basically, the body is dissolved in a hot chemical bath, leaving a sterile solution that can be flushed down the drain. The carbon footprint of this process is just a quarter of traditional fire cremation because it uses so much less energy; and only a sixth of a burial because it doesn't require the materials for concrete headstones, mahogany caskets or the chemicals used in embalming.\u003c/p>\n\u003cp>State lawmakers are considering a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB967\" target=\"_blank\" rel=\"noopener noreferrer\">bill\u003c/a> that would legalize water cremation. In the last decade, two previous efforts have failed, although the process has been approved in 14 other states, including neighboring Nevada. This year, a third attempt is gaining momentum in California, progressing further in the Legislature than the previous bills.\u003c/p>\n\u003cp>\u003cstrong>Not an Acid Bath\u003c/strong>\u003c/p>\n\u003cp>There’s only one place in California where bodies are currently dissolved — legally, at least. That would be a chilly lab at UCLA, where cadavers that have outlived their usefulness at the medical school end up. The room smells a little like shellfish, which I think might be the smell of melted flesh. But the guy in charge, Dean Fisher, laughs at that notion.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This just leaves us questioning. Why did part of grandma go to the waste treatment plant?'\u003ccite>Ned Dolejsi, Catholic Church spokesman\u003c/cite>\u003c/aside>\n\u003cp>Fisher, the head of the university's \u003ca href=\"https://www.uclahealth.org/donatedbody/default.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">Donated Body Program,\u003c/a> explains that I'm sniffing potassium hydroxide\u003cb>,\u003c/b> a base, and the chemical of choice for liquefying bodies, because it catalyzes the hydrogen in water to more rapidly attack the chemical bonds between molecules in the body. (The process is technically called\u003cem> alkaline hydrolysis.)\u003c/em>\u003c/p>\n\u003cp>“So, it's not an acid at all,\" said Fisher. \"Some people say this is an acid bath, and they're wrong.”\u003c/p>\n\u003cp>Potassium hydroxide is found in the Earth's crust — and in many household cleaning products. It's the same chemical that breaks down or composts organic matter in dirt.\u003c/p>\n\u003cp>“So, like, if you were to bury a body in soil, all we're doing is we're speeding that up,\" says Fisher. \"We're adding heat to that.”\u003c/p>\n\u003cfigure id=\"attachment_428986\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-428986 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/Fisher-machine-800x599.jpg\" alt=\"\" width=\"800\" height=\"599\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-800x599.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-768x575.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-1020x764.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-1180x883.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-960x719.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-520x389.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine.jpg 1893w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">UCLA's Dean Fisher opens an alkaline hydrolysis machine that can dissolve bodies. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Whirlpool for the Dead\u003c/strong>\u003c/p>\n\u003cp>That heat is applied inside a shiny stainless-steel chamber, about the size of a large van. The front of the machine has a circular hatch, modeled after a submarine door. The hatch leads to a dark tunnel where cadavers are heated to 302 degrees and then bathed in 270 gallons of liquid for three to four hours. That's about twice as long as the time required for a fire cremation.\u003c/p>\n\u003cp>The cost varies widely in the U.S., depending on location, but typically, funeral homes charge $150-$500 more for a water cremation than for one done with flames.\u003c/p>\n\u003cp>What's usually left at the end of the process is a tray scattered with clean white bones, and maybe some items of medical hardware. Fisher shows me an example when he opens the door, revealing the remains of a dissolved male body.\u003c/p>\n\u003cp>“There’s a pacemaker in there,\" says Fisher. \"There’s a couple of prosthetics. It looks like he’s had a hip replacement, and it looks like he’s had a knee replacement, also.”\u003c/p>\n\u003cp>Some of the metal in these parts can be recycled, and everything left over is sterile. Nothing organic survives during a water cremation. No bacteria — not even a strand of DNA.\u003c/p>\n\u003cp>The bones will be pulverized into a white powder that can be placed in an urn, just like the ashes in a traditional cremation.\u003c/p>\n\u003cfigure id=\"attachment_429008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-429008\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/IMG_33511-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The pulverized bones from a water cremation ready to be placed inside an urn. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>From a cupboard nearby, Fisher holds up a tooth with a mercury filling. The silver molar demonstrates part of why water is more eco-friendly than flame. When you burn a body, the toxic mercury in dental fillings vaporizes and escapes into the air.\u003c/p>\n\u003cp>\u003cstrong>Ick Factor\u003c/strong>\u003c/p>\n\u003cp>But water cremation proved a tough sell the last two times legalization was tried in California. There's an inherent ick factor: You’re reducing loved ones to a chemical broth that swirls down the drain.\u003c/p>\n\u003cp>“This just leaves us questioning,\" said Ned Dolejsi, the executive director of the \u003ca href=\"http://www.cacatholic.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Catholic Conference\u003c/a>. \"Why did part of grandma go to the waste treatment plant?”\u003cb> \u003c/b>He says water cremation isn't inherently wrong, but it also doesn’t treat life — or death — with dignity and respect.\u003c/p>\n\u003cp>The proposed bill sailed through the Assembly in June. Now it's before the Senate.\u003c/p>\n\u003cp>If the bill is made law, water cremation will be available in California starting in 2020.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been edited.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Pediatricians Release First-Ever Recommendations for Safe Tattoos",
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"content": "\u003cp>Ariana Marciano is adding to her collection of about 75 tattoos at Body Electric, a tattoo and piercing studio on trendy Melrose Avenue in Hollywood. \"I think they're so cool and I think they're visually really nice to look at,\" she says. There's a ram's head, an elk, a green-and-peach praying mantis, a love bug and a moth. Today she's getting a ladybug.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Ann%22\">Recommendations on tattoos from American Academy of Pediatrics\u003c/a>\u003c/aside>\n\u003cp>\"I love bugs,\" Marciano, 23, says. \"I think they're kind of overlooked.\" In about 20 minutes, a small ladybug with dots on its back and a bit of rusty orange takes its place on her elbow.Marciano is part of a trend; 38 percent of millennials have at least one tattoo, \u003ca href=\"http://www.pewsocialtrends.org/2010/02/24/millennials-confident-connected-open-to-change/\">according\u003c/a> to the Pew Research Center, and 23 percent have a piercing somewhere other than an earlobe. That compares to just 6 percent of boomers with tattoos, and 1 percent with other piercings.\u003c/p>\n\u003cp>The nation's pediatricians, who want teenagers and young adults to be aware of potential health issues with tattoos and piercings, released their first-ever recommendations on health and safety on Monday.\u003c/p>\n\u003cp>The report finds that most people who have a tattoo (86 percent) have never regretted getting one, and 30 percent says it makes them feel sexier.\u003c/p>\n\u003cp>But despite the popularity of body art, \"Most of my medical colleagues don't know regulations in the states, complication rates or later impact on young people when looking for a job,\" says \u003ca href=\"http://www.seattlechildrens.org/medical-staff/cora-collette-breuner/\">Dr. Cora Breuner\u003c/a>. She's a member of the division of adolescent medicine at Seattle Children's Hospital who chaired the AAP Committee on Adolescence that wrote the recommendations.