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"content": "\u003cp>For the majority of us, it's not a question of whether we'll someday experience back pain; it's a question of when.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Study after study after study has shown that long-term visits to chiropractors don't help patients. They don't prevent back pain; they don't solve back pain.'\u003c/aside>\n\u003cp>But searching for solutions can lead sufferers into an expensive and sometimes dangerous maze of ineffectual treatments, procedures and pills, as journalist and investigative reporter Cathryn Jakobson Ramin found. For years, she searched for ways to alleviate her own intractable back pain. Then she began to investigate the entire back pain ecosystem: doctors, chiropractors, surgery centers, pharmaceutical companies, \"posture mavens,\" collusion between personal injury attorneys and doctors ... you name it. [contextly_sidebar id=\"JG48iB524FEZTdlnUCsiXnLPWkVrjosK\"]\u003c/p>\n\u003cp>Her new book, \"\u003ca href=\"http://www.cathrynjakobsonramin.com/books/\" target=\"_blank\" rel=\"noopener noreferrer\">Crooked: Outwitting the Back Pain Industry and Getting On the Road to Recovery,\u003c/a>\" explores what she found, while also telling the story of how she overcame her chronic suffering. When it comes to people making money on -- literally -- the backs of other people, \"A lot of things didn't add up,\" she says. \"That generally means something is wrong.\"\u003c/p>\n\u003cp>Ramin recently spoke about her investigation with Eric Westervelt on \u003ca href=\"https://ww2.kqed.org/forum/2017/05/19/cathryn-jakobson-ramin-on-the-crooked-back-pain-industry/\" target=\"_blank\" rel=\"noopener noreferrer\">KQED's Forum\u003c/a> program. Here is some of what she said.\u003c/p>\n\u003cp>\u003cstrong>Beware the One Surgeon Who Says Yes\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ramin, who had ineffective minor surgery for her back pain, said the post-surgical woes of Tiger Woods and Golden State Warriors' coach Steve Kerr serve as prime examples of what can go wrong with back surgery.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Minimally invasive surgery' is a marketing term. 'The damage beneath the skin will be exactly the same as it would be in traditional spine surgery.'\u003c/aside>\n\u003cp>She said some athletes do have successful surgery for back pain, but that it's unlikely their example would apply to the rest of us. \"Those athletes are highly, highly trained and in excellent condition,\" she says.\u003c/p>\n\u003cp>Ramin says the fee-for-service payment system in the U.S. incentivizes unnecessary and potentially damaging spine surgery, where in other countries, spine surgery is rare.\u003c/p>\n\u003cp>And beware the surgeon who agrees to operate on you after other reputable doctors have turned you down. She gave the example of author, physician and marathon runner Jerome Groopman, who, after five surgeons had told him there was nothing they could do for his back injury, found a sixth who claimed he could operate and get him up and running in six weeks.\u003c/p>\n\u003cp>\"He spent the next 19 years in extraordinary pain,\" Ramin says.\u003c/p>\n\u003cp>Ramin also warns against taking the description \"minimally invasive spine surgery\" literally, calling it a marketing term.\u003c/p>\n\u003cp>\"These are sexy buzzwords,\" she says. \"Perhaps the incision is small -- and it isn't always. If in fact you do have a small incision, good for you, you might look better in a bathing suit. The damage beneath the skin will be exactly the same as it would be in regular, traditional, conventional spine surgery.\"\u003c/p>\n\u003cp>These procedures are often done in outpatient surgery centers , she says. \"If anything goes wrong afterward, you're not in a hospital environment.\"\u003c/p>\n\u003cp>\u003cstrong>Chiropractors: A Very Mixed Bag\u003c/strong>\u003c/p>\n\u003cp>Ramin says some chiropractors are completely ineffectual while some are treating patients the right way. Of the latter, \"They have stopped seeking vertebral subluxations [partial dislocations] which don't actually exist on any X-ray or any type of scan, and have moved onto the very excellent practice of rehabilitation. They may ultimately be a back patient's best hope because they have studied exercise science and they have worked hard on it.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">On yoga: 'One of the risk factors is finding yourself in a very competitive Northern California yoga class where you are pushed to do what you really cannot do.'\u003c/aside>\n\u003cp>However, \"If you see a chiropractor more than one or two sessions, you are wasting your time if you are being cracked, adjusted or walked over. Study after study after study has shown that long-term visits to chiropractors don't help patients. They don't prevent back pain; they don't solve back pain.\"\u003c/p>\n\u003cp>She said the World Health Organization has come up with a long list of all the diagnoses for which chiropractic is contra-indicated.( See page 20 \u003ca href=\"http://apps.who.int/medicinedocs/documents/s14076e/s14076e.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">here\u003c/a>.) \"And it's probably anything that would take you to a chiropractor.\"\u003c/p>\n\u003cp>Neck adjustments, she said, \"are to be avoided at all costs. There is no reason to let a chiropractor anywhere near your neck.\"\u003c/p>\n\u003cp>\u003cstrong>Pharmaceutical Companies: Painkilling Pill Pushers\u003c/strong>\u003c/p>\n\u003cp>In the 1990s, Ramin says, pharmaecutical companies embarked on a well-funded campaign to get primary care doctors to ask all their patients if they were experiencing any pain.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is no reason to let a chiropractor anywhere near your neck.'\u003c/aside>\n\u003cp>Oftentimes they were experiencing some back pain, \"because it is a human condition,\" she says. \"The answer to that from the primary care doctor's perspective, because of the active marketing from pharmaceutical companies, was to say 'Well, we can take care of that pain.' \"\u003c/p>\n\u003cp>Doctors often started out with short-acting pain killers, such as Vicodin, a potent and addictive narcotic. This was often followed by longer-acting, extended-release painkillers, such as the opioid-based Oxycodone -- which has led thousands into heroin addiction.\u003c/p>\n\u003cp>But, Ramin says, opioid painkillers don't work well for people with back pain.\u003c/p>\n\u003cp>\"They cause those patients to become very unmotivated and very sleepy,\" she says.\u003c/p>\n\u003cp>Plus, a condition called \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21412369\" target=\"_blank\" rel=\"noopener noreferrer\">opioid-induced hyperalgesia\u003c/a> can arise, in which the brain generates pain independent of the original injury.\u003c/p>\n\u003cp>\u003cstrong>Expensive Chairs and Standing Desks\u003c/strong>\u003c/p>\n\u003cp>Ergonomic \"experts\" rely on what Ramin calls \"smoke and mirrors.\"\u003c/p>\n\u003cp>For instance, many back sufferers will try new office chairs.\u003c/p>\n\u003cp>\"I had a stable of office chairs,\" she says. \"One after another, expensive office chairs parading through my office, and I found most of them to be not very good.\"\u003c/p>\n\u003cp>These chairs are \"often built for 250-pound men,\" she says.\u003c/p>\n\u003cp>\"I realized you could have a chair from Costco for $25 that could keep you in the right position.\"\u003c/p>\n\u003cp>The standard, erect typing position, she says, is actually a relic from when you had to press hard on typewriter keys to get them to work.\u003c/p>\n\u003cp>Regarding the use of standing desks, Ramin says those come with their own problems. \"It's a nice variation from sitting. But remember, if you are standing, you are putting tremendous pressure on possibly a different set of ligaments,\" she says. \"But still you're asking your ligaments to hold you up for a really extended period of time. We're seeing all kinds of problems related to standing desks, now. They tend to be knee and hip problems, but those will lead to back problems.\"\u003c/p>\n\u003cp>If you have a standing desk, you still need to move around every so often, she counsels.\u003c/p>\n\u003cp>\u003cstrong>The Yoga Trap\u003c/strong>\u003c/p>\n\u003cp>Some tremendous benefits can be gained from doing yoga, Ramin says, but there is potential harm, as well.\u003c/p>\n\u003cp>\"One of the risk factors is finding yourself in a very competitive Northern California yoga class where you are pushed to do what you really cannot do. Most of us who are even remotely competitive will experience that.\"\u003c/p>\n\u003cp>She says if you have back pain, there are limitations to what you should do in class, and you need an instructor who can give you variations on postures to suit your condition.\u003c/p>\n\u003cp>\"Be very careful about finding yourself in a flow yoga class where things are moving very fast and there's no way the teacher can keep a close eye on you.\"\u003c/p>\n\u003cp>Two type of yoga she recommends for back sufferers: Iyengar yoga and Viniyoga.\u003c/p>\n\u003cp>\"Both of them have a very powerful orthopedic focus,\" Ramin says.\u003c/p>\n\u003cp>\u003cb>So What Does Work? \u003c/b>\u003c/p>\n\u003cp>Two things: Exercise and changing the way you think about back pain.\u003c/p>\n\u003cp>\"Understanding that hurt does not mean harm,\" Ramin says. \"You can continue to live an active life. The most dangerous thing you can do for yourself is take to the couch or take to your bed or take to pain management. But of course that is what most people do.“\u003c/p>\n\u003cp>Ramin recommends finding a \"back whisperer\"--someone who understands the musculoskeletal system and is able to help people build strength, balance their gaits and move effectively.\u003c/p>\n\u003cp>Moving is the key. Our bodies are not built to sit or stand in one place for hours at a time, she says. \"The best posture is your next posture.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>For more info: Ramin's website features an extensive \u003ca href=\"http://www.cathrynjakobsonramin.com/resource-search\" target=\"_blank\" rel=\"noopener noreferrer\">resources section\u003c/a> directing people to information, videos and medical professionals who may be able to help alleviate back pain.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the majority of us, it's not a question of whether we'll someday experience back pain; it's a question of when.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Study after study after study has shown that long-term visits to chiropractors don't help patients. They don't prevent back pain; they don't solve back pain.'\u003c/aside>\n\u003cp>But searching for solutions can lead sufferers into an expensive and sometimes dangerous maze of ineffectual treatments, procedures and pills, as journalist and investigative reporter Cathryn Jakobson Ramin found. For years, she searched for ways to alleviate her own intractable back pain. Then she began to investigate the entire back pain ecosystem: doctors, chiropractors, surgery centers, pharmaceutical companies, \"posture mavens,\" collusion between personal injury attorneys and doctors ... you name it. \u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Her new book, \"\u003ca href=\"http://www.cathrynjakobsonramin.com/books/\" target=\"_blank\" rel=\"noopener noreferrer\">Crooked: Outwitting the Back Pain Industry and Getting On the Road to Recovery,\u003c/a>\" explores what she found, while also telling the story of how she overcame her chronic suffering. When it comes to people making money on -- literally -- the backs of other people, \"A lot of things didn't add up,\" she says. \"That generally means something is wrong.\"\u003c/p>\n\u003cp>Ramin recently spoke about her investigation with Eric Westervelt on \u003ca href=\"https://ww2.kqed.org/forum/2017/05/19/cathryn-jakobson-ramin-on-the-crooked-back-pain-industry/\" target=\"_blank\" rel=\"noopener noreferrer\">KQED's Forum\u003c/a> program. Here is some of what she said.\u003c/p>\n\u003cp>\u003cstrong>Beware the One Surgeon Who Says Yes\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ramin, who had ineffective minor surgery for her back pain, said the post-surgical woes of Tiger Woods and Golden State Warriors' coach Steve Kerr serve as prime examples of what can go wrong with back surgery.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Minimally invasive surgery' is a marketing term. 'The damage beneath the skin will be exactly the same as it would be in traditional spine surgery.'\u003c/aside>\n\u003cp>She said some athletes do have successful surgery for back pain, but that it's unlikely their example would apply to the rest of us. \"Those athletes are highly, highly trained and in excellent condition,\" she says.\u003c/p>\n\u003cp>Ramin says the fee-for-service payment system in the U.S. incentivizes unnecessary and potentially damaging spine surgery, where in other countries, spine surgery is rare.\u003c/p>\n\u003cp>And beware the surgeon who agrees to operate on you after other reputable doctors have turned you down. She gave the example of author, physician and marathon runner Jerome Groopman, who, after five surgeons had told him there was nothing they could do for his back injury, found a sixth who claimed he could operate and get him up and running in six weeks.\u003c/p>\n\u003cp>\"He spent the next 19 years in extraordinary pain,\" Ramin says.\u003c/p>\n\u003cp>Ramin also warns against taking the description \"minimally invasive spine surgery\" literally, calling it a marketing term.\u003c/p>\n\u003cp>\"These are sexy buzzwords,\" she says. \"Perhaps the incision is small -- and it isn't always. If in fact you do have a small incision, good for you, you might look better in a bathing suit. The damage beneath the skin will be exactly the same as it would be in regular, traditional, conventional spine surgery.\"\u003c/p>\n\u003cp>These procedures are often done in outpatient surgery centers , she says. \"If anything goes wrong afterward, you're not in a hospital environment.\"\u003c/p>\n\u003cp>\u003cstrong>Chiropractors: A Very Mixed Bag\u003c/strong>\u003c/p>\n\u003cp>Ramin says some chiropractors are completely ineffectual while some are treating patients the right way. Of the latter, \"They have stopped seeking vertebral subluxations [partial dislocations] which don't actually exist on any X-ray or any type of scan, and have moved onto the very excellent practice of rehabilitation. They may ultimately be a back patient's best hope because they have studied exercise science and they have worked hard on it.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">On yoga: 'One of the risk factors is finding yourself in a very competitive Northern California yoga class where you are pushed to do what you really cannot do.'\u003c/aside>\n\u003cp>However, \"If you see a chiropractor more than one or two sessions, you are wasting your time if you are being cracked, adjusted or walked over. Study after study after study has shown that long-term visits to chiropractors don't help patients. They don't prevent back pain; they don't solve back pain.\"\u003c/p>\n\u003cp>She said the World Health Organization has come up with a long list of all the diagnoses for which chiropractic is contra-indicated.( See page 20 \u003ca href=\"http://apps.who.int/medicinedocs/documents/s14076e/s14076e.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">here\u003c/a>.) \"And it's probably anything that would take you to a chiropractor.\"\u003c/p>\n\u003cp>Neck adjustments, she said, \"are to be avoided at all costs. There is no reason to let a chiropractor anywhere near your neck.\"\u003c/p>\n\u003cp>\u003cstrong>Pharmaceutical Companies: Painkilling Pill Pushers\u003c/strong>\u003c/p>\n\u003cp>In the 1990s, Ramin says, pharmaecutical companies embarked on a well-funded campaign to get primary care doctors to ask all their patients if they were experiencing any pain.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is no reason to let a chiropractor anywhere near your neck.'\u003c/aside>\n\u003cp>Oftentimes they were experiencing some back pain, \"because it is a human condition,\" she says. \"The answer to that from the primary care doctor's perspective, because of the active marketing from pharmaceutical companies, was to say 'Well, we can take care of that pain.' \"\u003c/p>\n\u003cp>Doctors often started out with short-acting pain killers, such as Vicodin, a potent and addictive narcotic. This was often followed by longer-acting, extended-release painkillers, such as the opioid-based Oxycodone -- which has led thousands into heroin addiction.\u003c/p>\n\u003cp>But, Ramin says, opioid painkillers don't work well for people with back pain.\u003c/p>\n\u003cp>\"They cause those patients to become very unmotivated and very sleepy,\" she says.\u003c/p>\n\u003cp>Plus, a condition called \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21412369\" target=\"_blank\" rel=\"noopener noreferrer\">opioid-induced hyperalgesia\u003c/a> can arise, in which the brain generates pain independent of the original injury.\u003c/p>\n\u003cp>\u003cstrong>Expensive Chairs and Standing Desks\u003c/strong>\u003c/p>\n\u003cp>Ergonomic \"experts\" rely on what Ramin calls \"smoke and mirrors.\"\u003c/p>\n\u003cp>For instance, many back sufferers will try new office chairs.\u003c/p>\n\u003cp>\"I had a stable of office chairs,\" she says. \"One after another, expensive office chairs parading through my office, and I found most of them to be not very good.\"\u003c/p>\n\u003cp>These chairs are \"often built for 250-pound men,\" she says.\u003c/p>\n\u003cp>\"I realized you could have a chair from Costco for $25 that could keep you in the right position.\"\u003c/p>\n\u003cp>The standard, erect typing position, she says, is actually a relic from when you had to press hard on typewriter keys to get them to work.\u003c/p>\n\u003cp>Regarding the use of standing desks, Ramin says those come with their own problems. \"It's a nice variation from sitting. But remember, if you are standing, you are putting tremendous pressure on possibly a different set of ligaments,\" she says. \"But still you're asking your ligaments to hold you up for a really extended period of time. We're seeing all kinds of problems related to standing desks, now. They tend to be knee and hip problems, but those will lead to back problems.\"\u003c/p>\n\u003cp>If you have a standing desk, you still need to move around every so often, she counsels.\u003c/p>\n\u003cp>\u003cstrong>The Yoga Trap\u003c/strong>\u003c/p>\n\u003cp>Some tremendous benefits can be gained from doing yoga, Ramin says, but there is potential harm, as well.\u003c/p>\n\u003cp>\"One of the risk factors is finding yourself in a very competitive Northern California yoga class where you are pushed to do what you really cannot do. Most of us who are even remotely competitive will experience that.\"\u003c/p>\n\u003cp>She says if you have back pain, there are limitations to what you should do in class, and you need an instructor who can give you variations on postures to suit your condition.\u003c/p>\n\u003cp>\"Be very careful about finding yourself in a flow yoga class where things are moving very fast and there's no way the teacher can keep a close eye on you.\"\u003c/p>\n\u003cp>Two type of yoga she recommends for back sufferers: Iyengar yoga and Viniyoga.\u003c/p>\n\u003cp>\"Both of them have a very powerful orthopedic focus,\" Ramin says.\u003c/p>\n\u003cp>\u003cb>So What Does Work? \u003c/b>\u003c/p>\n\u003cp>Two things: Exercise and changing the way you think about back pain.\u003c/p>\n\u003cp>\"Understanding that hurt does not mean harm,\" Ramin says. \"You can continue to live an active life. The most dangerous thing you can do for yourself is take to the couch or take to your bed or take to pain management. But of course that is what most people do.“\u003c/p>\n\u003cp>Ramin recommends finding a \"back whisperer\"--someone who understands the musculoskeletal system and is able to help people build strength, balance their gaits and move effectively.\u003c/p>\n\u003cp>Moving is the key. Our bodies are not built to sit or stand in one place for hours at a time, she says. \"The best posture is your next posture.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Medical abortions done at home with online help and pills sent in the mail appear to be just as safe as those done at a clinic, according to a new study.\u003c/p>\n\u003cp>The research tracked the outcomes of 1,000 women in Ireland and Northern Ireland, who used a website run by a group called Women on Web to get abortion pills. The Netherlands-based nonprofit provides advice and pills to women seeking an early abortion in more than 140 countries where access to abortion is restricted. Ireland and Northern Ireland have some of the world's strictest laws, often only granting approval when a woman's life is at risk.\u003c/p>\n\u003cp>To use the service, women complete an online form, which is reviewed by a doctor. They are sent two drugs in the mail — mifepristone and misoprostol — and given instructions on how to take the pills, which have been used since 1988 to induce early abortions. They are later asked to fill out an evaluation form.\u003c/p>\n\u003cp>About 95 percent of the women in the study reported successfully ending their pregnancy; nearly all were less than nine weeks pregnant at the time of the online consultation. The researchers said less than 10 percent reported symptoms of a potentially serious complication like very heavy bleeding, fever or persistent pain, comparable to the rates for women who seek medical abortions at clinics where abortion is legal. Seven women needed a blood transfusion and 26 received antibiotics. No deaths were reported.\u003c/p>\n\u003cp>Follow-up information was missing for about one-third of the 1,636 women who were sent pills over three years, so some complications may have been missed.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study was published online last week in the British journal, The BMJ. Women on Web provided the data and the patient feedback for the study; two of the authors are affiliated with the group. In the past decade, the group has helped about 50,000 women have a medical abortion at home.\u003c/p>\n\u003cp>\"We now have evidence that self-sourced medical abortion that's entirely outside the formal health care system can be safe and effective,\" said Dr. Abigail Aiken, an assistant professor at the University of Texas at Austin who led the study. \"Women are very capable of managing their own abortions and they're able to determine themselves when they need to seek medical attention.\"\u003cbr>\nOther experts agreed the study shows how women might be able to safely sidestep restrictive abortion laws.