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Breuner says she wants doctors and other health care professionals to be able to appropriately guide patients and their parents when a tattoo or body piercing is being considered. That includes being aware of regulations in their state. The federal government does not regulate the industry and rules \u003ca href=\"http://www.ncsl.org/research/health/tattooing-and-body-piercing.aspx\">vary from state to state\u003c/a>. In some states, minors as young as 14 can get tattoos if they have parental permission. And when it comes to sanitary conditions, there is wide variation in state regulations.\u003c/p>\n\u003cp>The AAP recommends that pediatricians talk with adolescent patients about the importance of hygienic practices in piercing and tattoo parlors, including making sure practitioners use new disposable gloves; needles from a sealed, sterile container; and fresh unused ink poured into a new disposable container with each client. This means infection control \"just like in a doctor's office,\" says Breuner.\u003c/p>\n\u003cp>At Body Electric, owner Brian Keith Thompson says, \"I want to leave the studio today the same way I came in — disease-free.\" He sets employees to work every morning cleaning floors and equipment. \"I'm a former Marine, so I am the commanding general inspecting it,\" he says.\u003c/p>\n\u003cp>His state, California, sets standards for sterilization, sanitation and safety for both tattooing and body piercing. Practitioners have to register with the state health department and are required to submit proof of hepatitis vaccination as well as take a yearly course in bloodborne diseases and infection control. While infection is rare, concern about infectious diseases such as HIV, hepatitis and skin infections caused by \u003cem>Staphylococcus aureus\u003c/em> (staph) bacteria remain.\u003c/p>\n\u003cp>People on medications that inhibit the immune system and can affect the healing process, such as steroids or Accutane, should avoid both tattoos and piercings, the pediatricians say. And everyone should be up to date on immunizations, especially tetanus.\u003c/p>\n\u003cp>After the procedure, the doctors say patients should watch for signs of infection, such as redness that spreads beyond the tattoo or piercing, increasing pain, or fever. If this happens, Breuner says, \"go to the doctor.\"\u003c/p>\n\u003cp>And doctors and patients should understand that healing times differ depending on the piercing. For example, an ear piercing may take just a few weeks to heal, but a piercing in the tongue can take up to six weeks, and a belly button piercing up to nine months, Breuner says.\u003c/p>\n\u003cp>And there's the key point that tattoos are permanent.\u003c/p>\n\u003cp>Even though he owns a tattoo parlor, Thompson says he often counsels teenage clients against tattoos that are easily visible on the hands, neck and fingers. \"I'll tell them no, you're 19, you should wait,\" he says, adding that many professions are still conservative when it comes to tattoos.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Definitely stay away from the face,\" says Thompson. \"We call that the job stopper; if you don't want to get employed, tattoo your face.\" And understand that tattoo removal by laser is painful, difficult, expensive and only partially effective.\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Teen+Wants+A+Tattoo%3F+Pediatricians+Say+Here%27s+How+To+Do+It+Safely&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Ariana Marciano is adding to her collection of about 75 tattoos at Body Electric, a tattoo and piercing studio on trendy Melrose Avenue in Hollywood. \"I think they're so cool and I think they're visually really nice to look at,\" she says. There's a ram's head, an elk, a green-and-peach praying mantis, a love bug and a moth. Today she's getting a ladybug.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Ann%22\">Recommendations on tattoos from American Academy of Pediatrics\u003c/a>\u003c/aside>\n\u003cp>\"I love bugs,\" Marciano, 23, says. \"I think they're kind of overlooked.\" In about 20 minutes, a small ladybug with dots on its back and a bit of rusty orange takes its place on her elbow.Marciano is part of a trend; 38 percent of millennials have at least one tattoo, \u003ca href=\"http://www.pewsocialtrends.org/2010/02/24/millennials-confident-connected-open-to-change/\">according\u003c/a> to the Pew Research Center, and 23 percent have a piercing somewhere other than an earlobe. That compares to just 6 percent of boomers with tattoos, and 1 percent with other piercings.\u003c/p>\n\u003cp>The nation's pediatricians, who want teenagers and young adults to be aware of potential health issues with tattoos and piercings, released their first-ever recommendations on health and safety on Monday.\u003c/p>\n\u003cp>The report finds that most people who have a tattoo (86 percent) have never regretted getting one, and 30 percent says it makes them feel sexier.\u003c/p>\n\u003cp>But despite the popularity of body art, \"Most of my medical colleagues don't know regulations in the states, complication rates or later impact on young people when looking for a job,\" says \u003ca href=\"http://www.seattlechildrens.org/medical-staff/cora-collette-breuner/\">Dr. Cora Breuner\u003c/a>. She's a member of the division of adolescent medicine at Seattle Children's Hospital who chaired the AAP Committee on Adolescence that wrote the recommendations.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Breuner says she wants doctors and other health care professionals to be able to appropriately guide patients and their parents when a tattoo or body piercing is being considered. That includes being aware of regulations in their state. The federal government does not regulate the industry and rules \u003ca href=\"http://www.ncsl.org/research/health/tattooing-and-body-piercing.aspx\">vary from state to state\u003c/a>. In some states, minors as young as 14 can get tattoos if they have parental permission. And when it comes to sanitary conditions, there is wide variation in state regulations.\u003c/p>\n\u003cp>The AAP recommends that pediatricians talk with adolescent patients about the importance of hygienic practices in piercing and tattoo parlors, including making sure practitioners use new disposable gloves; needles from a sealed, sterile container; and fresh unused ink poured into a new disposable container with each client. This means infection control \"just like in a doctor's office,\" says Breuner.\u003c/p>\n\u003cp>At Body Electric, owner Brian Keith Thompson says, \"I want to leave the studio today the same way I came in — disease-free.\" He sets employees to work every morning cleaning floors and equipment. \"I'm a former Marine, so I am the commanding general inspecting it,\" he says.\u003c/p>\n\u003cp>His state, California, sets standards for sterilization, sanitation and safety for both tattooing and body piercing. Practitioners have to register with the state health department and are required to submit proof of hepatitis vaccination as well as take a yearly course in bloodborne diseases and infection control. While infection is rare, concern about infectious diseases such as HIV, hepatitis and skin infections caused by \u003cem>Staphylococcus aureus\u003c/em> (staph) bacteria remain.\u003c/p>\n\u003cp>People on medications that inhibit the immune system and can affect the healing process, such as steroids or Accutane, should avoid both tattoos and piercings, the pediatricians say. And everyone should be up to date on immunizations, especially tetanus.\u003c/p>\n\u003cp>After the procedure, the doctors say patients should watch for signs of infection, such as redness that spreads beyond the tattoo or piercing, increasing pain, or fever. If this happens, Breuner says, \"go to the doctor.\"\u003c/p>\n\u003cp>And doctors and patients should understand that healing times differ depending on the piercing. For example, an ear piercing may take just a few weeks to heal, but a piercing in the tongue can take up to six weeks, and a belly button piercing up to nine months, Breuner says.\u003c/p>\n\u003cp>And there's the key point that tattoos are permanent.\u003c/p>\n\u003cp>Even though he owns a tattoo parlor, Thompson says he often counsels teenage clients against tattoos that are easily visible on the hands, neck and fingers. \"I'll tell them no, you're 19, you should wait,\" he says, adding that many professions are still conservative when it comes to tattoos.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Definitely stay away from the face,\" says Thompson. \"We call that the job stopper; if you don't want to get employed, tattoo your face.\" And understand that tattoo removal by laser is painful, difficult, expensive and only partially effective.\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Teen+Wants+A+Tattoo%3F+Pediatricians+Say+Here%27s+How+To+Do+It+Safely&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study Claiming AI Can Detect Sexual Orientation Cleared for Publication",
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"content": "\u003cp>\u003cstrong>Update, Sept. 19:\u003c/strong> The American Psychological Association says that a controversial research paper that applied computer facial recognition to successfully guess people’s sexual orientation has passed a review of documentation submitted by the researchers. The paper is set to be published in the association’s peer-reviewed \u003cem>Journal of Personality and Social Psychology\u003c/em>.\u003c/p>\n\u003cp>A spokesperson for the association said it completed the review last week. The association undertook the review to substantiate an institutional review board's vetting of the study, which ensured that the study met ethical guidelines.\u003c/p>\n\u003cp>\"Given the sensitive nature of photo-images used in the current study, we are currently taking this additional step with this as yet unpublished manuscript,\" a spokesperson for the APA wrote to KQED last week, before the review was completed.\u003c/p>\n\u003cp>The research, by Michal Kosinski and Yilun Wang of Stanford University, claims that a computer algorithm bested humans in distinguishing between a gay person and a straight person when analyzing images from public profiles on a dating website. (Here is a \u003ca href=\"https://osf.io/zn79k/\" target=\"_blank\" rel=\"noopener noreferrer\">preprint\u003c/a> of the study; it's not necessarily the final version of the paper.)Researchers claim AI can be taught to predict sexual orientation from analyzing photographs. LGBTQ advocates are outraged.\u003c/p>\n\u003cp>The research had led to a firestorm of criticism from LGBTQ advocates and academics since it was \u003ca href=\"https://www.economist.com/news/science-and-technology/21728614-machines-read-faces-are-coming-advances-ai-are-used-spot-signs?fsrc=scn/tw/te/bl/ed/advancesinaiareusedtospotsignsofsexuality\" target=\"_blank\" rel=\"noopener noreferrer\">first reported\u003c/a> Sept. 9 by The Economist. Two gay rights groups, Human Rights Campaign and GLAAD, \u003ca href=\"https://www.glaad.org/blog/glaad-and-hrc-call-stanford-university-responsible-media-debunk-dangerous-flawed-report\" target=\"_blank\" rel=\"noopener noreferrer\">called the research,\u003c/a> in a joint press release, \"junk science.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Analyzing Faces\u003c/strong>\u003c/p>\n\u003cp>Using basic facial-recognition technology, the researchers weeded through 130,741 public photos of men and women posted on a U.S. dating website, selecting for images that showed a single face large and clear enough to analyze. This left a pool of 35,326 pictures of 14,776 individuals. Gay and straight people, male and female, were represented evenly.\u003c/p>\n\u003cp>Software called VGG-Face analyzed the faces and looked for correlations between a person's face (nose length, jaw width, etc.) and their self-declared sexual identity on the website. Using a resulting model made up of these distinguishing characteristics, the program, when shown one photo of a gay man and one of a straight man, was able to identify their sexual orientation 81 percent of the time. For women, the success rate was 71 percent. (Accuracy increased when the model was shown more than one image of a person.) Human guessers correctly identified straight faces and gay faces just 61 percent of the time for men and 54 percent for women.\u003c/p>\n\u003cp>The researchers say in the paper that these results \"provide strong support\" for the prenatal hormone theory of gay and lesbian sexual orientation. The theory holds that under or overexposure to prenatal androgens are a key determinant of sexual orientation.\u003c/p>\n\u003cp>In an \u003ca href=\"https://docs.google.com/document/d/11oGZ1Ke3wK9E3BtOFfGfUQuuaSMR8AO2WfWH3aVke6U/preview#\" target=\"_blank\" rel=\"noopener noreferrer\">authors' note\u003c/a> (last updated Sept. 13), the researchers discuss the study's limitations at some length, including the narrow demographic characteristics of the individuals analyzed -- white people who self-reported to be gay or straight. They also expressed concerns about the implications of the study:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">We were really disturbed by these results and spent much time considering whether they should be made public at all. We did not want to enable the very risks that we are warning against. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Recent press reports,\u003c/span>\u003cspan style=\"font-weight: 400\"> however, suggest that governments and corporations are already using tools aimed at revealing intimate traits from faces. Facial images of billions of people are stockpiled in digital and traditional archives, including dating platforms, photo-sharing websites, and government databases. Profile pictures on Facebook, LinkedIn, and Google Plus are public by default. CCTV cameras and smartphones can be used to take pictures of others’ faces without their permission.\u003c/span>\u003c/p>\u003c/blockquote>\n\u003cp>Critics of the research expressed concerns that it will lead to the very invasion of privacy the authors seek to warn against. HRC/GLAAD also criticized the limited demographic pool used by the researchers, the \"superficial\" nature of the characteristics analyzed in the model, and the way media have represented the study.\u003c/p>\n\u003cp>The \u003ca href=\"https://docs.google.com/document/d/1UuEcSNFMduIaf0cOWdWbOV3NORLoKWdz3big4xuk7Z4/edit#\" target=\"_blank\" rel=\"noopener noreferrer\">authors responded\u003c/a> angrily, calling the HRC/GLAAD press release premature and misleading. \"\u003cspan style=\"font-weight: 400\">They do a great disservice to the LGBTQ community by dismissing our results outright without properly assessing the science behind it, and hurt the mission of the great organizations that they represent,\" they wrote. \u003c/span>\u003c/p>\n\u003cp>The researchers also stressed, in their authors' note, that they did not invent the tools used. Rather, they applied internet-available software to internet-available data, with the goal of demonstrating the privacy risks inherent in artificially intelligent technologies.\u003c/p>\n\u003cp>\"We studied existing technologies,\" wrote Kosinski and Wang, already widely used by companies and governments, to see whether they present a risk to the privacy of LGBTQ individuals.\"\u003c/p>\n\u003cp>They added, \"We were terrified to find that they do.\"\u003c/p>\n\u003cp>Such tools present a special threat, said the authors, to the privacy and safety of gay men and women living under repressive regimes where homosexuality is illegal.\u003c/p>\n\u003cp>But other LGBT academics and writers did not accept this line of reasoning. Oberlin sociology professor Greggor Mattson wrote a \u003ca href=\"https://greggormattson.com/2017/09/09/artificial-intelligence-discovers-gayface/\" target=\"_blank\" rel=\"noopener noreferrer\">takedown,\u003c/a> published on his website, describing the study as \"much less insightful than the researchers claim.\" The authors' discussion of their ethical concerns suffered from \"stunning tone-deafness,\" Mattson wrote.\u003c/p>\n\u003cp>At least one LGBT blogger, though, came to the researchers' defense.