\u003c/p>\n\u003cp>\"This undermines the efficacy of these laws and leaves them unenforceable,\" said Bernard Dickens, a professor emeritus of health law and policy at the University of Toronto, who co-wrote an accompanying commentary. He cited a number of legal loopholes that would make it difficult to prosecute people helping women have an abortion at home.\u003c/p>\n\u003cp>Aiken said the website does not operate in the U.S. but that a telemedicine study of the abortion pill is underway.\u003c/p>\n\u003cp>Linda Kavanath, a spokeswoman for the Abortion Rights Campaign in Ireland, said women should be reassured about the safety of doing a medical abortion on their own, adding that the threat of a 14-year jail sentence in Ireland has had a chilling effect.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"These services will exist until the legislation is changed to grant women access to abortion,\" she said. \"Women will always find a way to have abortions and we're just fortunate that these safe methods now exist.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Medical abortions done at home with online help and pills sent in the mail appear to be just as safe as those done at a clinic, according to a new study.\u003c/p>\n\u003cp>The research tracked the outcomes of 1,000 women in Ireland and Northern Ireland, who used a website run by a group called Women on Web to get abortion pills. The Netherlands-based nonprofit provides advice and pills to women seeking an early abortion in more than 140 countries where access to abortion is restricted. Ireland and Northern Ireland have some of the world's strictest laws, often only granting approval when a woman's life is at risk.\u003c/p>\n\u003cp>To use the service, women complete an online form, which is reviewed by a doctor. They are sent two drugs in the mail — mifepristone and misoprostol — and given instructions on how to take the pills, which have been used since 1988 to induce early abortions. They are later asked to fill out an evaluation form.\u003c/p>\n\u003cp>About 95 percent of the women in the study reported successfully ending their pregnancy; nearly all were less than nine weeks pregnant at the time of the online consultation. The researchers said less than 10 percent reported symptoms of a potentially serious complication like very heavy bleeding, fever or persistent pain, comparable to the rates for women who seek medical abortions at clinics where abortion is legal. Seven women needed a blood transfusion and 26 received antibiotics. No deaths were reported.\u003c/p>\n\u003cp>Follow-up information was missing for about one-third of the 1,636 women who were sent pills over three years, so some complications may have been missed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study was published online last week in the British journal, The BMJ. Women on Web provided the data and the patient feedback for the study; two of the authors are affiliated with the group. In the past decade, the group has helped about 50,000 women have a medical abortion at home.\u003c/p>\n\u003cp>\"We now have evidence that self-sourced medical abortion that's entirely outside the formal health care system can be safe and effective,\" said Dr. Abigail Aiken, an assistant professor at the University of Texas at Austin who led the study. \"Women are very capable of managing their own abortions and they're able to determine themselves when they need to seek medical attention.\"\u003cbr>\nOther experts agreed the study shows how women might be able to safely sidestep restrictive abortion laws.\u003c/p>\n\u003cp>\"This undermines the efficacy of these laws and leaves them unenforceable,\" said Bernard Dickens, a professor emeritus of health law and policy at the University of Toronto, who co-wrote an accompanying commentary. He cited a number of legal loopholes that would make it difficult to prosecute people helping women have an abortion at home.\u003c/p>\n\u003cp>Aiken said the website does not operate in the U.S. but that a telemedicine study of the abortion pill is underway.\u003c/p>\n\u003cp>Linda Kavanath, a spokeswoman for the Abortion Rights Campaign in Ireland, said women should be reassured about the safety of doing a medical abortion on their own, adding that the threat of a 14-year jail sentence in Ireland has had a chilling effect.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"These services will exist until the legislation is changed to grant women access to abortion,\" she said. \"Women will always find a way to have abortions and we're just fortunate that these safe methods now exist.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When 18-year-old Hannah Vanderkooy feels extremely tired or anxious, she heads to a spacelike capsule for a nap — during school. Like many teens struggling to get good grades and maybe even a college scholarship, Vanderkooy doesn't get enough sleep.\u003c/p>\n\u003cp>And she's not alone. Various studies indicate that chronically sleepy and stressed-out teenagers might be the new normal among U.S. adolescents who are competing for grades, colleges and, eventually, jobs.\u003c/p>\n\u003cp>Studies have shown teenagers actually need between \u003ca href=\"https://www.nhlbi.nih.gov/health/health-topics/topics/sdd/howmuch\">nine and 10 hours\u003c/a> of sleep a night. But the vast majority (69 percent) \u003ca href=\"https://www.cdc.gov/mmwr/volumes/65/wr/mm6513a1.htm\">aren't\u003c/a> getting it.\u003c/p>\n\u003cp>Enter \"napping pods.\" They're essentially egg-shaped lounge chairs that recline, with a circular lid that can be pulled over the chest to shield against light.\u003c/p>\n\u003cp>\"It just sort of envelops you in a really nice darkness, with soft lighting behind you,\" says Vanderkooy, a frequent user of the pods. She says she typically gets only four to five hours of sleep a night.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There's soft music playing in the pod and \"you just feel extremely relaxed,\" she says. The 20-minute experience is a wonderful \"oasis\" amid all the worry and stress of school, she says.\u003c/p>\n\u003cp>\"Being a senior, I have to apply for scholarships, do all my homework,\" she says — noting that she's taking three advanced placement courses. \"So my sleep cycle has just sort of become this night-owl life, and it's just kind of the new normal.\"\u003c/p>\n\u003cp>A nap can't substitute for a good night's sleep, but it certainly can help, says \u003ca href=\"http://www.aasmnet.org/articles.aspx?id=6126\">Dr. Nitun Verma\u003c/a>, a sleep specialist and spokesperson for the American Academy of Sleep Medicine.\u003c/p>\n\u003cp>A short nap for a teenager \"can give a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16931152\">boost\u003c/a> to memory and attention during the day, and it can increase school performance,\" he says, adding that in a perfect world, schools would roll back their start times.\u003c/p>\n\u003cp>As it is now, the average school starts at 7:30 in the morning while the start time \u003ca href=\"https://www.cdc.gov/media/releases/2015/p0806-school-sleep.html\">recommended\u003c/a> by researchers at the Centers for Disease Control and Prevention is 8:30 a.m. or later. On top of that, teens' \u003ca href=\"https://sleepfoundation.org/sleep-topics/sleep-drive-and-your-body-clock\">circadian rhythms\u003c/a> work against them — coaxing them to stay up late and then sleep late. So they are already sleep-deprived and \"waking up much earlier than normal,\" Verma says.\u003c/p>\n\u003cp>Several public schools in New Mexico are trying to tackle the problem by providing napping pods for their students.\u003c/p>\n\u003cp>\"We know lack of sleep changes \u003ca href=\"https://www.researchgate.net/publication/260760446_The_behavioral_and_health_consequences_of_sleep_deprivation_among_US_high_school_students_Relative_deprivation_matters\">mood\u003c/a> and makes you more anxious,\" says family nurse practitioner \u003ca href=\"https://schoolofnursing.nmsu.edu/sonfaculty/linda-summers-phd-msn-ma-mph-cfnp/\">Linda Summers\u003c/a>, who is an associate professor at New Mexico State University's school of nursing in Las Cruces.\u003c/p>\n\u003cp>Summers also works with the nearby Las Cruces High School health center, and has seen firsthand the effects of sleep deprivation on students there. So she decided to apply for a federal health grant to buy the \u003ca href=\"http://www.metronaps.com/\">pods\u003c/a>, which, at the time, cost $14,000 each. They were installed in four high schools.\u003c/p>\n\u003cp>And while the Las Cruces school napping pods were bought to remedy sleep deprivation, Summers says, \"it also turns out to be good for anger and stress.\"\u003c/p>\n\u003cp>Even if kids don't fall asleep, but simply \"zone out,\" she says, they emerge saying they feel \"refreshed and calm.\" This led Summers to embark on a study looking at the emotional impact of pods.\u003c/p>\n\u003cp>She recruited students who reported feeling \"agitated or upset about something,\" and had them describe their feelings before and after spending 20 minutes in the pod.\u003c/p>\n\u003cp>\"They all felt more rested, happier and more in control of their emotions,\" she says, \"after just 20 minutes.\" Summers now writes prescriptions for the nap pod for students who are anxious, angry or just plain sleepy.\u003c/p>\n\u003cp>The findings haven't been published yet, but they have been accepted for publication by a peer-reviewed journal. Summers says the teachers and school nurses she works with already see the pods as a big success. Each capsule is sort of a \"therapeutic study hall,\" she says, that helps students focus better when they're in the classroom.\u003c/p>\n\u003cp>Vanderkooy recalls falling asleep in one of her classes and being told by her teacher that she \"really, really\" needed to go take a nap.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I came back and I was awake and attentive,\" she says, able to take out her notes and proceed — \"just like a normal class.\"\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=Stressed-Out+High+Schoolers+Advised+To+Try+A+Nap+Pod&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There's soft music playing in the pod and \"you just feel extremely relaxed,\" she says. The 20-minute experience is a wonderful \"oasis\" amid all the worry and stress of school, she says.\u003c/p>\n\u003cp>\"Being a senior, I have to apply for scholarships, do all my homework,\" she says — noting that she's taking three advanced placement courses. \"So my sleep cycle has just sort of become this night-owl life, and it's just kind of the new normal.\"\u003c/p>\n\u003cp>A nap can't substitute for a good night's sleep, but it certainly can help, says \u003ca href=\"http://www.aasmnet.org/articles.aspx?id=6126\">Dr. Nitun Verma\u003c/a>, a sleep specialist and spokesperson for the American Academy of Sleep Medicine.\u003c/p>\n\u003cp>A short nap for a teenager \"can give a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16931152\">boost\u003c/a> to memory and attention during the day, and it can increase school performance,\" he says, adding that in a perfect world, schools would roll back their start times.\u003c/p>\n\u003cp>As it is now, the average school starts at 7:30 in the morning while the start time \u003ca href=\"https://www.cdc.gov/media/releases/2015/p0806-school-sleep.html\">recommended\u003c/a> by researchers at the Centers for Disease Control and Prevention is 8:30 a.m. or later. On top of that, teens' \u003ca href=\"https://sleepfoundation.org/sleep-topics/sleep-drive-and-your-body-clock\">circadian rhythms\u003c/a> work against them — coaxing them to stay up late and then sleep late. So they are already sleep-deprived and \"waking up much earlier than normal,\" Verma says.\u003c/p>\n\u003cp>Several public schools in New Mexico are trying to tackle the problem by providing napping pods for their students.\u003c/p>\n\u003cp>\"We know lack of sleep changes \u003ca href=\"https://www.researchgate.net/publication/260760446_The_behavioral_and_health_consequences_of_sleep_deprivation_among_US_high_school_students_Relative_deprivation_matters\">mood\u003c/a> and makes you more anxious,\" says family nurse practitioner \u003ca href=\"https://schoolofnursing.nmsu.edu/sonfaculty/linda-summers-phd-msn-ma-mph-cfnp/\">Linda Summers\u003c/a>, who is an associate professor at New Mexico State University's school of nursing in Las Cruces.\u003c/p>\n\u003cp>Summers also works with the nearby Las Cruces High School health center, and has seen firsthand the effects of sleep deprivation on students there. So she decided to apply for a federal health grant to buy the \u003ca href=\"http://www.metronaps.com/\">pods\u003c/a>, which, at the time, cost $14,000 each. They were installed in four high schools.\u003c/p>\n\u003cp>And while the Las Cruces school napping pods were bought to remedy sleep deprivation, Summers says, \"it also turns out to be good for anger and stress.\"\u003c/p>\n\u003cp>Even if kids don't fall asleep, but simply \"zone out,\" she says, they emerge saying they feel \"refreshed and calm.\" This led Summers to embark on a study looking at the emotional impact of pods.\u003c/p>\n\u003cp>She recruited students who reported feeling \"agitated or upset about something,\" and had them describe their feelings before and after spending 20 minutes in the pod.\u003c/p>\n\u003cp>\"They all felt more rested, happier and more in control of their emotions,\" she says, \"after just 20 minutes.\" Summers now writes prescriptions for the nap pod for students who are anxious, angry or just plain sleepy.\u003c/p>\n\u003cp>The findings haven't been published yet, but they have been accepted for publication by a peer-reviewed journal. Summers says the teachers and school nurses she works with already see the pods as a big success. Each capsule is sort of a \"therapeutic study hall,\" she says, that helps students focus better when they're in the classroom.\u003c/p>\n\u003cp>Vanderkooy recalls falling asleep in one of her classes and being told by her teacher that she \"really, really\" needed to go take a nap.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I came back and I was awake and attentive,\" she says, able to take out her notes and proceed — \"just like a normal class.\"\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=Stressed-Out+High+Schoolers+Advised+To+Try+A+Nap+Pod&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Special Recovery Schools Helping Teen Opioid Addicts",
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"content": "\u003cp>When Logan Snyder got hooked on pills after a prescription to treat pain from a kidney stone, she joined the millions already swept up in the nation's grim wave of addiction to opioid painkillers.\u003c/p>\n\u003cp>She was just 14.\u003c/p>\n\u003cp>Youth is a drawback when it comes to kicking drugs. Only half of U.S. treatment centers accept teenagers and even fewer offer teen-focused groups or programs. After treatment, adolescents find little structured support. They're outnumbered by adults at self-help meetings. Sober youth drop-in centers are rare. Returning to school means resisting offers to get high with old friends.\u003c/p>\n\u003cp>But Snyder is lucky: Her slide ended when her father got her into a residential drug treatment program. Now 17 and clean, she credits her continued success to Hope Academy in Indianapolis, a tuition-free recovery school where she's enrolled as a junior.\u003c/p>\n\u003cp>\"I am with people all day who are similar to me,\" she says. \"We're here to hold each other accountable.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The opioid epidemic, which researchers say is the worst addiction crisis in U.S. history, has mostly ensnared adults, especially those in their 20s, 30s and 40s. But teens have not been spared: Each day, 1,100 start misusing pain pills. Opioids killed 521 teens in 2015, federal data show.\u003c/p>\n\u003cp>Not enough is known about opioids and teen brains. But getting hooked early is trouble — the vast majority of adults in treatment report they started using as teenagers.\u003c/p>\n\u003cp>Researchers say young recovering addicts do better at places like Hope, special schools that use peer communities to support sobriety. There are only about three dozen such schools in the U.S., but interest is growing among educators and health officials because of the opioid epidemic.\u003c/p>\n\u003cp>\"I get a phone call every day from somebody who wants to start a recovery high school,\" says Rachelle Gardner, an addiction counselor who helped found Hope in 2006 as a charter school through the mayor's office. \"It's horrible to watch young people die. And who wants that to be our legacy?\"\u003c/p>\n\u003cp>Hope's 41 teenagers have abused marijuana, alcohol, painkillers and heroin. Most, like Snyder, have been through residential treatment, some more than once. Others, like 17-year-old Aiden Thompson, arrive with no treatment after a crisis.\u003c/p>\n\u003cp>\"I was really pissed off because I didn't want to be here,\" says Thompson, who came to Hope last year after his mom discovered his vodka and pill stash. \"Everything they said, I was like: 'That can't be true. No. No way.'\"\u003c/p>\n\u003cp>A week later, though, he found himself talking in group meetings. Now, he said, \"I don't even want to think about where I would be\" without the school.\u003c/p>\n\u003cp>Teens like Snyder and Thompson can change in these settings, even after years of drug abuse, in part because social acceptance is a fundamental need for people their age. The sway of positive peer pressure — what students at Hope call \"the community\" — is quiet, almost intangible. It's as simple as two teens passing in the hall: \"You all right?\" says one boy. The other nods, \"Yeah, I'm all right.\"\u003c/p>\n\u003cp>A student council plans events like coffee-and-music mornings. To join the council, a student must have 30 days of sobriety.\u003c/p>\n\u003cp>Random drug tests keep it real. Failing a urine test prompts a meeting with recovery coach Brad Trolson, who employs a technique called motivational interviewing, using open-ended questions and reflective listening to encourage students to think for themselves.\u003c/p>\n\u003cp>\"They're not used to anyone saying, 'What do you think you should do next?'\" Trolson says.\u003c/p>\n\u003cp>It's a daily fight, he says. Many have addicted parents or histories of abuse or neglect, key risk factors for addiction.\u003c/p>\n\u003cp>\"Their wounds will start to heal and they'll come open again,\" he says. \"You end up addressing those wounds over and over again.\"\u003c/p>\n\u003cp>Thompson, who relapsed over winter break, says he's learning to focus on one day of recovery at a time. \"I'm clean for today and that's all that matters,\" he says. \"I don't want to put all this weight on my shoulders to feel like I have to stay clean forever. I can just take it a day at a time and not be freaked out by it.\"\u003c/p>\n\u003cp>\"Just for today\" and other Alcoholics Anonymous slogans are the common language at Hope.\u003c/p>\n\u003cp>The school also embraces treatment with medication and doesn't see it as a crutch, as some AA adherents do. Two students get monthly shots of Vivitrol to block opioid cravings and one takes Suboxone, another anti-craving drug.\u003c/p>\n\u003cp>\"Whatever mechanism our students need in order to maintain a life of sobriety we will support,\" Gardner says.\u003c/p>\n\u003cp>Nationally, teen drug use is in long-term decline, according to an annual federal youth assessment of risky behaviors. But about 5 percent of high school seniors say they've abused prescription narcotics such as oxycodone. Other federal data show about 1.3 million adolescents, ages 12 to 17, need treatment for alcoholism or drug addiction.\u003c/p>\n\u003cp>As part of research funded by the National Institute on Drug Abuse, Andy Finch of Vanderbilt University is studying whether kids who've been treated for addiction do better in recovery schools. Early evidence shows recovery-school students are less likely to relapse than students who attend traditional schools after treatment.\u003c/p>\n\u003cp>\"There's a place in every community for a school like this,\" says Finch, who expects to publish his findings later this year.\u003c/p>\n\u003cp>On a recent morning at Hope, students and teachers gather for an all-school meeting called \"circle.\" A golden retriever named Banks pads about, then sits beside 18-year-old Ian Lewis, who hugs him with a tattooed arm.\u003c/p>\n\u003cp>\"Animals give unconditional love and sometimes that's hard for other people to give to each other,\" Lewis says. He wants to be a vet someday. His owl-and-skull tattoo reminds him to be wiser than two user friends who overdosed and a third who died driving drunk.\u003c/p>\n\u003cp>Today's circle is led by Snyder, who still has \"a lot of hard days\" and fears ending up like her user friends who died. She, too, has her eyes on graduation and college.\u003c/p>\n\u003cp>\"We don't get perfect,\" she reads aloud, \"but we do get better.\"\u003cbr>\nSnyder's hardest days are when she wakes up and skips her inner pep talk. Also hard are days when family problems close in, and days when she sees others escaping through drugs and wants to join them. Days when she can't imagine how she's going to solve her problems. Days when she feels alone.\u003c/p>\n\u003cp>Her new friends pull her back from the edge. They remind her that she doesn't want others to feel around her the way she feels around an addicted family member in her life.\u003c/p>\n\u003cp>\"That helps me to want to get better,\" she says.\u003c/p>\n\u003cp>There are no magic words, Snyder says, for those desperate to rescue a young addict.\u003c/p>\n\u003cp>\"Presence helps me rather than words,\" she says. \"If I don't want you to talk, then don't talk. Listen to me.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Above all, she wants to hear she's not alone \"because I often feel like that.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Logan Snyder got hooked on pills after a prescription to treat pain from a kidney stone, she joined the millions already swept up in the nation's grim wave of addiction to opioid painkillers.\u003c/p>\n\u003cp>She was just 14.\u003c/p>\n\u003cp>Youth is a drawback when it comes to kicking drugs. Only half of U.S. treatment centers accept teenagers and even fewer offer teen-focused groups or programs. After treatment, adolescents find little structured support. They're outnumbered by adults at self-help meetings. Sober youth drop-in centers are rare. Returning to school means resisting offers to get high with old friends.