\u003c/p>\n\u003cp>Alex Bollinger, writing at LGBTQ Nation, wrote a \u003ca href=\"https://www.lgbtqnation.com/2017/09/hrc-glaad-release-silly-statement-gay-face-study/\" target=\"_blank\" rel=\"noopener noreferrer\">post \u003c/a>titled \"HRC and GLAAD release a silly statement about the ‘gay face’ study.\"\u003c/p>\n\u003cblockquote>\u003cp>\"We should take a stance of curiosity instead of judgment.\u003c/p>\n\u003cp>\"This is just one study that looked at one sample and said a few things. There will be more studies later on that will say other things. Let’s see how that all unfolds before deciding what the correct answer is.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post was edited Oct. 9 to specify the nature of the American Psychological Association's review of the study.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update, Sept. 19:\u003c/strong> The American Psychological Association says that a controversial research paper that applied computer facial recognition to successfully guess people’s sexual orientation has passed a review of documentation submitted by the researchers. The paper is set to be published in the association’s peer-reviewed \u003cem>Journal of Personality and Social Psychology\u003c/em>.\u003c/p>\n\u003cp>A spokesperson for the association said it completed the review last week. The association undertook the review to substantiate an institutional review board's vetting of the study, which ensured that the study met ethical guidelines.\u003c/p>\n\u003cp>\"Given the sensitive nature of photo-images used in the current study, we are currently taking this additional step with this as yet unpublished manuscript,\" a spokesperson for the APA wrote to KQED last week, before the review was completed.\u003c/p>\n\u003cp>The research, by Michal Kosinski and Yilun Wang of Stanford University, claims that a computer algorithm bested humans in distinguishing between a gay person and a straight person when analyzing images from public profiles on a dating website. (Here is a \u003ca href=\"https://osf.io/zn79k/\" target=\"_blank\" rel=\"noopener noreferrer\">preprint\u003c/a> of the study; it's not necessarily the final version of the paper.)Researchers claim AI can be taught to predict sexual orientation from analyzing photographs. LGBTQ advocates are outraged.\u003c/p>\n\u003cp>The research had led to a firestorm of criticism from LGBTQ advocates and academics since it was \u003ca href=\"https://www.economist.com/news/science-and-technology/21728614-machines-read-faces-are-coming-advances-ai-are-used-spot-signs?fsrc=scn/tw/te/bl/ed/advancesinaiareusedtospotsignsofsexuality\" target=\"_blank\" rel=\"noopener noreferrer\">first reported\u003c/a> Sept. 9 by The Economist. Two gay rights groups, Human Rights Campaign and GLAAD, \u003ca href=\"https://www.glaad.org/blog/glaad-and-hrc-call-stanford-university-responsible-media-debunk-dangerous-flawed-report\" target=\"_blank\" rel=\"noopener noreferrer\">called the research,\u003c/a> in a joint press release, \"junk science.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Analyzing Faces\u003c/strong>\u003c/p>\n\u003cp>Using basic facial-recognition technology, the researchers weeded through 130,741 public photos of men and women posted on a U.S. dating website, selecting for images that showed a single face large and clear enough to analyze. This left a pool of 35,326 pictures of 14,776 individuals. Gay and straight people, male and female, were represented evenly.\u003c/p>\n\u003cp>Software called VGG-Face analyzed the faces and looked for correlations between a person's face (nose length, jaw width, etc.) and their self-declared sexual identity on the website. Using a resulting model made up of these distinguishing characteristics, the program, when shown one photo of a gay man and one of a straight man, was able to identify their sexual orientation 81 percent of the time. For women, the success rate was 71 percent. (Accuracy increased when the model was shown more than one image of a person.) Human guessers correctly identified straight faces and gay faces just 61 percent of the time for men and 54 percent for women.\u003c/p>\n\u003cp>The researchers say in the paper that these results \"provide strong support\" for the prenatal hormone theory of gay and lesbian sexual orientation. The theory holds that under or overexposure to prenatal androgens are a key determinant of sexual orientation.\u003c/p>\n\u003cp>In an \u003ca href=\"https://docs.google.com/document/d/11oGZ1Ke3wK9E3BtOFfGfUQuuaSMR8AO2WfWH3aVke6U/preview#\" target=\"_blank\" rel=\"noopener noreferrer\">authors' note\u003c/a> (last updated Sept. 13), the researchers discuss the study's limitations at some length, including the narrow demographic characteristics of the individuals analyzed -- white people who self-reported to be gay or straight. They also expressed concerns about the implications of the study:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">We were really disturbed by these results and spent much time considering whether they should be made public at all. We did not want to enable the very risks that we are warning against. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Recent press reports,\u003c/span>\u003cspan style=\"font-weight: 400\"> however, suggest that governments and corporations are already using tools aimed at revealing intimate traits from faces. Facial images of billions of people are stockpiled in digital and traditional archives, including dating platforms, photo-sharing websites, and government databases. Profile pictures on Facebook, LinkedIn, and Google Plus are public by default. CCTV cameras and smartphones can be used to take pictures of others’ faces without their permission.\u003c/span>\u003c/p>\u003c/blockquote>\n\u003cp>Critics of the research expressed concerns that it will lead to the very invasion of privacy the authors seek to warn against. HRC/GLAAD also criticized the limited demographic pool used by the researchers, the \"superficial\" nature of the characteristics analyzed in the model, and the way media have represented the study.\u003c/p>\n\u003cp>The \u003ca href=\"https://docs.google.com/document/d/1UuEcSNFMduIaf0cOWdWbOV3NORLoKWdz3big4xuk7Z4/edit#\" target=\"_blank\" rel=\"noopener noreferrer\">authors responded\u003c/a> angrily, calling the HRC/GLAAD press release premature and misleading. \"\u003cspan style=\"font-weight: 400\">They do a great disservice to the LGBTQ community by dismissing our results outright without properly assessing the science behind it, and hurt the mission of the great organizations that they represent,\" they wrote. \u003c/span>\u003c/p>\n\u003cp>The researchers also stressed, in their authors' note, that they did not invent the tools used. Rather, they applied internet-available software to internet-available data, with the goal of demonstrating the privacy risks inherent in artificially intelligent technologies.\u003c/p>\n\u003cp>\"We studied existing technologies,\" wrote Kosinski and Wang, already widely used by companies and governments, to see whether they present a risk to the privacy of LGBTQ individuals.\"\u003c/p>\n\u003cp>They added, \"We were terrified to find that they do.\"\u003c/p>\n\u003cp>Such tools present a special threat, said the authors, to the privacy and safety of gay men and women living under repressive regimes where homosexuality is illegal.\u003c/p>\n\u003cp>But other LGBT academics and writers did not accept this line of reasoning. Oberlin sociology professor Greggor Mattson wrote a \u003ca href=\"https://greggormattson.com/2017/09/09/artificial-intelligence-discovers-gayface/\" target=\"_blank\" rel=\"noopener noreferrer\">takedown,\u003c/a> published on his website, describing the study as \"much less insightful than the researchers claim.\" The authors' discussion of their ethical concerns suffered from \"stunning tone-deafness,\" Mattson wrote.\u003c/p>\n\u003cp>At least one LGBT blogger, though, came to the researchers' defense.\u003c/p>\n\u003cp>Alex Bollinger, writing at LGBTQ Nation, wrote a \u003ca href=\"https://www.lgbtqnation.com/2017/09/hrc-glaad-release-silly-statement-gay-face-study/\" target=\"_blank\" rel=\"noopener noreferrer\">post \u003c/a>titled \"HRC and GLAAD release a silly statement about the ‘gay face’ study.\"\u003c/p>\n\u003cblockquote>\u003cp>\"We should take a stance of curiosity instead of judgment.\u003c/p>\n\u003cp>\"This is just one study that looked at one sample and said a few things. There will be more studies later on that will say other things. Let’s see how that all unfolds before deciding what the correct answer is.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post was edited Oct. 9 to specify the nature of the American Psychological Association's review of the study.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Intravenous Hydrogen Peroxide: Unproven Treatment Offered by Naturopaths",