\u003c/p>\n\u003cp>But Snyder is lucky: Her slide ended when her father got her into a residential drug treatment program. Now 17 and clean, she credits her continued success to Hope Academy in Indianapolis, a tuition-free recovery school where she's enrolled as a junior.\u003c/p>\n\u003cp>\"I am with people all day who are similar to me,\" she says. \"We're here to hold each other accountable.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The opioid epidemic, which researchers say is the worst addiction crisis in U.S. history, has mostly ensnared adults, especially those in their 20s, 30s and 40s. But teens have not been spared: Each day, 1,100 start misusing pain pills. Opioids killed 521 teens in 2015, federal data show.\u003c/p>\n\u003cp>Not enough is known about opioids and teen brains. But getting hooked early is trouble — the vast majority of adults in treatment report they started using as teenagers.\u003c/p>\n\u003cp>Researchers say young recovering addicts do better at places like Hope, special schools that use peer communities to support sobriety. There are only about three dozen such schools in the U.S., but interest is growing among educators and health officials because of the opioid epidemic.\u003c/p>\n\u003cp>\"I get a phone call every day from somebody who wants to start a recovery high school,\" says Rachelle Gardner, an addiction counselor who helped found Hope in 2006 as a charter school through the mayor's office. \"It's horrible to watch young people die. And who wants that to be our legacy?\"\u003c/p>\n\u003cp>Hope's 41 teenagers have abused marijuana, alcohol, painkillers and heroin. Most, like Snyder, have been through residential treatment, some more than once. Others, like 17-year-old Aiden Thompson, arrive with no treatment after a crisis.\u003c/p>\n\u003cp>\"I was really pissed off because I didn't want to be here,\" says Thompson, who came to Hope last year after his mom discovered his vodka and pill stash. \"Everything they said, I was like: 'That can't be true. No. No way.'\"\u003c/p>\n\u003cp>A week later, though, he found himself talking in group meetings. Now, he said, \"I don't even want to think about where I would be\" without the school.\u003c/p>\n\u003cp>Teens like Snyder and Thompson can change in these settings, even after years of drug abuse, in part because social acceptance is a fundamental need for people their age. The sway of positive peer pressure — what students at Hope call \"the community\" — is quiet, almost intangible. It's as simple as two teens passing in the hall: \"You all right?\" says one boy. The other nods, \"Yeah, I'm all right.\"\u003c/p>\n\u003cp>A student council plans events like coffee-and-music mornings. To join the council, a student must have 30 days of sobriety.\u003c/p>\n\u003cp>Random drug tests keep it real. Failing a urine test prompts a meeting with recovery coach Brad Trolson, who employs a technique called motivational interviewing, using open-ended questions and reflective listening to encourage students to think for themselves.\u003c/p>\n\u003cp>\"They're not used to anyone saying, 'What do you think you should do next?'\" Trolson says.\u003c/p>\n\u003cp>It's a daily fight, he says. Many have addicted parents or histories of abuse or neglect, key risk factors for addiction.\u003c/p>\n\u003cp>\"Their wounds will start to heal and they'll come open again,\" he says. \"You end up addressing those wounds over and over again.\"\u003c/p>\n\u003cp>Thompson, who relapsed over winter break, says he's learning to focus on one day of recovery at a time. \"I'm clean for today and that's all that matters,\" he says. \"I don't want to put all this weight on my shoulders to feel like I have to stay clean forever. I can just take it a day at a time and not be freaked out by it.\"\u003c/p>\n\u003cp>\"Just for today\" and other Alcoholics Anonymous slogans are the common language at Hope.\u003c/p>\n\u003cp>The school also embraces treatment with medication and doesn't see it as a crutch, as some AA adherents do. Two students get monthly shots of Vivitrol to block opioid cravings and one takes Suboxone, another anti-craving drug.\u003c/p>\n\u003cp>\"Whatever mechanism our students need in order to maintain a life of sobriety we will support,\" Gardner says.\u003c/p>\n\u003cp>Nationally, teen drug use is in long-term decline, according to an annual federal youth assessment of risky behaviors. But about 5 percent of high school seniors say they've abused prescription narcotics such as oxycodone. Other federal data show about 1.3 million adolescents, ages 12 to 17, need treatment for alcoholism or drug addiction.\u003c/p>\n\u003cp>As part of research funded by the National Institute on Drug Abuse, Andy Finch of Vanderbilt University is studying whether kids who've been treated for addiction do better in recovery schools. Early evidence shows recovery-school students are less likely to relapse than students who attend traditional schools after treatment.\u003c/p>\n\u003cp>\"There's a place in every community for a school like this,\" says Finch, who expects to publish his findings later this year.\u003c/p>\n\u003cp>On a recent morning at Hope, students and teachers gather for an all-school meeting called \"circle.\" A golden retriever named Banks pads about, then sits beside 18-year-old Ian Lewis, who hugs him with a tattooed arm.\u003c/p>\n\u003cp>\"Animals give unconditional love and sometimes that's hard for other people to give to each other,\" Lewis says. He wants to be a vet someday. His owl-and-skull tattoo reminds him to be wiser than two user friends who overdosed and a third who died driving drunk.\u003c/p>\n\u003cp>Today's circle is led by Snyder, who still has \"a lot of hard days\" and fears ending up like her user friends who died. She, too, has her eyes on graduation and college.\u003c/p>\n\u003cp>\"We don't get perfect,\" she reads aloud, \"but we do get better.\"\u003cbr>\nSnyder's hardest days are when she wakes up and skips her inner pep talk. Also hard are days when family problems close in, and days when she sees others escaping through drugs and wants to join them. Days when she can't imagine how she's going to solve her problems. Days when she feels alone.\u003c/p>\n\u003cp>Her new friends pull her back from the edge. They remind her that she doesn't want others to feel around her the way she feels around an addicted family member in her life.\u003c/p>\n\u003cp>\"That helps me to want to get better,\" she says.\u003c/p>\n\u003cp>There are no magic words, Snyder says, for those desperate to rescue a young addict.\u003c/p>\n\u003cp>\"Presence helps me rather than words,\" she says. \"If I don't want you to talk, then don't talk. Listen to me.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Evidence Shows Arthroscopic Surgery for Arthritis Knee Pain Doesn't Help",
"title": "Evidence Shows Arthroscopic Surgery for Arthritis Knee Pain Doesn't Help",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>A panel of international health experts and patients last week challenged the effectiveness of one of the most common orthopedic procedures and recommended strongly against the use of arthroscopic surgery for patients with degenerative knee problems.\u003c/p>\n\u003caside class=\"pullquote alignright\">A surgery performed more than 2 million times a year across the globe is ineffective, an expert panel said after looking at multiple studies.\u003c/aside>\n\u003cp>The guidelines, \u003ca href=\"http://www.bmj.com/content/357/bmj.j1982\" target=\"_blank\" rel=\"noopener noreferrer\">published in the journal BMJ\u003c/a>, relied on 13 studies involving nearly 1,700 patients that found the surgery did not provide lasting pain relief or improve function. Those studies compared the surgery with a variety of options, including physical therapy, exercise and even placebo surgery.\u003c/p>\n\u003cp>The experts said that fewer than 15 percent of patients felt an improvement in pain and function three months after the procedure, and that those effects disappeared after one year. In addition, the surgery exposed patients to “rare but important harms,” such as infection.\u003c/p>\n\u003cp>Casey Quinlan, 64, who had the surgery in 2003 and was on the panel issuing the guidelines, said her orthopedist told her the procedure would not only help restore mobility in her knee after a nasty ski accident but also improve her arthritis.\u003c/p>\n\u003cp>Quinlan, of Richmond, Va., said the procedure did not deliver, since her arthritis remained unchanged. “It was not what I was told to expect,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In an \u003ca href=\"http://www.healthline.com/health/knee-arthroscopy\" target=\"_blank\" rel=\"noopener noreferrer\">arthroscopic knee surgery,\u003c/a> physicians make several small incisions around the joint and insert a tiny camera that allows them to see inside the knee as well as insert small instruments to correct problems they identify. Often the surgery is performed to remove part of a damaged meniscus, a disc of cartilage that helps cushion the knee.\u003c/p>\n\u003cp>The panel said meniscal tears “are common, usually incidental findings, and unlikely to be the cause of knee pain, aching or stiffness.”\u003c/p>\n\u003cp>The panel said the surgery is performed more than 2 million times a year across the globe, and in the United States alone costs more than $3 billion annually.\u003c/p>\n\u003cp>The panel’s recommendations are counter to guidelines from a number of medical groups. Most of those organizations have recommendations against arthroscopy for patients solely with arthritis that can be seen through an X-ray. But many still promote the procedure for people with ailments such as meniscal tears, which are frequently present in arthritic patients.\u003c/p>\n\u003cp>The American Academy of Orthopaedic Surgeons does not recommend the treatment for patients with arthritis, said David S. Jevsevar, chair of the AAOS Council on Research and Quality. He said the BMJ assessment is in line with current evidence, but he also cautioned that generalizing a variety of randomized trials does not necessarily take into account the circumstances of individual patients.\u003c/p>\n\u003cp>“Guidelines don’t apply to every patient,” he said. “There’s always going to be an exception.”\u003c/p>\n\u003cp>Reed Siemieniuk, a physician in Ontario, Canada, and the lead author of the panel’s statement, said he understands the frustration some people may have about the guideline — especially those who have seen an improvement.\u003c/p>\n\u003cp>“I think what’s important is that we need to look at the strongest evidence is a randomized controlled trial,” he said. “Despite those personal experiences that say it might be doing good, the evidence suggests that it might not be doing any good.”\u003c/p>\n\u003cp>Siemieniuk said that the panel’s reading of the studies suggests, “on average, the pain relief that you’re getting is not going to be important to you at all.”\u003c/p>\n\u003cp>The BMJ assessment is the latest in a string of studies that have raised concerns about the surgery. The journal published a \u003ca href=\"http://www.bmj.com/content/350/bmj.h2747\" target=\"_blank\" rel=\"noopener noreferrer\">study in 2015\u003c/a> by researchers in Denmark showing that arthroscopic repair of the meniscus for middle-aged people was not much better than exercise in relieving pain and carried a risk of rare but debilitating side effects.\u003c/p>\n\u003cp>The surgery was questioned in 2002 after \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa013259#t=article\" target=\"_blank\" rel=\"noopener noreferrer\">researchers reported\u003c/a> in The New England Journal of Medicine that in a randomized trial of older veterans with osteoarthritis in their knees, arthroscopic surgery was no more effective in treating pain than a “placebo surgery” in which patients had incisions made but no instruments were inserted into the knee. At least three other studies in that journal since then have also found arthroscopy is \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1305189#t=article\" target=\"_blank\" rel=\"noopener noreferrer\">not better than “sham surgery”\u003c/a> or \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1301408#t=article\" target=\"_blank\" rel=\"noopener noreferrer\">physical therapy\u003c/a> in relieving arthritis pain in the knees of older adults.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\" target=\"\">Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A panel of international health experts and patients last week challenged the effectiveness of one of the most common orthopedic procedures and recommended strongly against the use of arthroscopic surgery for patients with degenerative knee problems.\u003c/p>\n\u003caside class=\"pullquote alignright\">A surgery performed more than 2 million times a year across the globe is ineffective, an expert panel said after looking at multiple studies.\u003c/aside>\n\u003cp>The guidelines, \u003ca href=\"http://www.bmj.com/content/357/bmj.j1982\" target=\"_blank\" rel=\"noopener noreferrer\">published in the journal BMJ\u003c/a>, relied on 13 studies involving nearly 1,700 patients that found the surgery did not provide lasting pain relief or improve function. Those studies compared the surgery with a variety of options, including physical therapy, exercise and even placebo surgery.\u003c/p>\n\u003cp>The experts said that fewer than 15 percent of patients felt an improvement in pain and function three months after the procedure, and that those effects disappeared after one year. In addition, the surgery exposed patients to “rare but important harms,” such as infection.\u003c/p>\n\u003cp>Casey Quinlan, 64, who had the surgery in 2003 and was on the panel issuing the guidelines, said her orthopedist told her the procedure would not only help restore mobility in her knee after a nasty ski accident but also improve her arthritis.\u003c/p>\n\u003cp>Quinlan, of Richmond, Va., said the procedure did not deliver, since her arthritis remained unchanged. “It was not what I was told to expect,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In an \u003ca href=\"http://www.healthline.com/health/knee-arthroscopy\" target=\"_blank\" rel=\"noopener noreferrer\">arthroscopic knee surgery,\u003c/a> physicians make several small incisions around the joint and insert a tiny camera that allows them to see inside the knee as well as insert small instruments to correct problems they identify. Often the surgery is performed to remove part of a damaged meniscus, a disc of cartilage that helps cushion the knee.\u003c/p>\n\u003cp>The panel said meniscal tears “are common, usually incidental findings, and unlikely to be the cause of knee pain, aching or stiffness.”\u003c/p>\n\u003cp>The panel said the surgery is performed more than 2 million times a year across the globe, and in the United States alone costs more than $3 billion annually.\u003c/p>\n\u003cp>The panel’s recommendations are counter to guidelines from a number of medical groups. Most of those organizations have recommendations against arthroscopy for patients solely with arthritis that can be seen through an X-ray. But many still promote the procedure for people with ailments such as meniscal tears, which are frequently present in arthritic patients.\u003c/p>\n\u003cp>The American Academy of Orthopaedic Surgeons does not recommend the treatment for patients with arthritis, said David S. Jevsevar, chair of the AAOS Council on Research and Quality. He said the BMJ assessment is in line with current evidence, but he also cautioned that generalizing a variety of randomized trials does not necessarily take into account the circumstances of individual patients.\u003c/p>\n\u003cp>“Guidelines don’t apply to every patient,” he said. “There’s always going to be an exception.”\u003c/p>\n\u003cp>Reed Siemieniuk, a physician in Ontario, Canada, and the lead author of the panel’s statement, said he understands the frustration some people may have about the guideline — especially those who have seen an improvement.\u003c/p>\n\u003cp>“I think what’s important is that we need to look at the strongest evidence is a randomized controlled trial,” he said. “Despite those personal experiences that say it might be doing good, the evidence suggests that it might not be doing any good.”\u003c/p>\n\u003cp>Siemieniuk said that the panel’s reading of the studies suggests, “on average, the pain relief that you’re getting is not going to be important to you at all.”\u003c/p>\n\u003cp>The BMJ assessment is the latest in a string of studies that have raised concerns about the surgery. The journal published a \u003ca href=\"http://www.bmj.com/content/350/bmj.h2747\" target=\"_blank\" rel=\"noopener noreferrer\">study in 2015\u003c/a> by researchers in Denmark showing that arthroscopic repair of the meniscus for middle-aged people was not much better than exercise in relieving pain and carried a risk of rare but debilitating side effects.\u003c/p>\n\u003cp>The surgery was questioned in 2002 after \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa013259#t=article\" target=\"_blank\" rel=\"noopener noreferrer\">researchers reported\u003c/a> in The New England Journal of Medicine that in a randomized trial of older veterans with osteoarthritis in their knees, arthroscopic surgery was no more effective in treating pain than a “placebo surgery” in which patients had incisions made but no instruments were inserted into the knee. At least three other studies in that journal since then have also found arthroscopy is \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1305189#t=article\" target=\"_blank\" rel=\"noopener noreferrer\">not better than “sham surgery”\u003c/a> or \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1301408#t=article\" target=\"_blank\" rel=\"noopener noreferrer\">physical therapy\u003c/a> in relieving arthritis pain in the knees of older adults.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\" target=\"\">Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The Food and Drug Administration is under pressure from the Trump administration to approve drugs faster, but researchers at the Yale School of Medicine found that nearly a third of those approved from 2001 through 2010 had major safety issues years after they were widely available to patients.\u003c/p>\n\u003caside class=\"pullquote alignright\">Issues were more common among psychiatric drugs, \u003ca href=\"https://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cber/ucm133077.htm\">biologic\u003c/a> drugs, drugs that were granted 'accelerated approval' and drugs that were approved near the regulatory deadline for approval.\u003c/aside>\n\u003cp>Yale professor Dr. Joseph Ross and his colleagues reported in JAMA last week. \u003ca href=\"http://click.alerts.jamanetwork.com/click/g1lfu-asi8fi-5n5d0de4/\">The study\u003c/a> included safety actions through Feb. 28.\u003c/p>\n\u003cp>“While the administration pushes for less regulation and faster approvals, those decisions have consequences,” Ross said. The Yale researchers’ previous studies concluded that the FDA approves drugs \u003ca href=\"http://news.yale.edu/2017/04/05/fda-approves-drugs-more-quickly-peer-agency-europe\">faster\u003c/a> than its counterpart agency in Europe, and that the \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/1817794\">majority\u003c/a> of pivotal trials in drug approvals involved fewer than 1,000 patients and lasted six months or less.\u003c/p>\n\u003cp>It took a median time period of 4.2 years after the drugs were approved for these safety concerns to come to light, and issues were more common among psychiatric drugs, biologic drugs, drugs that were granted “accelerated approval” and drugs that were approved near the regulatory deadline for approval.\u003c/p>\n\u003cp>Drugs ushered through the FDA’s accelerated approval process were among those that had higher rates of safety interventions. These approvals typically rely on surrogate endpoints, meaning that researchers measured something other than survival, such as tumor size, to determine whether the drugs worked.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This [finding on surrogate endpoints] has the greatest relationship to policy today,” Ross said. “In the 21st Century Cures Act, there’s a push to have the FDA move to further support the use of surrogate markers … [but] they’re more likely to have concerns in the post-market setting.”\u003c/p>\n\u003cp>Former President Barack Obama signed the act into law on Dec. 13. Among other things, it offers ways to speed drug approval by pushing the FDA to consider different kinds of evidence beyond the three phases of traditional clinical trials. The new process has made some researchers worry that it will open the door for more unsafe approvals.\u003c/p>\n\u003cp>“I’m actually sympathetic to the idea that there are ways in which the FDA can be more streamlined and do a quicker job,” said Dr. Vinay Prasad, a hematologist-oncologist and professor at Oregon Health and Sciences University who did not work on the study. “The one place you don’t want to cut a corner is safety and efficacy prior to coming to market.”\u003c/p>\n\u003cp>Given criticism of the FDA’s mostly voluntary system for reporting new drug- and device-related health problems, it’s possible there are more unknown adverse side effects of which neither the FDA nor the general public is aware. The reports are not verified, and \u003ca href=\"https://www.ismp.org/newsletters/acutecare/showarticle.aspx?id=100\">critics\u003c/a> say this system is underutilized and filled with incomplete and late information. The FDA also monitors other available studies and reports to determine whether it needs to take action on a particular drug.\u003c/p>\n\u003cp>FDA spokeswoman Angela Hoague said the agency is reviewing Ross’ findings.\u003c/p>\n\u003cp>“In general, the FDA does not comment on specific studies, but evaluates them as part of the body of evidence to further our understanding about a particular issue and assist in our mission to protect public health,” she said.\u003c/p>\n\u003cp>Regardless, some observers may find the proportion of safety concerns alarming and others may be breathing a sigh of relief that it’s not higher, Ross said.\u003c/p>\n\u003cp>“That’s the million-dollar question: What’s the right amount? What’s the appropriate level of safety concerns to have identified only once the product is out of the gate?” said Dr. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. He did not work on the study.\u003c/p>\n\u003cp>Surprisingly, drugs approved in under 200 days were less likely to have safety issues, which the authors speculate could be because “some approval packages provide clearer evidence of safety, allowing for more rapid regulatory approval.”