"title": "Intravenous Hydrogen Peroxide: Unproven Treatment Offered by Naturopaths",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Many a parent has applied hydrogen peroxide to a child's cut or scrape to prevent infections. But a number of Southern California naturopathic doctors are using the mild antiseptic in an unconventional way: They intravenously infuse a saline solution with 3 percent hydrogen peroxide straight into a patient's bloodstream.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When you have something that has never been shown to be of value and has the potential to do a lot of harm, it shouldn’t be used.'\u003ccite>Dr. Paul Offit, University of Pennsylvania medical school\u003c/cite>\u003c/aside>\n\u003cp>Montrose osteopath Dr. Yoshi Rahm says this treatment, called IV hydrogen peroxide, does the same thing inside your body as it does on the outside. It's \"killing things,\" such as \"the infection that you currently have, or those unhealthy cancer cells you currently have,\" he says.There's no proof this treatment works. On top of that, IV hydrogen peroxide can be expensive and potentially dangerous. Yet it's not hard to find naturopaths in Southern California who offer it.\u003c/p>\n\u003cp>Some naturopaths promote it online. In this YouTube video, a doctor in Georgia says there are \"30 to 50 maladies\" that IV hydrogen peroxide can help fight, including colds, flus and bacterial and viral infections.\u003c/p>\n\u003cp>\"When you have one compound that someone's telling you can treat a wide variety of unrelated conditions, that's a red flag,\" says Dr. David Gorski, a professor at Wayne State University's medical school and editor of the website Science-Based Medicine.\u003c/p>\n\u003cp>\u003cstrong>Unproven and Untracked\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_435349\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/hydrogperoxdoc.jpg\">\u003cimg class=\"size-large wp-image-435349\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/hydrogperoxdoc-1020x851.jpg\" alt=\"\" width=\"640\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-1020x851.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-160x133.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-800x667.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-768x641.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-960x801.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-240x200.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-375x313.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-520x434.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc.jpg 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Yoshi Rahm estimates he's provided about 100 IV hydrogen peroxide treatments over the past four years. He acknowledges there's no scientific proof that it works. \u003ccite>(Rebecca Plevin/KPCC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>IV hydrogen peroxide has never been studied in a clinical trial, and the U.S. Food and Drug Administration hasn't approved any IV drugs that contain hydrogen peroxide as an active ingredient.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"When you have something that has never been shown to be of value and has the potential to do a lot of harm, it shouldn't be used,\" says Dr. Paul Offit, a professor at the University of Pennsylvania medical school and author of a book about alternative medicine.\u003c/p>\n\u003cp>The U.S. Centers for Disease Control and Prevention doesn't track adverse events from IV hydrogen peroxide. But according to news reports, one woman died in South Carolina in 2004 after a doctor administered it as a treatment for multiple sclerosis.\u003c/p>\n\u003cp>The coroner concluded the hydrogen peroxide produced bubbles in the woman's blood, which led to multiple organ failure and cardiac arrest.\u003c/p>\n\u003cp>IV hydrogen peroxide has a lot of risk and no proven benefits, Offit says.\u003c/p>\n\u003cp>\"If you're going to do placebo medicine, which is what I think this is, then use a placebo, because hydrogen peroxide can kill you,\" he says.\u003c/p>\n\u003cp>It's also expensive: In Southern California, treatments often cost more than a $100 per session.\u003c/p>\n\u003cp>\u003cstrong>No 'Solid Medical Evidence'\u003c/strong>\u003c/p>\n\u003cp>The California Naturopathic Doctors Association says it doesn't track how many people have gotten IV hydrogen peroxide or how many providers offer it, but the group referred KPCC to a naturopath in Grass Valley who says she's trained thousands on how to administer the treatment.\u003c/p>\n\u003cp>Dr. Rahm estimates he's provided about 100 treatments of IV hydrogen peroxide over the past four years. He says he's mainly used it on sinus infections and on cancer, as long as patients are also getting standard treatments like chemotherapy.\u003c/p>\n\u003cp>Rahm acknowledges there's no scientific proof that it works.\u003c/p>\n\u003cp>\"Honestly, I would say no, there's not like solid medical evidence behind it,\" Rahm says. \"Those studies haven't been done.\"\u003c/p>\n\u003cp>He defends the treatment by pointing to one patient's story as proof that it works.\u003c/p>\n\u003cp>Mercedes Curran, a 28-year-old from Beverly Glen Canyon, has MS, an unpredictable, degenerative disease of the central nervous system.\u003c/p>\n\u003cp>At one point, she couldn't control the right side of her body.\u003c/p>\n\u003cp>\"It felt like the right side of my body had 30 extra pounds on all of it,\" Curran recalls. \"Essentially, it would feel like that part of my body was dead.\"\u003c/p>\n\u003cp>Her neurologist recommended five rounds of steroids and physical therapy. Alongside that treatment, Rahm recommended 10 IV hydrogen peroxide sessions over two weeks.\u003c/p>\n\u003cp>Curran says she was skeptical, but willing to try it.\u003c/p>\n\u003cp>\"I wouldn't say I was desperate, but at the same time, of course I wanted to walk without having to drag my leg and I love to travel and all those other things,\" she says.\u003c/p>\n\u003cp>Dr. Offit says he has \"enormous sympathy\" for Curran's situation. He says she, like many others, turned to alternative medicine after coming up against the limits of Western medicine.\u003c/p>\n\u003cp>Still, \"there's just no reason to put people at this kind of risk,\" he says. \"I think these are very vulnerable people and it's just disheartening to see that there are clinicians who are willing to step into the breach and take advantage of these patients.\"\u003c/p>\n\u003cp>Curran estimates she’s spent about $2,000 altogether on her treatments. Each time, she would relax in a lounge chair in Rahm's office, as a saline solution with 3 percent hydrogen peroxide was infused into her bloodstream.\u003c/p>\n\u003cp>\"I felt better after the first session,\" Curran recalls. \"I just felt like I had more energy and my body wasn't as heavy. It could've been even after two or three sessions was the first time I could flex my foot.\"\u003c/p>\n\u003cp>\u003cstrong>Anecdotes Not Scientific Evidence\u003c/strong>\u003c/p>\n\u003cp>Experts say it's impossible to know why Curran started feeling better.\u003c/p>\n\u003cp>MS symptoms sometimes improve on their own. It could've been the steroids Curran's neurologist prescribed, which can take a few weeks to kick in. Or it could've been the placebo effect.\u003c/p>\n\u003cp>\"With one single case, we should be very careful and definitely not jump to the conclusions, especially when it comes to intravenous administration of a substance that can be toxic,\" says Dr. Regina Berkovich, a neurologist who specializes in MS at USC.\u003c/p>\n\u003cp>If naturopathic doctors like Rahm think IV hydrogen peroxide can help treat MS and other conditions, they should prove it, says Dr. Robert Califf, who served as FDA commissioner until January.\u003c/p>\n\u003cp>\"If the treatment works, he would be doing the world a favor to show it using good scientific principles,\" he says, while predicting that it wouldn't be proven to work.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Even in the mainstream drug industry, over 90 percent of drugs that get into human clinical trials end up not being safe and effective,\" says Califf.\u003c/p>\n\n",
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"excerpt": "Naturopaths in Southern California are treating patients intravenously with the antiseptic hydrogen peroxide. But this treatment can be expensive and possibly dangerous, and there's no evidence that it actually works.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Many a parent has applied hydrogen peroxide to a child's cut or scrape to prevent infections. But a number of Southern California naturopathic doctors are using the mild antiseptic in an unconventional way: They intravenously infuse a saline solution with 3 percent hydrogen peroxide straight into a patient's bloodstream.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When you have something that has never been shown to be of value and has the potential to do a lot of harm, it shouldn’t be used.'\u003ccite>Dr. Paul Offit, University of Pennsylvania medical school\u003c/cite>\u003c/aside>\n\u003cp>Montrose osteopath Dr. Yoshi Rahm says this treatment, called IV hydrogen peroxide, does the same thing inside your body as it does on the outside. It's \"killing things,\" such as \"the infection that you currently have, or those unhealthy cancer cells you currently have,\" he says.There's no proof this treatment works. On top of that, IV hydrogen peroxide can be expensive and potentially dangerous. Yet it's not hard to find naturopaths in Southern California who offer it.\u003c/p>\n\u003cp>Some naturopaths promote it online. In this YouTube video, a doctor in Georgia says there are \"30 to 50 maladies\" that IV hydrogen peroxide can help fight, including colds, flus and bacterial and viral infections.\u003c/p>\n\u003cp>\"When you have one compound that someone's telling you can treat a wide variety of unrelated conditions, that's a red flag,\" says Dr. David Gorski, a professor at Wayne State University's medical school and editor of the website Science-Based Medicine.\u003c/p>\n\u003cp>\u003cstrong>Unproven and Untracked\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_435349\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/hydrogperoxdoc.jpg\">\u003cimg class=\"size-large wp-image-435349\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/hydrogperoxdoc-1020x851.jpg\" alt=\"\" width=\"640\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-1020x851.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-160x133.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-800x667.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-768x641.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-960x801.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-240x200.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-375x313.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-520x434.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc.jpg 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Yoshi Rahm estimates he's provided about 100 IV hydrogen peroxide treatments over the past four years. He acknowledges there's no scientific proof that it works. \u003ccite>(Rebecca Plevin/KPCC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>IV hydrogen peroxide has never been studied in a clinical trial, and the U.S. Food and Drug Administration hasn't approved any IV drugs that contain hydrogen peroxide as an active ingredient.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"When you have something that has never been shown to be of value and has the potential to do a lot of harm, it shouldn't be used,\" says Dr. Paul Offit, a professor at the University of Pennsylvania medical school and author of a book about alternative medicine.\u003c/p>\n\u003cp>The U.S. Centers for Disease Control and Prevention doesn't track adverse events from IV hydrogen peroxide. But according to news reports, one woman died in South Carolina in 2004 after a doctor administered it as a treatment for multiple sclerosis.\u003c/p>\n\u003cp>The coroner concluded the hydrogen peroxide produced bubbles in the woman's blood, which led to multiple organ failure and cardiac arrest.\u003c/p>\n\u003cp>IV hydrogen peroxide has a lot of risk and no proven benefits, Offit says.\u003c/p>\n\u003cp>\"If you're going to do placebo medicine, which is what I think this is, then use a placebo, because hydrogen peroxide can kill you,\" he says.\u003c/p>\n\u003cp>It's also expensive: In Southern California, treatments often cost more than a $100 per session.\u003c/p>\n\u003cp>\u003cstrong>No 'Solid Medical Evidence'\u003c/strong>\u003c/p>\n\u003cp>The California Naturopathic Doctors Association says it doesn't track how many people have gotten IV hydrogen peroxide or how many providers offer it, but the group referred KPCC to a naturopath in Grass Valley who says she's trained thousands on how to administer the treatment.\u003c/p>\n\u003cp>Dr. Rahm estimates he's provided about 100 treatments of IV hydrogen peroxide over the past four years. He says he's mainly used it on sinus infections and on cancer, as long as patients are also getting standard treatments like chemotherapy.\u003c/p>\n\u003cp>Rahm acknowledges there's no scientific proof that it works.\u003c/p>\n\u003cp>\"Honestly, I would say no, there's not like solid medical evidence behind it,\" Rahm says. \"Those studies haven't been done.\"\u003c/p>\n\u003cp>He defends the treatment by pointing to one patient's story as proof that it works.\u003c/p>\n\u003cp>Mercedes Curran, a 28-year-old from Beverly Glen Canyon, has MS, an unpredictable, degenerative disease of the central nervous system.\u003c/p>\n\u003cp>At one point, she couldn't control the right side of her body.\u003c/p>\n\u003cp>\"It felt like the right side of my body had 30 extra pounds on all of it,\" Curran recalls. \"Essentially, it would feel like that part of my body was dead.\"\u003c/p>\n\u003cp>Her neurologist recommended five rounds of steroids and physical therapy. Alongside that treatment, Rahm recommended 10 IV hydrogen peroxide sessions over two weeks.\u003c/p>\n\u003cp>Curran says she was skeptical, but willing to try it.\u003c/p>\n\u003cp>\"I wouldn't say I was desperate, but at the same time, of course I wanted to walk without having to drag my leg and I love to travel and all those other things,\" she says.\u003c/p>\n\u003cp>Dr. Offit says he has \"enormous sympathy\" for Curran's situation. He says she, like many others, turned to alternative medicine after coming up against the limits of Western medicine.\u003c/p>\n\u003cp>Still, \"there's just no reason to put people at this kind of risk,\" he says. \"I think these are very vulnerable people and it's just disheartening to see that there are clinicians who are willing to step into the breach and take advantage of these patients.\"\u003c/p>\n\u003cp>Curran estimates she’s spent about $2,000 altogether on her treatments. Each time, she would relax in a lounge chair in Rahm's office, as a saline solution with 3 percent hydrogen peroxide was infused into her bloodstream.\u003c/p>\n\u003cp>\"I felt better after the first session,\" Curran recalls. \"I just felt like I had more energy and my body wasn't as heavy. It could've been even after two or three sessions was the first time I could flex my foot.\"\u003c/p>\n\u003cp>\u003cstrong>Anecdotes Not Scientific Evidence\u003c/strong>\u003c/p>\n\u003cp>Experts say it's impossible to know why Curran started feeling better.\u003c/p>\n\u003cp>MS symptoms sometimes improve on their own. It could've been the steroids Curran's neurologist prescribed, which can take a few weeks to kick in. Or it could've been the placebo effect.\u003c/p>\n\u003cp>\"With one single case, we should be very careful and definitely not jump to the conclusions, especially when it comes to intravenous administration of a substance that can be toxic,\" says Dr. Regina Berkovich, a neurologist who specializes in MS at USC.