\u003c/p>\n\u003cp>The study included market withdrawals of three drugs: the anti-inflammatory drug Bextra, a drug called Zelnorm that treats irritable bowel syndrome and the psoriasis drug Raptiva. Bextra and Zelnorm were withdrawn over cardiovascular risk, and Raptiva was withdrawn because of increased risk of a rare and fatal infection that damages material in the brain.\u003c/p>\n\u003cp>Still, it’s important to keep in mind that the post-approval safety issues cover the spectrum from relatively minor to serious, Alexander said. A good next step would be to dig into the extremely serious safety problems, determine whether the FDA could have flagged them sooner and how they might have been missed, he said.\u003c/p>\n\u003cp>Alexander commended the researchers, saying their study “underscores the importance of surveillance” after a drug has been launched. This helps researchers find new problems — and new benefits — associated with a drug.\u003c/p>\n\u003cp>“All too often, patients and clinicians mistakenly view FDA approval as [an] indication that a product is fully safe and effective,” he said. “Nothing could be further from the truth. We learn tremendous amounts about a product only once it’s on the market and only after use among a broad population.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of prescription drug development, costs and pricing is supported in part by the \u003ca href=\"http://www.arnoldfoundation.org/\">Laura and John Arnold Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Food and Drug Administration is under pressure from the Trump administration to approve drugs faster, but researchers at the Yale School of Medicine found that nearly a third of those approved from 2001 through 2010 had major safety issues years after they were widely available to patients.\u003c/p>\n\u003caside class=\"pullquote alignright\">Issues were more common among psychiatric drugs, \u003ca href=\"https://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cber/ucm133077.htm\">biologic\u003c/a> drugs, drugs that were granted 'accelerated approval' and drugs that were approved near the regulatory deadline for approval.\u003c/aside>\n\u003cp>Yale professor Dr. Joseph Ross and his colleagues reported in JAMA last week. \u003ca href=\"http://click.alerts.jamanetwork.com/click/g1lfu-asi8fi-5n5d0de4/\">The study\u003c/a> included safety actions through Feb. 28.\u003c/p>\n\u003cp>“While the administration pushes for less regulation and faster approvals, those decisions have consequences,” Ross said. The Yale researchers’ previous studies concluded that the FDA approves drugs \u003ca href=\"http://news.yale.edu/2017/04/05/fda-approves-drugs-more-quickly-peer-agency-europe\">faster\u003c/a> than its counterpart agency in Europe, and that the \u003ca href=\"http://jamanetwork.com/journals/jama/fullarticle/1817794\">majority\u003c/a> of pivotal trials in drug approvals involved fewer than 1,000 patients and lasted six months or less.\u003c/p>\n\u003cp>It took a median time period of 4.2 years after the drugs were approved for these safety concerns to come to light, and issues were more common among psychiatric drugs, biologic drugs, drugs that were granted “accelerated approval” and drugs that were approved near the regulatory deadline for approval.\u003c/p>\n\u003cp>Drugs ushered through the FDA’s accelerated approval process were among those that had higher rates of safety interventions. These approvals typically rely on surrogate endpoints, meaning that researchers measured something other than survival, such as tumor size, to determine whether the drugs worked.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This [finding on surrogate endpoints] has the greatest relationship to policy today,” Ross said. “In the 21st Century Cures Act, there’s a push to have the FDA move to further support the use of surrogate markers … [but] they’re more likely to have concerns in the post-market setting.”\u003c/p>\n\u003cp>Former President Barack Obama signed the act into law on Dec. 13. Among other things, it offers ways to speed drug approval by pushing the FDA to consider different kinds of evidence beyond the three phases of traditional clinical trials. The new process has made some researchers worry that it will open the door for more unsafe approvals.\u003c/p>\n\u003cp>“I’m actually sympathetic to the idea that there are ways in which the FDA can be more streamlined and do a quicker job,” said Dr. Vinay Prasad, a hematologist-oncologist and professor at Oregon Health and Sciences University who did not work on the study. “The one place you don’t want to cut a corner is safety and efficacy prior to coming to market.”\u003c/p>\n\u003cp>Given criticism of the FDA’s mostly voluntary system for reporting new drug- and device-related health problems, it’s possible there are more unknown adverse side effects of which neither the FDA nor the general public is aware. The reports are not verified, and \u003ca href=\"https://www.ismp.org/newsletters/acutecare/showarticle.aspx?id=100\">critics\u003c/a> say this system is underutilized and filled with incomplete and late information. The FDA also monitors other available studies and reports to determine whether it needs to take action on a particular drug.\u003c/p>\n\u003cp>FDA spokeswoman Angela Hoague said the agency is reviewing Ross’ findings.\u003c/p>\n\u003cp>“In general, the FDA does not comment on specific studies, but evaluates them as part of the body of evidence to further our understanding about a particular issue and assist in our mission to protect public health,” she said.\u003c/p>\n\u003cp>Regardless, some observers may find the proportion of safety concerns alarming and others may be breathing a sigh of relief that it’s not higher, Ross said.\u003c/p>\n\u003cp>“That’s the million-dollar question: What’s the right amount? What’s the appropriate level of safety concerns to have identified only once the product is out of the gate?” said Dr. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. He did not work on the study.\u003c/p>\n\u003cp>Surprisingly, drugs approved in under 200 days were less likely to have safety issues, which the authors speculate could be because “some approval packages provide clearer evidence of safety, allowing for more rapid regulatory approval.”\u003c/p>\n\u003cp>The study included market withdrawals of three drugs: the anti-inflammatory drug Bextra, a drug called Zelnorm that treats irritable bowel syndrome and the psoriasis drug Raptiva. Bextra and Zelnorm were withdrawn over cardiovascular risk, and Raptiva was withdrawn because of increased risk of a rare and fatal infection that damages material in the brain.\u003c/p>\n\u003cp>Still, it’s important to keep in mind that the post-approval safety issues cover the spectrum from relatively minor to serious, Alexander said. A good next step would be to dig into the extremely serious safety problems, determine whether the FDA could have flagged them sooner and how they might have been missed, he said.\u003c/p>\n\u003cp>Alexander commended the researchers, saying their study “underscores the importance of surveillance” after a drug has been launched. This helps researchers find new problems — and new benefits — associated with a drug.\u003c/p>\n\u003cp>“All too often, patients and clinicians mistakenly view FDA approval as [an] indication that a product is fully safe and effective,” he said. “Nothing could be further from the truth. We learn tremendous amounts about a product only once it’s on the market and only after use among a broad population.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of prescription drug development, costs and pricing is supported in part by the \u003ca href=\"http://www.arnoldfoundation.org/\">Laura and John Arnold Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>People in North America and Europe who are infected with HIV and who begin treatment with a triple-drug cocktail can expect to live nearly as long as people who aren’t infected by the virus, a new study suggested.\u003c/p>\n\u003cp class=\"danger-zone\">A combination of factors — including less toxic drugs and better medical management — have resulted in longevity gains for people who are HIV-positive, concluded \u003ca href=\"http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext?elsca1=tlpr\" target=\"_blank\" rel=\"noopener noreferrer\">the study\u003c/a>, published in the journal Lancet HIV.\u003c/p>\n\u003cp class=\"danger-zone\">“Between 1996-99 and 2008-10, life expectancy in people living with HIV starting [antiretroviral therapy] increased by around 10 years for both sexes, in Europe and North America,” wrote the authors, who work at a variety of academic institutions through North American and Europe.\u003c/p>\n\u003cp class=\"danger-zone\">The findings reflect a trend that has been apparent for some time among people with HIV and their health care providers. A disease that was once a death sentence has become a chronic condition for people who have access to and the ability to stick with an HIV drug regimen.\u003c/p>\n\u003cp>“We’re just getting better at what we do,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci, who was not involved in this study, is a leader in HIV research; he continues to see HIV-positive patients who get treatment at the National Institutes of Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have better drugs. … People are adhering better because they know these drugs really work,” he told STAT. “I think the combination of all of those [factors] easily explains in a logical way the results of that study.”\u003c/p>\n\u003cp>The authors also suggested patients may be more motivated to take care of their health — quitting smoking, say — and their doctors more motivated to aggressively treat other health conditions because both understand that HIV treatment is effective.\u003c/p>\n\u003cp>The researchers pooled data from 18 studies that followed or are following HIV-positive people in 10 countries in Europe and North America, giving them information on roughly 88,500 people. They compared survival and longevity data for people who began taking triple-drug therapies during three periods of time — 1996 to 1999, 2000 to 2003, and 2008 to 2010.\u003c/p>\n\u003cp>The researchers looked at both death figures in the first year of treatment — when patients were typically at their sickest — and then life expectancy of people who survived the first year of treatment.\u003c/p>\n\u003cp>They concluded that an HIV-positive 20-year-old who started antiretroviral therapy between 2008 and 2010 and whose infection was well controlled by the drugs could expect to live to the age of 78.\u003c/p>\n\u003cp>Still, a commentary published with the study noted that these gains, while impressive, aren’t being made by all infected with HIV, particularly by individuals who are not white, have a history of injection drug use, or began treatment with low white blood cell counts.\u003c/p>\n\u003cp>Ingrid Katz of Harvard Medical School and Brendan Maughan-Brown of the University of Cape Town in South Africa wrote that in order to make additional gains in life expectancy, early detection of HIV and commencement of treatment will be needed.\u003c/p>\n\u003cp>Fauci said he thinks that further life expectancy gains can be made for people with HIV. But he believes the damage the virus does can’t be completely erased by early treatment. “I think we’re going to get really close to a normal life expectancy,” he said. “I would be surprised if it would be exactly the same. But I think it will be close enough to be dramatic.”\u003c/p>\n\u003cp>The study was funded by Britain’s Medical Research Council and the UK Department of International Development as well as the European Union.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/05/10/hiv-life-expectancy-study/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People in North America and Europe who are infected with HIV and who begin treatment with a triple-drug cocktail can expect to live nearly as long as people who aren’t infected by the virus, a new study suggested.\u003c/p>\n\u003cp class=\"danger-zone\">A combination of factors — including less toxic drugs and better medical management — have resulted in longevity gains for people who are HIV-positive, concluded \u003ca href=\"http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext?elsca1=tlpr\" target=\"_blank\" rel=\"noopener noreferrer\">the study\u003c/a>, published in the journal Lancet HIV.\u003c/p>\n\u003cp class=\"danger-zone\">“Between 1996-99 and 2008-10, life expectancy in people living with HIV starting [antiretroviral therapy] increased by around 10 years for both sexes, in Europe and North America,” wrote the authors, who work at a variety of academic institutions through North American and Europe.\u003c/p>\n\u003cp class=\"danger-zone\">The findings reflect a trend that has been apparent for some time among people with HIV and their health care providers. A disease that was once a death sentence has become a chronic condition for people who have access to and the ability to stick with an HIV drug regimen.\u003c/p>\n\u003cp>“We’re just getting better at what we do,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci, who was not involved in this study, is a leader in HIV research; he continues to see HIV-positive patients who get treatment at the National Institutes of Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have better drugs. … People are adhering better because they know these drugs really work,” he told STAT. “I think the combination of all of those [factors] easily explains in a logical way the results of that study.”\u003c/p>\n\u003cp>The authors also suggested patients may be more motivated to take care of their health — quitting smoking, say — and their doctors more motivated to aggressively treat other health conditions because both understand that HIV treatment is effective.\u003c/p>\n\u003cp>The researchers pooled data from 18 studies that followed or are following HIV-positive people in 10 countries in Europe and North America, giving them information on roughly 88,500 people. They compared survival and longevity data for people who began taking triple-drug therapies during three periods of time — 1996 to 1999, 2000 to 2003, and 2008 to 2010.\u003c/p>\n\u003cp>The researchers looked at both death figures in the first year of treatment — when patients were typically at their sickest — and then life expectancy of people who survived the first year of treatment.\u003c/p>\n\u003cp>They concluded that an HIV-positive 20-year-old who started antiretroviral therapy between 2008 and 2010 and whose infection was well controlled by the drugs could expect to live to the age of 78.\u003c/p>\n\u003cp>Still, a commentary published with the study noted that these gains, while impressive, aren’t being made by all infected with HIV, particularly by individuals who are not white, have a history of injection drug use, or began treatment with low white blood cell counts.\u003c/p>\n\u003cp>Ingrid Katz of Harvard Medical School and Brendan Maughan-Brown of the University of Cape Town in South Africa wrote that in order to make additional gains in life expectancy, early detection of HIV and commencement of treatment will be needed.\u003c/p>\n\u003cp>Fauci said he thinks that further life expectancy gains can be made for people with HIV. But he believes the damage the virus does can’t be completely erased by early treatment. “I think we’re going to get really close to a normal life expectancy,” he said. “I would be surprised if it would be exactly the same. But I think it will be close enough to be dramatic.”\u003c/p>\n\u003cp>The study was funded by Britain’s Medical Research Council and the UK Department of International Development as well as the European Union.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/05/10/hiv-life-expectancy-study/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>If you were a former NASA scientist and current biohacker afflicted with severe and irresolvable gastrointestinal woes, what would you do?\u003c/p>\n\u003cp>(a) Live with the problem as best you could\u003cbr>\n(b) Attempt to replace all the bacteria in your body by taking antibiotics then swallowing a capsule of someone else’s poop\u003c/p>\n\u003caside class=\"pullquote alignright\">An experiment no one recommends: Killing your bacteria with antibiotics, then performing a fecal transplant on yourself.\u003c/aside>\n\u003cp>The correct answer — well, it isn’t (a). Not if you’re Josiah Zayner.\u003c/p>\n\u003cp>Zayner’s experiment was the subject of a short New York Times \u003ca href=\"https://www.nytimes.com/video/opinion/100000005015342/gut-hack.html\" target=\"_blank\" rel=\"noopener noreferrer\">documentary\u003c/a> last month and it is pretty interesting, to say the least. (Disclosure: Danielle Venton was acquainted with one of the filmmakers in high school.)\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" width=\"640\" height=\"361\" src=\"//static01.nyt.com/video/players/offsite/index.html?videoId=100000005015342\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"#interview\">See below for our interview with Zayner\u003c/a>, a year after the experiment. Future of You first met the mid-30s, erstwhile NASA Ames bio-researcher, upon the launch of his business, providing \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/02/22/gene-editing-coming-to-a-kitchen-counter-near-you/\" target=\"_blank\" rel=\"noopener noreferrer\">in-home CRISPR/Cas9 gene-editing kits\u003c/a> to the public. That was\u003ca href=\"https://www.digitaltrends.com/cool-tech/the-odin-diy-crispr-kit/\" target=\"_blank\" rel=\"noopener noreferrer\"> controversial\u003c/a> enough.\u003c/p>\n\u003cp>Then last May, Zayner, who has suffered from ulcers, irritable bowel syndrome and frequent diarrhea that have not responded well to conventional treatments, decided to take matters into his own hands — or guts — in an attempt to replace his microbiome and mitigate his bad GI problems.\u003c/p>\n\u003cp>Bacteria are “almost an extension of you that can be helpful or harmful,” Zayner says. “It’s like this moving cloud that comes with you wherever you go. We and bacteria are like one organism.”\u003c/p>\n\u003cp>Watch the video and you’ll see him replacing part of that organism by taking antibiotics to eradicate his own bacteria, then ingesting the feces of a friend (“\u003ca href=\"http://www.urbandictionary.com/define.php?term=Yolo\" target=\"_blank\" rel=\"noopener noreferrer\">Yolo\u003c/a>,” he says at the moment of truth, the biohacker equivalent of “Down the hatch.”) He also swabbed his body and mouth with a saline solution containing the donor’s bacteria.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2015/06/15/in-future-fecal-transplants-the-tool-wont-be-stool/\" target=\"_blank\" rel=\"noopener noreferrer\">Fecal transplants\u003c/a> are now an accepted therapy for a certain type of infection. The thing is, Zayner didn’t bother to test his donor’s sample. That puts him at risk, as the documentary warns, for “\u003cspan class=\"s1\">transference of parasites and pathogens, and even blood-borne illnesses like hepatitis.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">“S\u003cspan class=\"s1\">ometimes there’s this thin line, you know, between being crazy and being knowledgeable,” Zayner admits. “And I can’t tell.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Verge covered the experiment at the time. Writer Arielle Duhaime-Ross thought the process was less than scientifically rigid:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">I couldn’t help but notice Zayner cutting corners. After drying off, he put on a brand-new Hanes white T-shirt to prevent his old microbiome from recolonizing his body, but an old — though freshly laundered — pair of jeans. He sampled his arms, nose, and mouth, but he didn’t bother to take microbial samples from his genitalia, and didn’t plan on applying Michael’s skin bacteria to his penis or testicles. He told me that there just isn’t much scientific value in gathering that information. Over the course of his experiment, Zayner would only take a third of the poop pills that someone undergoing a standard FMT [Fecal Microbiota Transplantation\u003cem>] \u003c/em>procedure would, stretched over a longer period of time.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">Says a podcaster from The Verge: “T\u003cspan class=\"s1\">his guy is doing something that is legitimately dangerous and probably kind of stupid.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The experiment, according to Zayner, as well as genetic sequencing from an independent lab, was at least a partial success. (But need we say it: Don’t try this at home.)\u003ca id=\"interview\">\u003c/a>\u003c/p>\n\u003cp>Now that about a year has passed, we wanted to catch up with Zayner to see how he’s feeling about his health, the procedure and his critics. The following has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>In the video, that did not look too fun.\u003c/strong>\u003c/p>\n\u003cp>Yeah. The original plan wasn’t to have people document it. I was going to document it myself. But other people got involved, including a reporter and the people who made the documentary. So in the hotel room there’s like four other people that you can’t see who are badgering me with questions, taking pictures, and I’m just like ‘Oh my gosh, I just feel sick. Can’t you people leave me alone?’ ”\u003c/p>\n\u003cp>\u003cstrong>How are you feeling now?\u003c/strong>\u003c/p>\n\u003cp>I was really amazed by the results. There’s been no blood in my stool since the transplant, which just kind of blows me away; prior to the transplant it had been multiple times a week.\u003c/p>\n\u003cp>\u003cstrong>While the transfer of the gut microbes seemed to be successful , the bacteria in your skin and nasal passages were unchanged. Why do you think that is? \u003c/strong>\u003c/p>\n\u003cp>I think I was recolonized by my own bacteria when I got back home to my own apartment.\u003c/p>\n\u003cp>\u003cstrong>Have you noticed any personality or mood changes? \u003c/strong>\u003c/p>\n\u003cp>I asked people close to me to say if they saw any changes. It doesn’t seem like there’s anything aside from an addiction-level sugar craving. I’ve never encountered a craving like this. At first I didn’t fight against it. I’d go to the grocery store and find myself buying 50 candy bars.\u003c/p>\n\u003cp>\u003cstrong>Does your donor friend have a sweet-tooth? \u003c/strong>\u003c/p>\n\u003cp>I asked him if he had sugar cravings, too, and he said, “I could eat a box of Oreos in one sitting.”\u003c/p>\n\u003cp>\u003cstrong>Have any microbiome researchers reached out to you? \u003c/strong>\u003c/p>\n\u003cp>A ton, but none of them want me to mention their name or talk about them publicly — people from MIT, UCLA, Harvard, University of Chicago, UC Irvine, UC Davis, the FDA. They might be a little bit critical, but they’re mostly interested.