\u003c/p>\n\u003cp>If naturopathic doctors like Rahm think IV hydrogen peroxide can help treat MS and other conditions, they should prove it, says Dr. Robert Califf, who served as FDA commissioner until January.\u003c/p>\n\u003cp>\"If the treatment works, he would be doing the world a favor to show it using good scientific principles,\" he says, while predicting that it wouldn't be proven to work.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>If you want to have a role in shaping the near and coming future of biotechnology, the time is now. A science degree is not required, but a sense of urgency is.\u003c/p>\n\u003cp>This was the primary takeaway from Jennifer Doudna’s recent public remarks at\u003ca href=\"http://crisprcon.org/\" target=\"_blank\" rel=\"noopener noreferrer\"> CRISPRcon\u003c/a>, a two day event at UC Berkeley, intended to get nonspecialists talking about the promise and potential peril of the fast-moving biotech landscape.\u003c/p>\n\u003cp>“Decisions about gene editing have an impact on all of us,” said Michael Krasney, host of KQED’s “Forum” radio program and the CRISPRcon emcee. “That’s why there are no outsiders in discussing this topic.” (For a primer on how CRISPR gene editing works, check out our story “\u003ca href=\"https://ww2.kqed.org/futureofyou/2015/12/30/a-crispr-solution-to-bubble-boy-disease/\" target=\"_blank\" rel=\"noopener noreferrer\">CRISPR: What You Need to Know About the Medical Science ‘Breakthrough of the Year\u003c/a>.”)\u003c/p>\n\u003caside class=\"pullquote alignright\">“We can no longer say, well there’s a lot of technology development to be done before we have to worry about that application, it’s now a question of ‘We know this can work, are we willing to go there or not?'” \u003ccite>Jennifer Doudna, one of the inventors of CRISPR/Cas9 gene-editing technology\u003c/cite>\u003c/aside>\n\u003cp>The National Academies of Sciences, Engineering and Medicine wants public input, as well. The rationale is, if it affects the public, the public should have a say.\u003c/p>\n\u003cp>\u003cstrong>What’s at Stake\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In her new book, “\u003ca href=\"http://www.acrackincreation.com/\" target=\"_blank\" rel=\"noopener noreferrer\">A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution\u003c/a>,” Doudna (who co-authored the book with former student Samuel Sternberg) writes humans are “on the cusp of a new age in genetic engineering and biological mastery.”\u003c/p>\n\u003cp>“It won’t be long before CRISPR allows us to bend nature to our will.”\u003c/p>\n\u003cp>CRISPR applications could bring us \u003ca href=\"https://www.sciencedaily.com/releases/2017/05/170518140335.htm\" target=\"_blank\" rel=\"noopener noreferrer\">higher tomato yields\u003c/a> or cattle \u003ca href=\"https://geneticliteracyproject.org/2016/05/11/gene-edited-hornless-cow-improve-animal-welfare-regulatory-fate-unclear/\" target=\"_blank\" rel=\"noopener noreferrer\">born without horns\u003c/a> (allowing livestock to avoid the potentially painful procedure of having them removed). Ongoing medical research using CRISPR includes \u003ca href=\"https://www.nature.com/news/first-crispr-clinical-trial-gets-green-light-from-us-panel-1.20137\" target=\"_blank\" rel=\"noopener noreferrer\">gene editing to target immune response\u003c/a> in cancer patients and to \u003ca href=\"https://www.nature.com/news/crispr-deployed-to-combat-sickle-cell-anaemia-1.20782\" target=\"_blank\" rel=\"noopener noreferrer\">correct sickle-cell anemia\u003c/a>, a painful blood disorder.\u003c/p>\n\u003cp>But the $10 million question at CRISPRcon loomed large:\u003c/p>\n\u003cp>“How do you decide which genes are appropriate for germline editing?” asked a woman in the audience, during a question and answer session with Doudna. Germline editing means that the changes made affect sperm or egg cells, and therefore can be inherited.\u003c/p>\n\u003cp>[contextly_sidebar id=”HfCYio1aAJwJdg2Ip7LwMBF1sWeN5NFY”]”That’s a question that could be debated and discussed for the entire time of the conference,” said Doudna. But her short answer, referencing a \u003ca href=\"http://www.nationalacademies.org/gene-editing/consensus-study/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\">recent report with recommendations\u003c/a> from the National Academies, was, “We look for situations where there would be no other reasonable way to deal with a genetic disease other than gene editing. And when you think about it that way, those situations are rather rare.”\u003c/p>\n\u003cp>Preimplantation genetic diagnosis (for parents using in vitro fertilization) and genetic counseling can offer routes to avoid serious genetic mutations without gene editing. This latter technique would, however, require parents to decide if they are willing to terminate a pregnancy.\u003c/p>\n\u003cp>Doudna believes that in most cases genetic counseling and preimplantation genetic diagnosis are sufficient to deal with disorders caused by a single gene. But some couples might not have any other option to conceive a healthy embryo outside of editing their genes. For example, if both parents both have the same disease-causing gene, “That’s an issue where gene editing could be relevant in the future.”\u003c/p>\n\u003cp>For any parents who want to select for green-eyed, athletic geniuses, their best bet is still a random roll of the dice, not gene-editing, if the National Academies has anything to do with it. “Do not proceed at this time with human genome editing for purposes other than treatment or prevention of disease and disability,” the study recommends.\u003c/p>\n\u003cp>But the question of whether embryos should be edited to avoid disease and disability has reached new urgency, says Doudna, with the publication several weeks ago of the first \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/07/27/scientists-in-us-edit-human-embryos-with-crispr-for-first-time-reports-suggest/\" target=\"_blank\" rel=\"noopener noreferrer\">paper\u003c/a> that lays out a good protocol (a written procedure) for targeting a gene linked to disease. It has the potential of being useful in clinical applications.\u003c/p>\n\u003cp>“What they showed, importantly,” said Doudna, “was that there was very few off-target effects [unintended changes] and also they could avoid something called ‘mosaicism’. ” That arises when the desired edit occurs in only some of the cells in the developing embryo. Both edited and non-editing cells replicate, resulting in an organism with a genetic patchwork, which may or may not be harmful.\u003c/p>\n\u003cp>“We now understand that, when applied in certain ways this technology can be very robust, in viable human embryos. We can no longer say, ‘Well, there’s a lot of technology development to be done before we have to worry about that application.’ It’s now a question of, ‘We know this can work, are we willing to go there or not?’ ”\u003c/p>\n\u003cp>Since CRISPRcon, the paper in question has come in for some \u003ca href=\"https://ipscell.com/2017/08/doubts-raised-on-key-points-of-nature-paper-on-crispr-gene-editing-of-human-embryos/\" target=\"_blank\" rel=\"noopener noreferrer\">recent criticism from scientists\u003c/a> not involved in the research. They call into question the main conclusions of the paper and say more definitive studies are needed. That said, most scientists believe precise editing in embryos will be possible someday, and likely someday soon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For members of the public eager to be part of the debate, events like CRISPRcon provide a rare forum with scientists like Doudna who have \u003ca href=\"https://ipscell.com/2015/06/doudnacongress/\" target=\"_blank\" rel=\"noopener noreferrer\">testified before Congress\u003c/a> regarding the science and ethics of gene editing. But for the average person on the street, the most direct route to voicing opinions and concerns may be \u003ca href=\"http://www.nationalacademies.org/gene-editing/consensus-study/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\">submitting comments\u003c/a> on the homepage of the National Academies’ Human Gene-Editing Initiative. Of course, there is also the tried and true method of \u003ca href=\"https://callyourrep.co/\" target=\"_blank\" rel=\"noopener noreferrer\">calling your representatives\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you want to have a role in shaping the near and coming future of biotechnology, the time is now. A science degree is not required, but a sense of urgency is.\u003c/p>\n\u003cp>This was the primary takeaway from Jennifer Doudna’s recent public remarks at\u003ca href=\"http://crisprcon.org/\" target=\"_blank\" rel=\"noopener noreferrer\"> CRISPRcon\u003c/a>, a two day event at UC Berkeley, intended to get nonspecialists talking about the promise and potential peril of the fast-moving biotech landscape.\u003c/p>\n\u003cp>“Decisions about gene editing have an impact on all of us,” said Michael Krasney, host of KQED’s “Forum” radio program and the CRISPRcon emcee. “That’s why there are no outsiders in discussing this topic.” (For a primer on how CRISPR gene editing works, check out our story “\u003ca href=\"https://ww2.kqed.org/futureofyou/2015/12/30/a-crispr-solution-to-bubble-boy-disease/\" target=\"_blank\" rel=\"noopener noreferrer\">CRISPR: What You Need to Know About the Medical Science ‘Breakthrough of the Year\u003c/a>.”)\u003c/p>\n\u003caside class=\"pullquote alignright\">“We can no longer say, well there’s a lot of technology development to be done before we have to worry about that application, it’s now a question of ‘We know this can work, are we willing to go there or not?'” \u003ccite>Jennifer Doudna, one of the inventors of CRISPR/Cas9 gene-editing technology\u003c/cite>\u003c/aside>\n\u003cp>The National Academies of Sciences, Engineering and Medicine wants public input, as well. The rationale is, if it affects the public, the public should have a say.\u003c/p>\n\u003cp>\u003cstrong>What’s at Stake\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In her new book, “\u003ca href=\"http://www.acrackincreation.com/\" target=\"_blank\" rel=\"noopener noreferrer\">A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution\u003c/a>,” Doudna (who co-authored the book with former student Samuel Sternberg) writes humans are “on the cusp of a new age in genetic engineering and biological mastery.”\u003c/p>\n\u003cp>“It won’t be long before CRISPR allows us to bend nature to our will.”\u003c/p>\n\u003cp>CRISPR applications could bring us \u003ca href=\"https://www.sciencedaily.com/releases/2017/05/170518140335.htm\" target=\"_blank\" rel=\"noopener noreferrer\">higher tomato yields\u003c/a> or cattle \u003ca href=\"https://geneticliteracyproject.org/2016/05/11/gene-edited-hornless-cow-improve-animal-welfare-regulatory-fate-unclear/\" target=\"_blank\" rel=\"noopener noreferrer\">born without horns\u003c/a> (allowing livestock to avoid the potentially painful procedure of having them removed). Ongoing medical research using CRISPR includes \u003ca href=\"https://www.nature.com/news/first-crispr-clinical-trial-gets-green-light-from-us-panel-1.20137\" target=\"_blank\" rel=\"noopener noreferrer\">gene editing to target immune response\u003c/a> in cancer patients and to \u003ca href=\"https://www.nature.com/news/crispr-deployed-to-combat-sickle-cell-anaemia-1.20782\" target=\"_blank\" rel=\"noopener noreferrer\">correct sickle-cell anemia\u003c/a>, a painful blood disorder.\u003c/p>\n\u003cp>But the $10 million question at CRISPRcon loomed large:\u003c/p>\n\u003cp>“How do you decide which genes are appropriate for germline editing?” asked a woman in the audience, during a question and answer session with Doudna. Germline editing means that the changes made affect sperm or egg cells, and therefore can be inherited.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>”That’s a question that could be debated and discussed for the entire time of the conference,” said Doudna. But her short answer, referencing a \u003ca href=\"http://www.nationalacademies.org/gene-editing/consensus-study/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\">recent report with recommendations\u003c/a> from the National Academies, was, “We look for situations where there would be no other reasonable way to deal with a genetic disease other than gene editing. And when you think about it that way, those situations are rather rare.”\u003c/p>\n\u003cp>Preimplantation genetic diagnosis (for parents using in vitro fertilization) and genetic counseling can offer routes to avoid serious genetic mutations without gene editing. This latter technique would, however, require parents to decide if they are willing to terminate a pregnancy.\u003c/p>\n\u003cp>Doudna believes that in most cases genetic counseling and preimplantation genetic diagnosis are sufficient to deal with disorders caused by a single gene. But some couples might not have any other option to conceive a healthy embryo outside of editing their genes. For example, if both parents both have the same disease-causing gene, “That’s an issue where gene editing could be relevant in the future.”\u003c/p>\n\u003cp>For any parents who want to select for green-eyed, athletic geniuses, their best bet is still a random roll of the dice, not gene-editing, if the National Academies has anything to do with it. “Do not proceed at this time with human genome editing for purposes other than treatment or prevention of disease and disability,” the study recommends.\u003c/p>\n\u003cp>But the question of whether embryos should be edited to avoid disease and disability has reached new urgency, says Doudna, with the publication several weeks ago of the first \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/07/27/scientists-in-us-edit-human-embryos-with-crispr-for-first-time-reports-suggest/\" target=\"_blank\" rel=\"noopener noreferrer\">paper\u003c/a> that lays out a good protocol (a written procedure) for targeting a gene linked to disease. It has the potential of being useful in clinical applications.\u003c/p>\n\u003cp>“What they showed, importantly,” said Doudna, “was that there was very few off-target effects [unintended changes] and also they could avoid something called ‘mosaicism’. ” That arises when the desired edit occurs in only some of the cells in the developing embryo. Both edited and non-editing cells replicate, resulting in an organism with a genetic patchwork, which may or may not be harmful.\u003c/p>\n\u003cp>“We now understand that, when applied in certain ways this technology can be very robust, in viable human embryos. We can no longer say, ‘Well, there’s a lot of technology development to be done before we have to worry about that application.’ It’s now a question of, ‘We know this can work, are we willing to go there or not?’ ”\u003c/p>\n\u003cp>Since CRISPRcon, the paper in question has come in for some \u003ca href=\"https://ipscell.com/2017/08/doubts-raised-on-key-points-of-nature-paper-on-crispr-gene-editing-of-human-embryos/\" target=\"_blank\" rel=\"noopener noreferrer\">recent criticism from scientists\u003c/a> not involved in the research. They call into question the main conclusions of the paper and say more definitive studies are needed. That said, most scientists believe precise editing in embryos will be possible someday, and likely someday soon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For members of the public eager to be part of the debate, events like CRISPRcon provide a rare forum with scientists like Doudna who have \u003ca href=\"https://ipscell.com/2015/06/doudnacongress/\" target=\"_blank\" rel=\"noopener noreferrer\">testified before Congress\u003c/a> regarding the science and ethics of gene editing. But for the average person on the street, the most direct route to voicing opinions and concerns may be \u003ca href=\"http://www.nationalacademies.org/gene-editing/consensus-study/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\">submitting comments\u003c/a> on the homepage of the National Academies’ Human Gene-Editing Initiative. Of course, there is also the tried and true method of \u003ca href=\"https://callyourrep.co/\" target=\"_blank\" rel=\"noopener noreferrer\">calling your representatives\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"radiolab": {
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},
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"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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