\u003c/p>\n\u003cp>\u003cstrong>Have you heard of other people trying this? Is that a concern, or even a hope of yours?\u003c/strong>\u003c/p>\n\u003cp>It is a little bit of a concern, because what I did was pretty drastic. I wasn’t just trying to do a fecal transplant. I was trying to do a whole-body microbiome transplant.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>You weren’t just trying to supplement, you were trying to wipe out and replace… \u003c/strong>\u003c/p>\n\u003cp>A lot of people focused just on the fecal transplant. And that was the thing that provided the greatest benefit to me and worked. But I was also trying as hard as I could to wipe out all of the bacteria on my body and in my body, which — most people thought I would either die or end up hospitalized, which is crazy. That didn’t happen.\u003c/p>\n\u003cp>\u003cstrong>But were you worried about safety?\u003c/strong>\u003c/p>\n\u003cp>Based upon my planning, I thought the chances of something bad happening\u003cstrong> \u003c/strong>were pretty small. But when you have a lot of people around…mostly the people who were documenting it were really worried about a lot of things. Their attitude rubbed off on me and I got more and more worried.\u003c/p>\n\u003cp>\u003cstrong>The donor’s samples — why didn’t you have those tested for things that could be dangerous?\u003c/strong>\u003c/p>\n\u003cp>I really thought about that. A part of it might have been foolhardy, but part of me was like the whole purpose of this experiment was to create an idea of how somebody could do something like this. A lot of people don’t have access to getting donors tested.\u003c/p>\n\u003cp>I thought the process I went through was pretty stringent. If you go to \u003ca href=\"http://www.openbiome.org/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenBiome\u003c/a>, the website that takes fecal transplants from people and they freeze them to give to people, they have a questionnaire you can fill out to see if you qualify as a donor. It’s pretty extensive and it’s something I mimicked.\u003c/p>\n\u003cp>The major things that you’re probably worried about are more blood-borne diseases and illnesses. People always say you should be afraid of feces because of hemorrhagic E. coli. Honestly, I don’t think there is anybody who has hemorrhagic E. coli colonizing them and doesn’t know about it. So I wasn’t too concerned about that.\u003c/p>\n\u003cp>Maybe this sounds crazy, but there is a certain amount of trust that you want to be able to place in humanity or other people.\u003c/p>\n\u003cp>\u003cstrong>The donor was also your \u003cem>friend\u003c/em>. \u003c/strong>\u003c/p>\n\u003cp>Totally. It was kind of symbolic in that way. If I can’t trust this person, then we’re all screwed.\u003c/p>\n\u003cp>\u003cstrong>You said you want this kind of experiment to be accessible to people. Is that because you want people to be able to understand it easily, or do you see this as a prototype?\u003c/strong>\u003c/p>\n\u003cp>Kind of a prototype, but you have to understand, I don’t recommend this to people.\u003c/p>\n\u003cp>The position I’m in right now is really strange where I’ve become this “biohacker” figure. I get contacted by a ton of people all the time, and a lot of those are people with medical issues. And they have no treatment, no cure, and they’re just looking for help. They’re looking for some way they can treat themselves.\u003c/p>\n\u003cp>The U.S. unfortunately has decided to not allow doctors to prescribe feces to people for any disease other than Clostridium difficile infections that haven’t been able to be treated with antibiotics.\u003c/p>\n\u003cp>To me, that’s kind of disturbing. And the fact that people have the opportunity to seek treatment themselves, I think, is empowering. So what I really wanted to do was say, “Hey look, I tried to do something in a very scientific way. And I’m not saying it works, I’m not saying it’ll work for you or your disease or cure your ailments at all. But maybe you can also try to take your health into your own hands. Maybe if there’s no hope from the medical community, no hope for cures, you can perhaps figure out something on your own — through experimentation, through reading scientific papers — and help yourself.\u003c/p>\n\u003cp>\u003cstrong>The podcasters at \u003cem>The Verge \u003c/em>had some pretty harsh words for you. What did you think about that? \u003c/strong>\u003c/p>\n\u003cp>You know, I understand from a professional point of view what they were trying to do. But some of the stuff they said just cracked me up.\u003c/p>\n\u003cp>They said that what I was doing was stupid — which is hilarious when you’re talking about a person who is suffering from something. It’s like, “Hey, you’re suffering from some problem and I think you trying to help yourself is the stupidest thing you could do.”\u003c/p>\n\u003cp>They don’t know what it’s like when you have to go to the bathroom five times in an hour and\u003cb> \u003c/b>blood is spewing out of your butt and you’re in terrible pain.\u003c/p>\n\u003cp>People always bring up this issue about whether what I did was “scientific” or not. That critique is very dogmatic about the way that science is or should be done. What’s important about what I did was whether it works or not, right? I mean, if this actually worked, why wouldn’t people be interested? And look, I’m not trying to publish any of this, I’m not trying to have it peer-reviewed in any normal terms.\u003c/p>\n\u003cp>\u003cstrong>But you would like it if people took a look at what you did and said, ‘Maybe there’s something here.’\u003c/strong>\u003c/p>\n\u003cp>Yeah, but I think they know there is. There are clinics oversees, in the UK and other places that actually will give fecal transplants to people suffering from gastrointestinal illness. It’s something interesting that in the U.S. isn’t allowed.\u003c/p>\n\u003chr>\n\u003cp>We reached out to a handful of microbiome researchers for their thoughts on Zayner’s experiment. One, Owen White from the University of Maryland School of Medicine, responded.\u003c/p>\n\u003cp>“If I had a molecular biology background and was suffering from problems like Josiah, I would find it irresistible not to want to at least try some type of intervention on myself,” wrote White in an email.\u003c/p>\n\u003cp>“(T)here is something inherently deserving about exerting your own agency over things that you cannot ordinarily control,” White said. “That being said, I strongly agree with all the criticisms that were shown in the video.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>For more, see Josiah Zayner’s \u003ca href=\"http://www.ifyoudontknownowyaknow.com/2016/05/i-transplanted-someone-elses-microbiome.html\" target=\"_blank\" rel=\"noopener noreferrer\">blog post about the transplant\u003c/a>, his \u003ca href=\"https://www.reddit.com/r/IAmA/comments/4i5euw/im_dr_josiah_zayner_former_scientist_at_nasa/\" target=\"_blank\" rel=\"noopener noreferrer\">AmA (Ask me Anything) entry on Reddit\u003c/a> or Arielle Duhaime-Ross’s \u003ca href=\"https://www.theverge.com/2016/5/4/11581994/fmt-fecal-matter-transplant-josiah-zayner-microbiome-ibs-c-diff\" target=\"_blank\" rel=\"noopener noreferrer\">coverage for The Verge\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you were a former NASA scientist and current biohacker afflicted with severe and irresolvable gastrointestinal woes, what would you do?\u003c/p>\n\u003cp>(a) Live with the problem as best you could\u003cbr>\n(b) Attempt to replace all the bacteria in your body by taking antibiotics then swallowing a capsule of someone else’s poop\u003c/p>\n\u003caside class=\"pullquote alignright\">An experiment no one recommends: Killing your bacteria with antibiotics, then performing a fecal transplant on yourself.\u003c/aside>\n\u003cp>The correct answer — well, it isn’t (a). Not if you’re Josiah Zayner.\u003c/p>\n\u003cp>Zayner’s experiment was the subject of a short New York Times \u003ca href=\"https://www.nytimes.com/video/opinion/100000005015342/gut-hack.html\" target=\"_blank\" rel=\"noopener noreferrer\">documentary\u003c/a> last month and it is pretty interesting, to say the least. (Disclosure: Danielle Venton was acquainted with one of the filmmakers in high school.)\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" width=\"640\" height=\"361\" src=\"//static01.nyt.com/video/players/offsite/index.html?videoId=100000005015342\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"#interview\">See below for our interview with Zayner\u003c/a>, a year after the experiment. Future of You first met the mid-30s, erstwhile NASA Ames bio-researcher, upon the launch of his business, providing \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/02/22/gene-editing-coming-to-a-kitchen-counter-near-you/\" target=\"_blank\" rel=\"noopener noreferrer\">in-home CRISPR/Cas9 gene-editing kits\u003c/a> to the public. That was\u003ca href=\"https://www.digitaltrends.com/cool-tech/the-odin-diy-crispr-kit/\" target=\"_blank\" rel=\"noopener noreferrer\"> controversial\u003c/a> enough.\u003c/p>\n\u003cp>Then last May, Zayner, who has suffered from ulcers, irritable bowel syndrome and frequent diarrhea that have not responded well to conventional treatments, decided to take matters into his own hands — or guts — in an attempt to replace his microbiome and mitigate his bad GI problems.\u003c/p>\n\u003cp>Bacteria are “almost an extension of you that can be helpful or harmful,” Zayner says. “It’s like this moving cloud that comes with you wherever you go. We and bacteria are like one organism.”\u003c/p>\n\u003cp>Watch the video and you’ll see him replacing part of that organism by taking antibiotics to eradicate his own bacteria, then ingesting the feces of a friend (“\u003ca href=\"http://www.urbandictionary.com/define.php?term=Yolo\" target=\"_blank\" rel=\"noopener noreferrer\">Yolo\u003c/a>,” he says at the moment of truth, the biohacker equivalent of “Down the hatch.”) He also swabbed his body and mouth with a saline solution containing the donor’s bacteria.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2015/06/15/in-future-fecal-transplants-the-tool-wont-be-stool/\" target=\"_blank\" rel=\"noopener noreferrer\">Fecal transplants\u003c/a> are now an accepted therapy for a certain type of infection. The thing is, Zayner didn’t bother to test his donor’s sample. That puts him at risk, as the documentary warns, for “\u003cspan class=\"s1\">transference of parasites and pathogens, and even blood-borne illnesses like hepatitis.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">“S\u003cspan class=\"s1\">ometimes there’s this thin line, you know, between being crazy and being knowledgeable,” Zayner admits. “And I can’t tell.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Verge covered the experiment at the time. Writer Arielle Duhaime-Ross thought the process was less than scientifically rigid:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">I couldn’t help but notice Zayner cutting corners. After drying off, he put on a brand-new Hanes white T-shirt to prevent his old microbiome from recolonizing his body, but an old — though freshly laundered — pair of jeans. He sampled his arms, nose, and mouth, but he didn’t bother to take microbial samples from his genitalia, and didn’t plan on applying Michael’s skin bacteria to his penis or testicles. He told me that there just isn’t much scientific value in gathering that information. Over the course of his experiment, Zayner would only take a third of the poop pills that someone undergoing a standard FMT [Fecal Microbiota Transplantation\u003cem>] \u003c/em>procedure would, stretched over a longer period of time.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">Says a podcaster from The Verge: “T\u003cspan class=\"s1\">his guy is doing something that is legitimately dangerous and probably kind of stupid.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The experiment, according to Zayner, as well as genetic sequencing from an independent lab, was at least a partial success. (But need we say it: Don’t try this at home.)\u003ca id=\"interview\">\u003c/a>\u003c/p>\n\u003cp>Now that about a year has passed, we wanted to catch up with Zayner to see how he’s feeling about his health, the procedure and his critics. The following has been edited for length and clarity.\u003c/p>\n\u003cp>\u003cstrong>In the video, that did not look too fun.\u003c/strong>\u003c/p>\n\u003cp>Yeah. The original plan wasn’t to have people document it. I was going to document it myself. But other people got involved, including a reporter and the people who made the documentary. So in the hotel room there’s like four other people that you can’t see who are badgering me with questions, taking pictures, and I’m just like ‘Oh my gosh, I just feel sick. Can’t you people leave me alone?’ ”\u003c/p>\n\u003cp>\u003cstrong>How are you feeling now?\u003c/strong>\u003c/p>\n\u003cp>I was really amazed by the results. There’s been no blood in my stool since the transplant, which just kind of blows me away; prior to the transplant it had been multiple times a week.\u003c/p>\n\u003cp>\u003cstrong>While the transfer of the gut microbes seemed to be successful , the bacteria in your skin and nasal passages were unchanged. Why do you think that is? \u003c/strong>\u003c/p>\n\u003cp>I think I was recolonized by my own bacteria when I got back home to my own apartment.\u003c/p>\n\u003cp>\u003cstrong>Have you noticed any personality or mood changes? \u003c/strong>\u003c/p>\n\u003cp>I asked people close to me to say if they saw any changes. It doesn’t seem like there’s anything aside from an addiction-level sugar craving. I’ve never encountered a craving like this. At first I didn’t fight against it. I’d go to the grocery store and find myself buying 50 candy bars.\u003c/p>\n\u003cp>\u003cstrong>Does your donor friend have a sweet-tooth? \u003c/strong>\u003c/p>\n\u003cp>I asked him if he had sugar cravings, too, and he said, “I could eat a box of Oreos in one sitting.”\u003c/p>\n\u003cp>\u003cstrong>Have any microbiome researchers reached out to you? \u003c/strong>\u003c/p>\n\u003cp>A ton, but none of them want me to mention their name or talk about them publicly — people from MIT, UCLA, Harvard, University of Chicago, UC Irvine, UC Davis, the FDA. They might be a little bit critical, but they’re mostly interested.\u003c/p>\n\u003cp>\u003cstrong>Have you heard of other people trying this? Is that a concern, or even a hope of yours?\u003c/strong>\u003c/p>\n\u003cp>It is a little bit of a concern, because what I did was pretty drastic. I wasn’t just trying to do a fecal transplant. I was trying to do a whole-body microbiome transplant.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>You weren’t just trying to supplement, you were trying to wipe out and replace… \u003c/strong>\u003c/p>\n\u003cp>A lot of people focused just on the fecal transplant. And that was the thing that provided the greatest benefit to me and worked. But I was also trying as hard as I could to wipe out all of the bacteria on my body and in my body, which — most people thought I would either die or end up hospitalized, which is crazy. That didn’t happen.\u003c/p>\n\u003cp>\u003cstrong>But were you worried about safety?\u003c/strong>\u003c/p>\n\u003cp>Based upon my planning, I thought the chances of something bad happening\u003cstrong> \u003c/strong>were pretty small. But when you have a lot of people around…mostly the people who were documenting it were really worried about a lot of things. Their attitude rubbed off on me and I got more and more worried.\u003c/p>\n\u003cp>\u003cstrong>The donor’s samples — why didn’t you have those tested for things that could be dangerous?\u003c/strong>\u003c/p>\n\u003cp>I really thought about that. A part of it might have been foolhardy, but part of me was like the whole purpose of this experiment was to create an idea of how somebody could do something like this. A lot of people don’t have access to getting donors tested.\u003c/p>\n\u003cp>I thought the process I went through was pretty stringent. If you go to \u003ca href=\"http://www.openbiome.org/\" target=\"_blank\" rel=\"noopener noreferrer\">OpenBiome\u003c/a>, the website that takes fecal transplants from people and they freeze them to give to people, they have a questionnaire you can fill out to see if you qualify as a donor. It’s pretty extensive and it’s something I mimicked.\u003c/p>\n\u003cp>The major things that you’re probably worried about are more blood-borne diseases and illnesses. People always say you should be afraid of feces because of hemorrhagic E. coli. Honestly, I don’t think there is anybody who has hemorrhagic E. coli colonizing them and doesn’t know about it. So I wasn’t too concerned about that.\u003c/p>\n\u003cp>Maybe this sounds crazy, but there is a certain amount of trust that you want to be able to place in humanity or other people.\u003c/p>\n\u003cp>\u003cstrong>The donor was also your \u003cem>friend\u003c/em>. \u003c/strong>\u003c/p>\n\u003cp>Totally. It was kind of symbolic in that way. If I can’t trust this person, then we’re all screwed.\u003c/p>\n\u003cp>\u003cstrong>You said you want this kind of experiment to be accessible to people. Is that because you want people to be able to understand it easily, or do you see this as a prototype?\u003c/strong>\u003c/p>\n\u003cp>Kind of a prototype, but you have to understand, I don’t recommend this to people.\u003c/p>\n\u003cp>The position I’m in right now is really strange where I’ve become this “biohacker” figure. I get contacted by a ton of people all the time, and a lot of those are people with medical issues. And they have no treatment, no cure, and they’re just looking for help. They’re looking for some way they can treat themselves.\u003c/p>\n\u003cp>The U.S. unfortunately has decided to not allow doctors to prescribe feces to people for any disease other than Clostridium difficile infections that haven’t been able to be treated with antibiotics.\u003c/p>\n\u003cp>To me, that’s kind of disturbing. And the fact that people have the opportunity to seek treatment themselves, I think, is empowering. So what I really wanted to do was say, “Hey look, I tried to do something in a very scientific way. And I’m not saying it works, I’m not saying it’ll work for you or your disease or cure your ailments at all. But maybe you can also try to take your health into your own hands. Maybe if there’s no hope from the medical community, no hope for cures, you can perhaps figure out something on your own — through experimentation, through reading scientific papers — and help yourself.\u003c/p>\n\u003cp>\u003cstrong>The podcasters at \u003cem>The Verge \u003c/em>had some pretty harsh words for you. What did you think about that? \u003c/strong>\u003c/p>\n\u003cp>You know, I understand from a professional point of view what they were trying to do. But some of the stuff they said just cracked me up.\u003c/p>\n\u003cp>They said that what I was doing was stupid — which is hilarious when you’re talking about a person who is suffering from something. It’s like, “Hey, you’re suffering from some problem and I think you trying to help yourself is the stupidest thing you could do.”\u003c/p>\n\u003cp>They don’t know what it’s like when you have to go to the bathroom five times in an hour and\u003cb> \u003c/b>blood is spewing out of your butt and you’re in terrible pain.\u003c/p>\n\u003cp>People always bring up this issue about whether what I did was “scientific” or not. That critique is very dogmatic about the way that science is or should be done. What’s important about what I did was whether it works or not, right? I mean, if this actually worked, why wouldn’t people be interested? And look, I’m not trying to publish any of this, I’m not trying to have it peer-reviewed in any normal terms.\u003c/p>\n\u003cp>\u003cstrong>But you would like it if people took a look at what you did and said, ‘Maybe there’s something here.’\u003c/strong>\u003c/p>\n\u003cp>Yeah, but I think they know there is. There are clinics oversees, in the UK and other places that actually will give fecal transplants to people suffering from gastrointestinal illness. It’s something interesting that in the U.S. isn’t allowed.\u003c/p>\n\u003chr>\n\u003cp>We reached out to a handful of microbiome researchers for their thoughts on Zayner’s experiment. One, Owen White from the University of Maryland School of Medicine, responded.\u003c/p>\n\u003cp>“If I had a molecular biology background and was suffering from problems like Josiah, I would find it irresistible not to want to at least try some type of intervention on myself,” wrote White in an email.\u003c/p>\n\u003cp>“(T)here is something inherently deserving about exerting your own agency over things that you cannot ordinarily control,” White said. “That being said, I strongly agree with all the criticisms that were shown in the video.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>For more, see Josiah Zayner’s \u003ca href=\"http://www.ifyoudontknownowyaknow.com/2016/05/i-transplanted-someone-elses-microbiome.html\" target=\"_blank\" rel=\"noopener noreferrer\">blog post about the transplant\u003c/a>, his \u003ca href=\"https://www.reddit.com/r/IAmA/comments/4i5euw/im_dr_josiah_zayner_former_scientist_at_nasa/\" target=\"_blank\" rel=\"noopener noreferrer\">AmA (Ask me Anything) entry on Reddit\u003c/a> or Arielle Duhaime-Ross’s \u003ca href=\"https://www.theverge.com/2016/5/4/11581994/fmt-fecal-matter-transplant-josiah-zayner-microbiome-ibs-c-diff\" target=\"_blank\" rel=\"noopener noreferrer\">coverage for The Verge\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The SF Giants Are Zapping Their Brains With Electricity. Will It Help?",
"title": "The SF Giants Are Zapping Their Brains With Electricity. Will It Help?",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>The San Francisco Giants, with the worst record in the National League, could probably use a shot of electricity about now.\u003c/p>\n\u003cp>Actually, they're already getting a shot of electricity\u003cspan style=\"font-weight: 400\">—\u003c/span>literally.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003c/aside>\n\u003cp>About a third of the major league roster, including \"some big-name players,\" are working out while using high-tech headgear that sends a weak electric current to the brain, says Geoff Head, the team's official sports scientist. The technology, called transcranial direct current stimulation, or tDCS, theoretically improves athletic performance.\u003c/p>\n\u003cp>So ... which players?\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/science/2017/05/WebTDCS.mp3\" program=\"Listen to the radio version of this story by clicking below\" image=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/05/SciencePlayer_BG.jpeg\"]\u003c/p>\n\u003cp>Head wouldn't name names, but said if the technology showed results by the end of the season, some players would probably go public saying they used it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Tyler Beede, at least, is a believer. Watching a promotional video in which the Giants' top pitching prospect hurls pitch after pitch while wearing a set of headphones, you'd think he was listening to tunes. But he's not -- instead, he's getting the juice, tDCS-style.\u003c/p>\n\u003cp>“It’s a very unique feeling,\" Beede explains in the video. \"You put it on, and it does have that kind of tickling, zapping feeling on your brain, but that’s kind of the reason you know its working.”\u003c/p>\n\u003cp>Beede, currently playing for the Giants' Sacramento AAA team, credits his \u003ca href=\"http://www.milb.com/player/index.jsp?player_id=595881#/career/R/pitching/2017/ALL\" target=\"_blank\" rel=\"noopener noreferrer\">improved pitching\u003c/a> in 2016 at least in part to the technology.\u003c/p>\n\u003cp>\u003cstrong>Tech Central\u003c/strong>\u003c/p>\n\u003cp>The headphones, from Halo Neuroscience, are just the latest health tech the team has sampled. Being in San Francisco, digital health startups frequently approach the club in hopes of getting a major league tryout, and Halo is located just blocks from the Giants' AT&T Park.\u003c/p>\n\u003cfigure id=\"attachment_385549\" class=\"wp-caption alignleft\" style=\"max-width: 320px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/AustinSlaterCatching.jpg\">\u003cimg class=\"size-large wp-image-385549\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/AustinSlaterCatching-1020x1275.jpg\" alt=\"\" width=\"320\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1020x1275.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-800x1000.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-768x960.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1920x2400.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1180x1475.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-960x1200.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-240x300.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-375x469.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-520x650.jpg 520w\" sizes=\"(max-width: 320px) 100vw, 320px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sacramento River Cats catcher Austin Slater giving his brain a little electrical juice. \u003ccite>(Halo Neuroscience)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Head says his role as sports scientist is to \"weed through\" a lot of the gadgets that companies send the team's way. Plenty of them, says Head, \"overpromise and underdeliver.\"\u003c/p>\n\u003cp>But Head decided to try the headset, called Halo Sport, during spring training last year\u003cspan style=\"font-weight: 400\">—he gave them to s\u003c/span>ome minor leaguers to wear as they sprinted 20-yard dashes. After two weeks, Head analyzed the results and found that the players who wore the equipment had\u003cstrong> \u003c/strong>shaved off a few one-hundredths of a second compared to a control group.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In the promotional video, Beede says, \"Your brain just becomes so in tune with what you’ve been doing that it can memorize your movements to help you go to that next level.\"\u003c/p>\n\u003cp>\u003cstrong>Targeting the Motor Cortex\u003c/strong>\u003c/p>\n\u003cp>Using Halo's headset is kind of like plugging your brain into a 9-volt battery\u003cstrong>,\u003c/strong> giving your neurons a little extra jolt and priming them for action.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Brain stimulation has been around since recorded history. They used to use electric fish to help migraines or gout or some other problems in ancient Egypt.’ \u003ccite>Theodore Zanto, UCSF neuroscientist\u003c/cite>\u003c/aside>\n\u003cp>The earphones are actually just for show, allowing the wearer to use the technology \"without necessarily displaying it to the world,\" a spokesperson for Halo said. The electrodes in the $750 headset are hidden inside the band that connects the earphones. The electrodes target the motor cortex, which is the region of the brain located across the top of your head, spanning ear to ear. The motor cortex sends electrical signals from your neurons to targeted groups of muscle fibers, causing them to contract.\u003c/p>\n\u003cp>“People like to say that electricity is the currency of the brain and that in many ways the brain is a circuit,\" says Marom Bikson, a professor of biomedical engineering at City College of New York. \"So when we apply electricity to the brain, we interact with that circuit, and we can change how that circuit works.\"\u003c/p>\n\u003cp>Theodore Zanto, director of the Neuroscape Neuroscience Research Program at UCSF, thinks applying electricity to the motor cortex enables it to \"trigger the 'execute movement' signal faster,\" he says.\u003c/p>\n\u003cp>Wiring the brain received a pretty bad rap last century when \u003ca href=\"http://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161\" target=\"_blank\" rel=\"noopener noreferrer\">electroconvulsive therapy \u003c/a>was used to deliberately induce brain seizures in order to treat mental illness.\u003c/p>\n\u003cp>But tDCS uses a very low-voltage electrical charge\u003cb>. \u003c/b>Researchers say the major concerns are minor burns, itching, fatigue and nausea. Most of the known injuries have occurred in the the do-it-yourself community, from people who constructed homemade tDCS headsets after watching YouTube tutorials.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Jury's Still Out\u003c/strong>\u003c/p>\n\u003cp>Even though companies like \u003ca href=\"https://www.haloneuro.com/\">Halo\u003c/a>, \u003ca href=\"http://www.thync.com/\">Thync\u003c/a> and \u003ca href=\"https://www.foc.us/edge-tdcs-headset\">Focus\u003c/a> promise their brain-boosting headsets will reduce fatigue, sharpen focus and improve muscle endurance, experts are cautious.\u003c/p>\n\u003cp>More than a thousand peer-reviewed studies have looked at how a mild brain jolt from electricity improves everything from \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/17614951\" target=\"_blank\" rel=\"noopener noreferrer\">physical actions\u003c/a> to \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004959\" target=\"_blank\" rel=\"noopener noreferrer\">memory\u003c/a> to \u003ca href=\"https://www.sciencedaily.com/releases/2016/04/160414095949.htm\" target=\"_blank\" rel=\"noopener noreferrer\">creativity\u003c/a>, and the results are highly inconsistent.\u003c/p>\n\u003cp>“One of the reasons why we believe the effects are highly variable is because everyone has slightly different thicknesses of scalp, thicknesses of skull, different amounts of cerebrospinal fluid, and that’s what the current has to travel through before it even gets to the brain,\" says Zanto. He also says age, gender, ethnicity and illness can influence results.\u003c/p>\n\u003cp>Bikson says marketing claims about tDCS often exaggerate the results from lab studies. For example, researchers may measure how fast someone can press a sensor with their finger before and after wearing a tDCS device.\u003c/p>\n\u003cp>\"And we may see a positive effect,\" says Bikson. \"But that is a world away, though, from a professional basketball player having a marginal improvement in their three-point success percentage after tDCS.\"\u003c/p>\n\u003cp>Even though a lot of the data is conflicting, the most positive results do support using tDCS to improve motor control. Hence the slew of startups targeting athletes.\u003c/p>\n\u003cp>The Giants' Head says even a tiny advantage can help win games at the major league level. An improvement of two-hundredths of a second can be \"the difference between safe and out sometimes,\" he says.\u003c/p>\n\u003cp>\u003cstrong>'This is My Brain on Fire'\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_383008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-383008\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/IMG_1879-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">World record holding powerlifter Emily Hu wears Halo Sport headphones while she warms up at Boss Barbell gym in Mountain View. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At a Mountain View gym recently, Emily Hu, a world record holder in power lifting, tightened her silent black Halo headphones before sliding underneath a bar to bench press 220 pounds.\u003c/p>\n\u003cp>\"If I feel the tingling sensation I think, ‘OK. This is my brain on fire,\" says Hu. \"Let’s go!’”\u003c/p>\n\u003cp>About a year ago she tried stimulating her brain for the first time, while doing squats. Usually she adds just a few pounds to the bar between workouts, but the week she tried tDCS she was able to add nine, peaking at 295 pounds.\u003c/p>\n\u003cp>“Some people say, 'You know that could have been a fluke because that was only one data point,' \" says Hu. \" But for me it was a positive enough change that I thought, 'Well, I am going to stick with this device.' ”\u003c/p>\n\u003cp>Even though Hu hasn’t seen the same kind of improvement every week, she wears the headphones routinely while warming up. “I think it gives me a false sense of confidence to feel the device work,” she says, grinning.\u003c/p>\n\u003cp>\u003cstrong>Here to Stay?\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Neither Zanto nor Bikson, both academics, are popping tDCS devices onto their own heads -- not to improve athletic performance, anyway. But they both predict the technology is here to stay.\u003c/p>\n\u003cp>“Brain stimulation has been around since recorded history,\" says Zanto. \"They used to use electric fish to help migraines or gout or some other problems in ancient Egypt.\"\u003c/p>\n\u003cp>But the hype around tDCS inspires a lot of new questions. What are the long-term effects of wiring your brain daily? When you zap one part of the brain, are you influencing another region unknowingly, maybe even destructively?\u003c/p>\n\u003cp>And might using tDCS one day be considered a form of cheating?\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Maybe years from now we’ll look back at what we’re doing today and we’ll just say to ourselves we really were just feeling around in the dark,\" says Zanto.\u003c/p>\n\n",
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"excerpt": "An increasing number of professional athletes are stimulating their brains electrically to gain a competitive edge. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The San Francisco Giants, with the worst record in the National League, could probably use a shot of electricity about now.\u003c/p>\n\u003cp>Actually, they're already getting a shot of electricity\u003cspan style=\"font-weight: 400\">—\u003c/span>literally.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003c/aside>\n\u003cp>About a third of the major league roster, including \"some big-name players,\" are working out while using high-tech headgear that sends a weak electric current to the brain, says Geoff Head, the team's official sports scientist. The technology, called transcranial direct current stimulation, or tDCS, theoretically improves athletic performance.\u003c/p>\n\u003cp>So ... which players?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Head wouldn't name names, but said if the technology showed results by the end of the season, some players would probably go public saying they used it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Tyler Beede, at least, is a believer. Watching a promotional video in which the Giants' top pitching prospect hurls pitch after pitch while wearing a set of headphones, you'd think he was listening to tunes. But he's not -- instead, he's getting the juice, tDCS-style.\u003c/p>\n\u003cp>“It’s a very unique feeling,\" Beede explains in the video. \"You put it on, and it does have that kind of tickling, zapping feeling on your brain, but that’s kind of the reason you know its working.”\u003c/p>\n\u003cp>Beede, currently playing for the Giants' Sacramento AAA team, credits his \u003ca href=\"http://www.milb.com/player/index.jsp?player_id=595881#/career/R/pitching/2017/ALL\" target=\"_blank\" rel=\"noopener noreferrer\">improved pitching\u003c/a> in 2016 at least in part to the technology.\u003c/p>\n\u003cp>\u003cstrong>Tech Central\u003c/strong>\u003c/p>\n\u003cp>The headphones, from Halo Neuroscience, are just the latest health tech the team has sampled. Being in San Francisco, digital health startups frequently approach the club in hopes of getting a major league tryout, and Halo is located just blocks from the Giants' AT&T Park.\u003c/p>\n\u003cfigure id=\"attachment_385549\" class=\"wp-caption alignleft\" style=\"max-width: 320px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/AustinSlaterCatching.jpg\">\u003cimg class=\"size-large wp-image-385549\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/AustinSlaterCatching-1020x1275.jpg\" alt=\"\" width=\"320\" height=\"400\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1020x1275.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-160x200.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-800x1000.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-768x960.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1920x2400.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-1180x1475.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-960x1200.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-240x300.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-375x469.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/05/AustinSlaterCatching-520x650.jpg 520w\" sizes=\"(max-width: 320px) 100vw, 320px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sacramento River Cats catcher Austin Slater giving his brain a little electrical juice. \u003ccite>(Halo Neuroscience)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Head says his role as sports scientist is to \"weed through\" a lot of the gadgets that companies send the team's way. Plenty of them, says Head, \"overpromise and underdeliver.\"\u003c/p>\n\u003cp>But Head decided to try the headset, called Halo Sport, during spring training last year\u003cspan style=\"font-weight: 400\">—he gave them to s\u003c/span>ome minor leaguers to wear as they sprinted 20-yard dashes. After two weeks, Head analyzed the results and found that the players who wore the equipment had\u003cstrong> \u003c/strong>shaved off a few one-hundredths of a second compared to a control group.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In the promotional video, Beede says, \"Your brain just becomes so in tune with what you’ve been doing that it can memorize your movements to help you go to that next level.\"\u003c/p>\n\u003cp>\u003cstrong>Targeting the Motor Cortex\u003c/strong>\u003c/p>\n\u003cp>Using Halo's headset is kind of like plugging your brain into a 9-volt battery\u003cstrong>,\u003c/strong> giving your neurons a little extra jolt and priming them for action.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Brain stimulation has been around since recorded history. They used to use electric fish to help migraines or gout or some other problems in ancient Egypt.’ \u003ccite>Theodore Zanto, UCSF neuroscientist\u003c/cite>\u003c/aside>\n\u003cp>The earphones are actually just for show, allowing the wearer to use the technology \"without necessarily displaying it to the world,\" a spokesperson for Halo said. The electrodes in the $750 headset are hidden inside the band that connects the earphones. The electrodes target the motor cortex, which is the region of the brain located across the top of your head, spanning ear to ear. The motor cortex sends electrical signals from your neurons to targeted groups of muscle fibers, causing them to contract.\u003c/p>\n\u003cp>“People like to say that electricity is the currency of the brain and that in many ways the brain is a circuit,\" says Marom Bikson, a professor of biomedical engineering at City College of New York. \"So when we apply electricity to the brain, we interact with that circuit, and we can change how that circuit works.\"\u003c/p>\n\u003cp>Theodore Zanto, director of the Neuroscape Neuroscience Research Program at UCSF, thinks applying electricity to the motor cortex enables it to \"trigger the 'execute movement' signal faster,\" he says.\u003c/p>\n\u003cp>Wiring the brain received a pretty bad rap last century when \u003ca href=\"http://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161\" target=\"_blank\" rel=\"noopener noreferrer\">electroconvulsive therapy \u003c/a>was used to deliberately induce brain seizures in order to treat mental illness.\u003c/p>\n\u003cp>But tDCS uses a very low-voltage electrical charge\u003cb>. \u003c/b>Researchers say the major concerns are minor burns, itching, fatigue and nausea. Most of the known injuries have occurred in the the do-it-yourself community, from people who constructed homemade tDCS headsets after watching YouTube tutorials.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Jury's Still Out\u003c/strong>\u003c/p>\n\u003cp>Even though companies like \u003ca href=\"https://www.haloneuro.com/\">Halo\u003c/a>, \u003ca href=\"http://www.thync.com/\">Thync\u003c/a> and \u003ca href=\"https://www.foc.us/edge-tdcs-headset\">Focus\u003c/a> promise their brain-boosting headsets will reduce fatigue, sharpen focus and improve muscle endurance, experts are cautious.\u003c/p>\n\u003cp>More than a thousand peer-reviewed studies have looked at how a mild brain jolt from electricity improves everything from \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/17614951\" target=\"_blank\" rel=\"noopener noreferrer\">physical actions\u003c/a> to \u003ca href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0004959\" target=\"_blank\" rel=\"noopener noreferrer\">memory\u003c/a> to \u003ca href=\"https://www.sciencedaily.com/releases/2016/04/160414095949.htm\" target=\"_blank\" rel=\"noopener noreferrer\">creativity\u003c/a>, and the results are highly inconsistent.\u003c/p>\n\u003cp>“One of the reasons why we believe the effects are highly variable is because everyone has slightly different thicknesses of scalp, thicknesses of skull, different amounts of cerebrospinal fluid, and that’s what the current has to travel through before it even gets to the brain,\" says Zanto. He also says age, gender, ethnicity and illness can influence results.\u003c/p>\n\u003cp>Bikson says marketing claims about tDCS often exaggerate the results from lab studies. For example, researchers may measure how fast someone can press a sensor with their finger before and after wearing a tDCS device.\u003c/p>\n\u003cp>\"And we may see a positive effect,\" says Bikson. \"But that is a world away, though, from a professional basketball player having a marginal improvement in their three-point success percentage after tDCS.\"\u003c/p>\n\u003cp>Even though a lot of the data is conflicting, the most positive results do support using tDCS to improve motor control. Hence the slew of startups targeting athletes.\u003c/p>\n\u003cp>The Giants' Head says even a tiny advantage can help win games at the major league level. An improvement of two-hundredths of a second can be \"the difference between safe and out sometimes,\" he says.\u003c/p>\n\u003cp>\u003cstrong>'This is My Brain on Fire'\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_383008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-383008\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/05/IMG_1879-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">World record holding powerlifter Emily Hu wears Halo Sport headphones while she warms up at Boss Barbell gym in Mountain View. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At a Mountain View gym recently, Emily Hu, a world record holder in power lifting, tightened her silent black Halo headphones before sliding underneath a bar to bench press 220 pounds.\u003c/p>\n\u003cp>\"If I feel the tingling sensation I think, ‘OK. This is my brain on fire,\" says Hu. \"Let’s go!’”\u003c/p>\n\u003cp>About a year ago she tried stimulating her brain for the first time, while doing squats. Usually she adds just a few pounds to the bar between workouts, but the week she tried tDCS she was able to add nine, peaking at 295 pounds.\u003c/p>\n\u003cp>“Some people say, 'You know that could have been a fluke because that was only one data point,' \" says Hu. \" But for me it was a positive enough change that I thought, 'Well, I am going to stick with this device.' ”\u003c/p>\n\u003cp>Even though Hu hasn’t seen the same kind of improvement every week, she wears the headphones routinely while warming up. “I think it gives me a false sense of confidence to feel the device work,” she says, grinning.\u003c/p>\n\u003cp>\u003cstrong>Here to Stay?\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Neither Zanto nor Bikson, both academics, are popping tDCS devices onto their own heads -- not to improve athletic performance, anyway. But they both predict the technology is here to stay.\u003c/p>\n\u003cp>“Brain stimulation has been around since recorded history,\" says Zanto. \"They used to use electric fish to help migraines or gout or some other problems in ancient Egypt.\"\u003c/p>\n\u003cp>But the hype around tDCS inspires a lot of new questions. What are the long-term effects of wiring your brain daily? When you zap one part of the brain, are you influencing another region unknowingly, maybe even destructively?\u003c/p>\n\u003cp>And might using tDCS one day be considered a form of cheating?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Maybe years from now we’ll look back at what we’re doing today and we’ll just say to ourselves we really were just feeling around in the dark,\" says Zanto.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Dropping Medication in Favor of Diet to Treat Kids' ADHD",
"title": "Dropping Medication in Favor of Diet to Treat Kids' ADHD",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Dr. Rebecca Carey admits to being a little embarrassed about what her son, Mark, eats every day. Hamburger patties for breakfast, or bacon. A pack of raisins and a cookie for lunch; a turkey and cheese sandwich “if I’m lucky,” says Carey, but it usually comes back home. His favorite dinner is fish cakes and pasta, but all vegetables remain firmly untouched.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I just felt in my heart of hearts there had to be a better way.'\u003c/aside>\n\u003cp>It’s the kind of diet — low in fruits and vegetables, high in carbs — that a doctor like herself might caution against. But it’s also low in milk, sugar, and artificial food additives — all things Carey believes worsen 10-year-old Mark’s attention deficit hyperactivity disorder, or ADHD, symptoms. Twice a day, in the morning at their home in Newburgh, Ind., and from the school nurse at lunch, he takes a vitamin and mineral supplement, which helps make up for the lack of veggies.\u003c/p>\n\u003cp>It’s been six months on this diet, which Carey researched herself and tested out on Mark, and in that time he has transitioned off his ADHD medication. It wasn’t all smooth sailing; there were fights in the candy section of the grocery store, and Carey struggled to find quick, high-protein breakfasts. “But honestly, I would never go back,” she said.\u003c/p>\n\u003cp>Carey is not the only one who’s trying this approach. Medication and therapy remain the most effective treatments for ADHD. But driven by concerns about the short- and long-term side effects of psychiatric medications on children, some parents are looking for ways to keep their kids on lower doses of the drugs, or to quit the drugs entirely.\u003c/p>\n\u003cp>But addressing ADHD symptoms by changing diet can be a minefield. For one thing, while some diet interventions have scientific evidence to back them up, others don’t — and even the ones that do only seem effective for a subset of kids. Diet tweaks are oftentimes pretty harmless to try, but not universally so. And most pediatricians aren’t nearly as familiar with these approaches as they are with conventional medication.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So amid a lot of confusing and contradictory information on the internet, and a big nutrition knowledge gap in the medical system, parents at their wits’ end are mapping out their own treatment plans through trial and error over the dinner table.\u003c/p>\n\u003cp>\u003cstrong>Medication and Side Effects\u003c/strong>\u003c/p>\n\u003cp>As of 2011, the latest data from the Centers for Disease Control and Prevention show, at least 6.4 million children in the US had been diagnosed with ADHD. Only about 6 percent are taking medication for the condition. The vast majority, then, are doing something else — perhaps counseling, or other forms of treatment, or nothing at all.\u003c/p>\n\u003caside class=\"pullquote alignright\">One analysis found omega-3 supplements seemed to help with ADHD symptoms.\u003c/aside>\n\u003cp>The most common types of drug used for ADHD are methylphenidate and amphetamine, both stimulants that work on the central nervous system, sold under brand names Ritalin and Adderall. These drugs are considered the most effective ADHD treatment. Less is known, however, about the drugs’ long-term effects. Common side effects include loss of appetite, trouble sleeping, and anxiousness.\u003c/p>\n\u003cp>Those side effects became a problem for Mark soon after he was first diagnosed with ADHD in kindergarten. At home, he’d always been a sensitive, irritable child, but in the classroom he started having “freakouts,” said Carey: throwing things, hiding under his desk, biting other students. Carey’s pediatrician put Mark through a behavioral test, found he measured high on the ADHD spectrum, and prescribed him behavioral therapy and Concerta, another common brand of methylphenidate.\u003c/p>\n\u003cp>Carey was uncomfortable with the medication from the beginning. It became a constant fight to get Mark to eat; he shedded weight, and couldn’t fall asleep at night. Carey had a “gnawing feeling” that he’d have to always be on the drug. And it wasn’t helping his symptoms — instead, he seemed to be getting worse. After a year, his psychiatrist thought he was showing signs of bipolar disorder, and prescribed medication for that.\u003c/p>\n\u003cp>“I just felt in my heart of hearts there had to be a better way,” said Carey. As a physician specializing in gastrointestinal disease, Carey had seen diet do tremendous things for her own patients. Mark’s diagnoses got her thinking about nutrition’s role in the brain, and she started to chart her own course of research and experimentation.\u003c/p>\n\u003cp>\u003cstrong>Weighing Pros and Cons\u003c/strong>\u003c/p>\n\u003cp>Dietary interventions tend to be relatively low-risk — but the evidence base for most of them, in terms of improving ADHD symptoms, is still small.\u003c/p>\n\u003cp>To try to balance those factors against one another, a group of specialists in child and adolescent psychiatry at Ohio State University in 2011 devised what they call the SECS vs. RUDE test. Looking at the scientific literature surrounding 15 different dietary or nutritional interventions, they asked: Are they Safe, Easy, Cheap, and Sensible; or Risky, Unrealistic, Difficult, and Expensive?\u003c/p>\n\u003cp>“SECS doesn’t need as much evidence for someone to try it on an individual basis,” said Dr. L. Eugene Arnold, a physician at Ohio State’s medical center who specializes in childhood ADHD and autism and who coauthored the 2011 study. “You want more evidence before you invest a lot of money or undertake something risky.”\u003c/p>\n\u003cp>Delaying “standard treatment” — medication and behavioral therapy — in favor of alternative approaches can be risky if it means symptoms go untreated, wrote Arnold and coauthors in their review. If a treatment doesn’t work, there is also the loss of family resources, including time and money, to consider.\u003c/p>\n\u003cp>Some of the things their analysis found that fall under the SECS category are fatty acid supplements, specifically omega-3 supplements, which seem to improve ADHD symptoms.\u003c/p>\n\u003cp>Arnold and coauthors looked at five randomized, placebo-controlled, double-blind trials (the gold standard of clinical research) that tested combinations of fatty acids on ADHD symptoms, in both children and adults. Four had a statistically significant positive effect on symptoms.\u003c/p>\n\u003cp>Omega-3 fatty acids, said Arnold, show “small but significant benefits,” and as long as these supplements are low in mercury, it makes sense to try.\u003c/p>\n\u003cp>Other interventions, however — like homeopathic and herbal treatments — were both uncertain and potentially risky, the analysis found.\u003c/p>\n\u003cp>A supplement with less evidence, but which still passes the SECS test, is the one that Mark Carey takes. Called EMPowerplus, the supplement contains 36 different vitamins and minerals, and is marketed to help with psychiatric disorders, including bipolar disorder, ADHD, and depression.\u003c/p>\n\u003cp>But only one of the studies done on the pill was placebo-controlled and double-blinded. It showed a reduction in ADHD symptoms in adults. More research is needed on EMPowerplus and similar broad-spectrum micronutrient supplements before conclusions about their effectiveness can be made, Arnold said.\u003c/p>\n\u003cp>\u003cstrong>Eliminating Additives, Foods\u003c/strong>\u003c/p>\n\u003cp>More difficult interventions tend to be the ones that eliminate whole classes of foods. Elimination diets involve taking foods out of the diet — one of the first iterations of which, for hyperactivity, was the Feingold Diet.\u003c/p>\n\u003cp>Developed back in the 1970s, the Feingold Diet focused on the link between artificial colors and flavorings and ADHD. Research since then has supported a link. A \u003ca href=\"http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.443.1875&rep=rep1&type=pdf\">2004 meta-analysis\u003c/a> of only the gold standard of studies — double-blind and placebo controlled — concluded that artificial food colorings increase hyperactivity in kids with ADHD. And another 2004 \u003ca href=\"http://adc.bmj.com/content/89/6/506\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> found that kids even without a hyperactive disorder experience behavioral effects of colorings. Preschoolers given a drink with artificial coloring were rated as more hyperactive by their parents than those given a naturally colored placebo. (The study was blinded, so parents didn’t know which their kids received.)\u003c/p>\n\u003cp>Lidy Pelsser, a researcher at the Netherlands ADHD research center, \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62227-1/abstract\">led a trial\u003c/a> in 2009 in which 100 families of children with ADHD were recruited to take part in a five-week “few-foods” experiment. Half were instructed to keep their kids on a healthy diet, and half were instructed to give their children only “turkey, rice, some vegetables, and water — and that’s it,” said Pelsser. Of the 41 families who completed the few-foods diet, 32 responded positively, with 60 to 70 percent improvements on ADHD tests compared to when they’d started.\u003c/p>\n\u003cp>Pelsser described this approach not as a cure, but as a “diagnostic tool” that is going to have different results depending on the child. If there’s no improvement in behavior after five weeks, “the child is allowed to eat everything again and medication would be appropriate,” she said. If the child improves significantly, then the parents can start adding foods back in slowly and one at a time to figure out which may be triggers.\u003c/p>\n\u003cp>She warned that this approach is “aggravating.” It is low-risk, but also difficult for families.\u003c/p>\n\u003cp>When it works, it seems to work really well, said Pelsser, and families are increasingly willing to try. “What I see is more awareness in parents that they do not want to give their medication and they are desperately looking for other ways to help their child.”\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322780/\" target=\"_blank\" rel=\"noopener noreferrer\">2014 review\u003c/a> estimated that a strict elimination diet may have a 10 to 30 percent chance of showing symptom improvements for ADHD.\u003c/p>\n\u003cp>Arnold also pointed out that these approaches don’t have to replace medication.\u003c/p>\n\u003cp>“We know that behavioral treatments tend to enhance the effects of medication, so that the patient can respond to a lower dose,” said Arnold. “There’s no reason to believe that wouldn’t work the same way with diet and nutrition.”\u003c/p>\n\u003cp>\u003cstrong>Parents Helping Parents\u003c/strong>\u003c/p>\n\u003cp>Although diet is widely promoted by doctors as an important lifestyle factor in managing ADHD, along with exercise, routine, and good sleep habits, the acceptance of diet and nutrition as an effective primary treatment is still very “grassroots” within the medical community, according to Dr. Anna Esparham, a Kansas-based pediatrician and member of the American Academy of Pediatrics’s integrative health unit.\u003c/p>\n\u003cp>Carey recalls a feeling of isolation. “I was so despondent about where Mark was and despondent about the treatment options for him that I felt like I couldn’t be the only one,” she said.\u003c/p>\n\u003cp>So in September 2016, she started a support group for other parents like her who felt like they were struggling outside the mainstream. The first meetings were held at her church — “I didn’t want it affiliated with anything, I just wanted to start it in the local community,” she said — but after six months the group had grown large enough and was taking up enough of Carey’s time that she needed help. She brought it to the medical director at St. Mary’s hospital, in Evansville, Ind., where Carey works, and now the hospital hosts the group, which draws about 30 people to its meetings.\u003c/p>\n\u003cp>Each week a different speaker comes to talk about topics that the parents indicated they were interested in in a poll at the beginning — things like vision therapy, curbing screen time, and a behavioral therapy called the “nurtured heart” approach.\u003c/p>\n\u003cp>Carey acknowledges that these things “might not be mainstream or have lots of randomized control trials behind them,” but she figured parents — including herself — deserved to have a place could openly discuss alternatives to the status quo.\u003c/p>\n\u003cp>Ideally, someday, that place could also be the doctor’s office. Esparham thinks a big part of the reason parents and providers don’t discuss diet interventions for ADHD is a general ignorance of nutrition in the medical field. “A lot of doctors do not know how to give nutritional advice because they didn’t get in school, in residency, in training,” said Esparham.\u003c/p>\n\u003cp>Pelsser, the Dutch researcher, thinks it might take more than just education — it might take a perspective shift as well. “In the Netherlands as well as the United States there is a lot of skepticism about the effect of food on ADHD, despite the research,” she said. “I think it’s difficult to accept that things could be different from what we have been thinking all the time. It takes courage to say, well, after all, we may be wrong.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/05/02/diet-nutrition-adhd/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Rebecca Carey admits to being a little embarrassed about what her son, Mark, eats every day. Hamburger patties for breakfast, or bacon. A pack of raisins and a cookie for lunch; a turkey and cheese sandwich “if I’m lucky,” says Carey, but it usually comes back home. His favorite dinner is fish cakes and pasta, but all vegetables remain firmly untouched.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I just felt in my heart of hearts there had to be a better way.'\u003c/aside>\n\u003cp>It’s the kind of diet — low in fruits and vegetables, high in carbs — that a doctor like herself might caution against. But it’s also low in milk, sugar, and artificial food additives — all things Carey believes worsen 10-year-old Mark’s attention deficit hyperactivity disorder, or ADHD, symptoms. Twice a day, in the morning at their home in Newburgh, Ind., and from the school nurse at lunch, he takes a vitamin and mineral supplement, which helps make up for the lack of veggies.\u003c/p>\n\u003cp>It’s been six months on this diet, which Carey researched herself and tested out on Mark, and in that time he has transitioned off his ADHD medication. It wasn’t all smooth sailing; there were fights in the candy section of the grocery store, and Carey struggled to find quick, high-protein breakfasts. “But honestly, I would never go back,” she said.\u003c/p>\n\u003cp>Carey is not the only one who’s trying this approach. Medication and therapy remain the most effective treatments for ADHD. But driven by concerns about the short- and long-term side effects of psychiatric medications on children, some parents are looking for ways to keep their kids on lower doses of the drugs, or to quit the drugs entirely.\u003c/p>\n\u003cp>But addressing ADHD symptoms by changing diet can be a minefield. For one thing, while some diet interventions have scientific evidence to back them up, others don’t — and even the ones that do only seem effective for a subset of kids. Diet tweaks are oftentimes pretty harmless to try, but not universally so. And most pediatricians aren’t nearly as familiar with these approaches as they are with conventional medication.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So amid a lot of confusing and contradictory information on the internet, and a big nutrition knowledge gap in the medical system, parents at their wits’ end are mapping out their own treatment plans through trial and error over the dinner table.\u003c/p>\n\u003cp>\u003cstrong>Medication and Side Effects\u003c/strong>\u003c/p>\n\u003cp>As of 2011, the latest data from the Centers for Disease Control and Prevention show, at least 6.4 million children in the US had been diagnosed with ADHD. Only about 6 percent are taking medication for the condition. The vast majority, then, are doing something else — perhaps counseling, or other forms of treatment, or nothing at all.\u003c/p>\n\u003caside class=\"pullquote alignright\">One analysis found omega-3 supplements seemed to help with ADHD symptoms.\u003c/aside>\n\u003cp>The most common types of drug used for ADHD are methylphenidate and amphetamine, both stimulants that work on the central nervous system, sold under brand names Ritalin and Adderall. These drugs are considered the most effective ADHD treatment. Less is known, however, about the drugs’ long-term effects. Common side effects include loss of appetite, trouble sleeping, and anxiousness.\u003c/p>\n\u003cp>Those side effects became a problem for Mark soon after he was first diagnosed with ADHD in kindergarten. At home, he’d always been a sensitive, irritable child, but in the classroom he started having “freakouts,” said Carey: throwing things, hiding under his desk, biting other students. Carey’s pediatrician put Mark through a behavioral test, found he measured high on the ADHD spectrum, and prescribed him behavioral therapy and Concerta, another common brand of methylphenidate.\u003c/p>\n\u003cp>Carey was uncomfortable with the medication from the beginning. It became a constant fight to get Mark to eat; he shedded weight, and couldn’t fall asleep at night. Carey had a “gnawing feeling” that he’d have to always be on the drug. And it wasn’t helping his symptoms — instead, he seemed to be getting worse. After a year, his psychiatrist thought he was showing signs of bipolar disorder, and prescribed medication for that.\u003c/p>\n\u003cp>“I just felt in my heart of hearts there had to be a better way,” said Carey. As a physician specializing in gastrointestinal disease, Carey had seen diet do tremendous things for her own patients. Mark’s diagnoses got her thinking about nutrition’s role in the brain, and she started to chart her own course of research and experimentation.\u003c/p>\n\u003cp>\u003cstrong>Weighing Pros and Cons\u003c/strong>\u003c/p>\n\u003cp>Dietary interventions tend to be relatively low-risk — but the evidence base for most of them, in terms of improving ADHD symptoms, is still small.\u003c/p>\n\u003cp>To try to balance those factors against one another, a group of specialists in child and adolescent psychiatry at Ohio State University in 2011 devised what they call the SECS vs. RUDE test. Looking at the scientific literature surrounding 15 different dietary or nutritional interventions, they asked: Are they Safe, Easy, Cheap, and Sensible; or Risky, Unrealistic, Difficult, and Expensive?\u003c/p>\n\u003cp>“SECS doesn’t need as much evidence for someone to try it on an individual basis,” said Dr. L. Eugene Arnold, a physician at Ohio State’s medical center who specializes in childhood ADHD and autism and who coauthored the 2011 study. “You want more evidence before you invest a lot of money or undertake something risky.”\u003c/p>\n\u003cp>Delaying “standard treatment” — medication and behavioral therapy — in favor of alternative approaches can be risky if it means symptoms go untreated, wrote Arnold and coauthors in their review. If a treatment doesn’t work, there is also the loss of family resources, including time and money, to consider.\u003c/p>\n\u003cp>Some of the things their analysis found that fall under the SECS category are fatty acid supplements, specifically omega-3 supplements, which seem to improve ADHD symptoms.\u003c/p>\n\u003cp>Arnold and coauthors looked at five randomized, placebo-controlled, double-blind trials (the gold standard of clinical research) that tested combinations of fatty acids on ADHD symptoms, in both children and adults. Four had a statistically significant positive effect on symptoms.\u003c/p>\n\u003cp>Omega-3 fatty acids, said Arnold, show “small but significant benefits,” and as long as these supplements are low in mercury, it makes sense to try.\u003c/p>\n\u003cp>Other interventions, however — like homeopathic and herbal treatments — were both uncertain and potentially risky, the analysis found.\u003c/p>\n\u003cp>A supplement with less evidence, but which still passes the SECS test, is the one that Mark Carey takes. Called EMPowerplus, the supplement contains 36 different vitamins and minerals, and is marketed to help with psychiatric disorders, including bipolar disorder, ADHD, and depression.\u003c/p>\n\u003cp>But only one of the studies done on the pill was placebo-controlled and double-blinded. It showed a reduction in ADHD symptoms in adults. More research is needed on EMPowerplus and similar broad-spectrum micronutrient supplements before conclusions about their effectiveness can be made, Arnold said.\u003c/p>\n\u003cp>\u003cstrong>Eliminating Additives, Foods\u003c/strong>\u003c/p>\n\u003cp>More difficult interventions tend to be the ones that eliminate whole classes of foods. Elimination diets involve taking foods out of the diet — one of the first iterations of which, for hyperactivity, was the Feingold Diet.\u003c/p>\n\u003cp>Developed back in the 1970s, the Feingold Diet focused on the link between artificial colors and flavorings and ADHD. Research since then has supported a link. A \u003ca href=\"http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.443.1875&rep=rep1&type=pdf\">2004 meta-analysis\u003c/a> of only the gold standard of studies — double-blind and placebo controlled — concluded that artificial food colorings increase hyperactivity in kids with ADHD. And another 2004 \u003ca href=\"http://adc.bmj.com/content/89/6/506\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> found that kids even without a hyperactive disorder experience behavioral effects of colorings. Preschoolers given a drink with artificial coloring were rated as more hyperactive by their parents than those given a naturally colored placebo. (The study was blinded, so parents didn’t know which their kids received.)\u003c/p>\n\u003cp>Lidy Pelsser, a researcher at the Netherlands ADHD research center, \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62227-1/abstract\">led a trial\u003c/a> in 2009 in which 100 families of children with ADHD were recruited to take part in a five-week “few-foods” experiment. Half were instructed to keep their kids on a healthy diet, and half were instructed to give their children only “turkey, rice, some vegetables, and water — and that’s it,” said Pelsser. Of the 41 families who completed the few-foods diet, 32 responded positively, with 60 to 70 percent improvements on ADHD tests compared to when they’d started.\u003c/p>\n\u003cp>Pelsser described this approach not as a cure, but as a “diagnostic tool” that is going to have different results depending on the child. If there’s no improvement in behavior after five weeks, “the child is allowed to eat everything again and medication would be appropriate,” she said. If the child improves significantly, then the parents can start adding foods back in slowly and one at a time to figure out which may be triggers.\u003c/p>\n\u003cp>She warned that this approach is “aggravating.” It is low-risk, but also difficult for families.\u003c/p>\n\u003cp>When it works, it seems to work really well, said Pelsser, and families are increasingly willing to try. “What I see is more awareness in parents that they do not want to give their medication and they are desperately looking for other ways to help their child.”\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322780/\" target=\"_blank\" rel=\"noopener noreferrer\">2014 review\u003c/a> estimated that a strict elimination diet may have a 10 to 30 percent chance of showing symptom improvements for ADHD.\u003c/p>\n\u003cp>Arnold also pointed out that these approaches don’t have to replace medication.\u003c/p>\n\u003cp>“We know that behavioral treatments tend to enhance the effects of medication, so that the patient can respond to a lower dose,” said Arnold. “There’s no reason to believe that wouldn’t work the same way with diet and nutrition.”\u003c/p>\n\u003cp>\u003cstrong>Parents Helping Parents\u003c/strong>\u003c/p>\n\u003cp>Although diet is widely promoted by doctors as an important lifestyle factor in managing ADHD, along with exercise, routine, and good sleep habits, the acceptance of diet and nutrition as an effective primary treatment is still very “grassroots” within the medical community, according to Dr. Anna Esparham, a Kansas-based pediatrician and member of the American Academy of Pediatrics’s integrative health unit.\u003c/p>\n\u003cp>Carey recalls a feeling of isolation. “I was so despondent about where Mark was and despondent about the treatment options for him that I felt like I couldn’t be the only one,” she said.\u003c/p>\n\u003cp>So in September 2016, she started a support group for other parents like her who felt like they were struggling outside the mainstream. The first meetings were held at her church — “I didn’t want it affiliated with anything, I just wanted to start it in the local community,” she said — but after six months the group had grown large enough and was taking up enough of Carey’s time that she needed help. She brought it to the medical director at St. Mary’s hospital, in Evansville, Ind., where Carey works, and now the hospital hosts the group, which draws about 30 people to its meetings.\u003c/p>\n\u003cp>Each week a different speaker comes to talk about topics that the parents indicated they were interested in in a poll at the beginning — things like vision therapy, curbing screen time, and a behavioral therapy called the “nurtured heart” approach.\u003c/p>\n\u003cp>Carey acknowledges that these things “might not be mainstream or have lots of randomized control trials behind them,” but she figured parents — including herself — deserved to have a place could openly discuss alternatives to the status quo.\u003c/p>\n\u003cp>Ideally, someday, that place could also be the doctor’s office. Esparham thinks a big part of the reason parents and providers don’t discuss diet interventions for ADHD is a general ignorance of nutrition in the medical field. “A lot of doctors do not know how to give nutritional advice because they didn’t get in school, in residency, in training,” said Esparham.\u003c/p>\n\u003cp>Pelsser, the Dutch researcher, thinks it might take more than just education — it might take a perspective shift as well. “In the Netherlands as well as the United States there is a lot of skepticism about the effect of food on ADHD, despite the research,” she said. “I think it’s difficult to accept that things could be different from what we have been thinking all the time. It takes courage to say, well, after all, we may be wrong.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/05/02/diet-nutrition-adhd/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>People with a brain injury or dementia often struggle to remember simple things, like names or places. In research published recently in the journal \u003cem>Current Biology, \u003c/em>scientists have shown it may be possible to improve this sort of memory using tiny pulses of electricity — if they're properly timed.\u003c/p>\n\u003cp>A typical person's ability to remember things tends to vary a lot, says \u003ca href=\"http://memory.psych.upenn.edu/Michael_J._Kahana\">Michael Kahana,\u003c/a> who directs the computational memory lab at the University of Pennsylvania.\u003c/p>\n\u003cp>\"Some days we're at the top of our game,\" he says, \"and some days we're just off our game.\"\u003c/p>\n\u003cp>That's also true for people whose memory has been impaired — by a brain injury or disease. So Kahana wondered whether there might be some way to help these people perform at their peak level all the time.\u003c/p>\n\u003cp>\"If they could just move their game up so that every day was their best day, then it would really significantly change their quality of life,\" Kahana says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>He and a team of researchers thought they might be able to do this by stimulating memory circuits in the brain. They tried the approach with a group of patients who had severe epilepsy.\u003c/p>\n\u003cp>These people already had electrodes temporarily implanted in their brains as part of their treatment. And that gave the scientists a way to deliver tiny pulses of electricity to areas deep in the brain.\u003c/p>\n\u003cp>Unfortunately, Kahana says, the stimulation made things worse.\u003c/p>\n\u003cp>\"Not only were we not able to enhance memory,\" he says, \"but we actually reliably and consistently \u003cem>impaired\u003c/em> memory in those patients.\"\u003c/p>\n\u003cp>So the team began studying more epilepsy patients to figure out why. This time, though, they used the electrodes to monitor brain activity as the volunteers did memory tasks — and the scientists were able to identify electrical patterns that predicted whether a person was going to remember something or not.\u003c/p>\n\u003cp>Then, the team tried another stimulation experiment, and this one yielded a breakthrough.\u003c/p>\n\u003cp>\"When memory was predicted to be poor,\" he explains, \"brain stimulation enhanced memory, and when it was predicted to be good, brain stimulation impaired memory.\"\u003c/p>\n\u003cp>In other words, on a bad memory day, stimulation helped. On a good day, it hurt.\u003c/p>\n\u003cp>When stimulation was delivered to the right place at the right time, the researchers found, it could improve memory performance among the patients by as much as 50 percent.\u003c/p>\n\u003cp>The research was funded by the Defense Advanced Research Projects Agency or \u003ca href=\"http://www.npr.org/2017/03/28/521779864/inside-darpa-the-pentagon-agency-whose-technology-has-changed-the-world\">DARPA\u003c/a>. Several years ago, DARPA launched an ambitious effort to help the troops who were returning from Iraq and Afghanistan with memory problems caused by \u003ca href=\"https://www.cdc.gov/traumaticbraininjury/\">traumatic brain injuries\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"http://www.darpa.mil/staff/dr-justin-sanchez\">Justin Sanchez\u003c/a>, who is in charge of the program, says Kahana's work shows DARPA's investment is paying off.\u003c/p>\n\u003cp>\"When I first heard about these results, my mind was absolutely blown,\" Sanchez says. \"It's like the impossible happened.\"\u003c/p>\n\u003cp>A medical device based on this research could eventually do for an injured brain what a prosthetic limb does for an injured body, he says. There's a long research road ahead — brain stimulation still has way to go, before it can be proved useful as a memory aid. But it's a start.\u003c/p>\n\u003cp>\"Over 270,000 military personnel are living with traumatic brain injuries and the options for them are very few,\" Sanchez says. Now we can offer them some hope for the future.\"\u003c/p>\n\u003cp>And if the approach pans out, it might help people with a wide range of memory problems, Kahana suggests.\u003c/p>\n\u003cp>\"Traumatic brain injury is certainly high on our list,\" he says. \"But we're also thinking very much about Alzheimer's disease and the other dementias that affect memory.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Alzheimer's alone affects more than 5 million Americans.\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=Electrical+Stimulation+To+Boost+Memory%3A+Maybe+It%27s+All+In+The+Timing&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People with a brain injury or dementia often struggle to remember simple things, like names or places. In research published recently in the journal \u003cem>Current Biology, \u003c/em>scientists have shown it may be possible to improve this sort of memory using tiny pulses of electricity — if they're properly timed.\u003c/p>\n\u003cp>A typical person's ability to remember things tends to vary a lot, says \u003ca href=\"http://memory.psych.upenn.edu/Michael_J._Kahana\">Michael Kahana,\u003c/a> who directs the computational memory lab at the University of Pennsylvania.\u003c/p>\n\u003cp>\"Some days we're at the top of our game,\" he says, \"and some days we're just off our game.\"\u003c/p>\n\u003cp>That's also true for people whose memory has been impaired — by a brain injury or disease. So Kahana wondered whether there might be some way to help these people perform at their peak level all the time.\u003c/p>\n\u003cp>\"If they could just move their game up so that every day was their best day, then it would really significantly change their quality of life,\" Kahana says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>He and a team of researchers thought they might be able to do this by stimulating memory circuits in the brain. They tried the approach with a group of patients who had severe epilepsy.\u003c/p>\n\u003cp>These people already had electrodes temporarily implanted in their brains as part of their treatment. And that gave the scientists a way to deliver tiny pulses of electricity to areas deep in the brain.\u003c/p>\n\u003cp>Unfortunately, Kahana says, the stimulation made things worse.\u003c/p>\n\u003cp>\"Not only were we not able to enhance memory,\" he says, \"but we actually reliably and consistently \u003cem>impaired\u003c/em> memory in those patients.\"\u003c/p>\n\u003cp>So the team began studying more epilepsy patients to figure out why. This time, though, they used the electrodes to monitor brain activity as the volunteers did memory tasks — and the scientists were able to identify electrical patterns that predicted whether a person was going to remember something or not.\u003c/p>\n\u003cp>Then, the team tried another stimulation experiment, and this one yielded a breakthrough.\u003c/p>\n\u003cp>\"When memory was predicted to be poor,\" he explains, \"brain stimulation enhanced memory, and when it was predicted to be good, brain stimulation impaired memory.\"\u003c/p>\n\u003cp>In other words, on a bad memory day, stimulation helped. On a good day, it hurt.\u003c/p>\n\u003cp>When stimulation was delivered to the right place at the right time, the researchers found, it could improve memory performance among the patients by as much as 50 percent.\u003c/p>\n\u003cp>The research was funded by the Defense Advanced Research Projects Agency or \u003ca href=\"http://www.npr.org/2017/03/28/521779864/inside-darpa-the-pentagon-agency-whose-technology-has-changed-the-world\">DARPA\u003c/a>. Several years ago, DARPA launched an ambitious effort to help the troops who were returning from Iraq and Afghanistan with memory problems caused by \u003ca href=\"https://www.cdc.gov/traumaticbraininjury/\">traumatic brain injuries\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"http://www.darpa.mil/staff/dr-justin-sanchez\">Justin Sanchez\u003c/a>, who is in charge of the program, says Kahana's work shows DARPA's investment is paying off.\u003c/p>\n\u003cp>\"When I first heard about these results, my mind was absolutely blown,\" Sanchez says. \"It's like the impossible happened.\"\u003c/p>\n\u003cp>A medical device based on this research could eventually do for an injured brain what a prosthetic limb does for an injured body, he says. There's a long research road ahead — brain stimulation still has way to go, before it can be proved useful as a memory aid. But it's a start.\u003c/p>\n\u003cp>\"Over 270,000 military personnel are living with traumatic brain injuries and the options for them are very few,\" Sanchez says. Now we can offer them some hope for the future.\"\u003c/p>\n\u003cp>And if the approach pans out, it might help people with a wide range of memory problems, Kahana suggests.\u003c/p>\n\u003cp>\"Traumatic brain injury is certainly high on our list,\" he says. \"But we're also thinking very much about Alzheimer's disease and the other dementias that affect memory.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Alzheimer's alone affects more than 5 million Americans.\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=Electrical+Stimulation+To+Boost+Memory%3A+Maybe+It%27s+All+In+The+Timing&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Four out of five older Americans with hearing loss just ignore it, in part because a hearing aid is an unwelcome sign of aging. But what if hearing aids looked like stylish fashion accessories and could be bought at your local pharmacy like reading glasses?\u003c/p>\n\u003cp>That's the vision of Kristen \"KR\" Liu, who's the director of accessibility and advocacy for Doppler Labs, a company marketing one of these devices. She thinks a hearing aid could be \"something that's hip and cool and people have multiple pairs and it's fashionable.\"\u003c/p>\n\u003cp>Liu, who has severe hearing loss herself, helped design a device designed to let people with hearing loss blend in. One person may be using the technology to stream music or take a phone call, she says. Another may be wearing it to amplify speech and hear the conversation. \"And no one is going to know the difference,\" Liu says. \"So you're wearing technology in your ear, proudly.\"\u003c/p>\n\u003cp>The device is a small circular instrument that fits snugly in the ear. It can be adjusted to individual hearing using a smartphone app to control volume, cut out background noise or turn up the sound in a theater. \"It's pretty much a hearing aid,\" says Liu, except the company isn't allowed to call it that.\u003c/p>\n\u003cp>That's because the Food and Drug Administration, which regulates medical devices, doesn't allow hearing aids to be sold over the counter. So devices sold directly to consumers are marketed as \"personal sound amplification products,\" or PSAPs. They range in price from about $250 to $350 and are considerably cheaper than hearing aids, which can cost up to $6,000 and are typically not covered by Medicare or most private insurance companies. Hearing aids are customized by a hearing specialist such as an audiologist, following a hearing test.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>PSAPs can only be marketed as sound amplifiers for people with normal hearing who want to make things louder, like music or the sounds of birds chirping. Hearing loss advocates believe this means people with mild to moderate hearing loss who could benefit from the devices don't know about them. There are dozens of the devices on the market, but their quality varies wildly, as an analysis of 11 of them last year for hearing care professionals shows. And there's no easy way for potential purchasers to figure out which work best.\u003c/p>\n\u003cp>The Hearing Loss Association of America, a consumer group, wants Congress to create a new category of aids for people with mild to moderate hearing loss by passing the Over-the-Counter Hearing Aid Act of2017. (People with severe hearing loss would still need to be seen by a medical professional.) The bill would direct the FDA to come up with safety and effectiveness standards for these new hearing aids.\u003c/p>\n\u003cp>The FDA is already moving in that direction, and in December said it would no longer require adults to be medically evaluated before buying a hearing aid. Proponents of direct-to-consumer sales hope Congressional action would get the FDA moving faster. A 2016 report from the National Academies of Sciences also endorsed allowing over-the-counter sales.\u003c/p>\n\u003cp>This could be life changing for people with hearing loss, says Richard Einhorn, a composer of modern classical music who is on the board of the Hearing Loss Association of America.\u003c/p>\n\u003cp>Early one morning in 2010, he woke up with his ears ringing — a loud, piercing hiss. \"I hit the panic button,\" Einhorn says. \"I jumped out of bed and immediately fell over onto the floor.\"\u003c/p>\n\u003cp>An inner ear infection, likely a virus, had caused him to lose his balance. He went deaf in his right ear. He already had some hearing loss in his left ear. His hearing aids cost $5,000 and were not covered by insurance.\u003c/p>\n\u003cp>\"I'm a composer, for goodness sake,\" Einhorn says. \"This is not an easy purchase to scrounge up the money for.\"\u003c/p>\n\u003cp>Opening up the hearing aid market would foster competition and drive prices down, says Einhorn.\u003c/p>\n\u003cp>It would also encourage companies to come up with new and better products, says Liu. She envisions a future that solves one of the biggest problems for many people – hearing in a noisy environment, like a party or a busy restaurant. She wants a hearing aid that would automatically adjust to different sound environments, so she could hear the person talking to her and not the background distraction.\u003c/p>\n\u003cp>\"Nothing like that exists today,\" Liu says. \"But I very much see something like that down the road.\"\u003c/p>\n\u003cp>Some audio specialists support rolling back regulations, while others are skeptical.\u003c/p>\n\u003cp>Hearing loss is complex, says Neil DiSarno, chief staff officer for audiology at the American Speech-Language-Hearing Association. This makes it difficult for consumers to \"self-evaluate, self-treat and self-monitor,\" he says. If people buy their hearing aids directly over the counter, they'll miss out on all the skills audiologists can teach them, like how to lip read and how to distinguish high frequency sounds, he says.\u003c/p>\n\u003cp>The market for over-the-counter hearing aids could be huge. More than 35 million Americans have some degree of hearing loss. And for older Americans, not dealing with the problem can have a big impact on age-related cognitive decline, says Dr. Frank Lin, associate professor of otolaryngology at Johns Hopkins University School of Medicine. Lin has done studies looking at the link between hearing loss and cognitive decline.\u003c/p>\n\u003cp>\"The greater the hearing loss, the greater the risk of loss of thinking and memory abilities over time,\" he says, which can lead to feelings of insecurity and social isolation – a known risk factor for dementia.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lin says his findings should serve as a \"wake-up call\" for policy makers. If people have easier access to more affordable hearing aids, he says, that could lead to benefits that go far beyond hearing.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>PSAPs can only be marketed as sound amplifiers for people with normal hearing who want to make things louder, like music or the sounds of birds chirping. Hearing loss advocates believe this means people with mild to moderate hearing loss who could benefit from the devices don't know about them. There are dozens of the devices on the market, but their quality varies wildly, as an analysis of 11 of them last year for hearing care professionals shows. And there's no easy way for potential purchasers to figure out which work best.\u003c/p>\n\u003cp>The Hearing Loss Association of America, a consumer group, wants Congress to create a new category of aids for people with mild to moderate hearing loss by passing the Over-the-Counter Hearing Aid Act of2017. (People with severe hearing loss would still need to be seen by a medical professional.) The bill would direct the FDA to come up with safety and effectiveness standards for these new hearing aids.\u003c/p>\n\u003cp>The FDA is already moving in that direction, and in December said it would no longer require adults to be medically evaluated before buying a hearing aid. Proponents of direct-to-consumer sales hope Congressional action would get the FDA moving faster. A 2016 report from the National Academies of Sciences also endorsed allowing over-the-counter sales.\u003c/p>\n\u003cp>This could be life changing for people with hearing loss, says Richard Einhorn, a composer of modern classical music who is on the board of the Hearing Loss Association of America.\u003c/p>\n\u003cp>Early one morning in 2010, he woke up with his ears ringing — a loud, piercing hiss. \"I hit the panic button,\" Einhorn says. \"I jumped out of bed and immediately fell over onto the floor.\"\u003c/p>\n\u003cp>An inner ear infection, likely a virus, had caused him to lose his balance. He went deaf in his right ear. He already had some hearing loss in his left ear. His hearing aids cost $5,000 and were not covered by insurance.\u003c/p>\n\u003cp>\"I'm a composer, for goodness sake,\" Einhorn says. \"This is not an easy purchase to scrounge up the money for.\"\u003c/p>\n\u003cp>Opening up the hearing aid market would foster competition and drive prices down, says Einhorn.\u003c/p>\n\u003cp>It would also encourage companies to come up with new and better products, says Liu. She envisions a future that solves one of the biggest problems for many people – hearing in a noisy environment, like a party or a busy restaurant. She wants a hearing aid that would automatically adjust to different sound environments, so she could hear the person talking to her and not the background distraction.\u003c/p>\n\u003cp>\"Nothing like that exists today,\" Liu says. \"But I very much see something like that down the road.\"\u003c/p>\n\u003cp>Some audio specialists support rolling back regulations, while others are skeptical.\u003c/p>\n\u003cp>Hearing loss is complex, says Neil DiSarno, chief staff officer for audiology at the American Speech-Language-Hearing Association. This makes it difficult for consumers to \"self-evaluate, self-treat and self-monitor,\" he says. If people buy their hearing aids directly over the counter, they'll miss out on all the skills audiologists can teach them, like how to lip read and how to distinguish high frequency sounds, he says.\u003c/p>\n\u003cp>The market for over-the-counter hearing aids could be huge. More than 35 million Americans have some degree of hearing loss. And for older Americans, not dealing with the problem can have a big impact on age-related cognitive decline, says Dr. Frank Lin, associate professor of otolaryngology at Johns Hopkins University School of Medicine. Lin has done studies looking at the link between hearing loss and cognitive decline.\u003c/p>\n\u003cp>\"The greater the hearing loss, the greater the risk of loss of thinking and memory abilities over time,\" he says, which can lead to feelings of insecurity and social isolation – a known risk factor for dementia.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lin says his findings should serve as a \"wake-up call\" for policy makers. If people have easier access to more affordable hearing aids, he says, that could lead to benefits that go far beyond hearing.\u003c/p>\n\n\u003c/div>\u003c/p>",
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